Inspection on 09/06/05 for Silverlea Residential Home

This inspection was carried out on 9th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Silverlea Residential Home 21/01/08

Silverlea Residential Home 18/07/07

Silverlea Residential Home 20/02/07

Silverlea Residential Home 15/06/06

Silverlea Residential Home 02/03/06

Silverlea Residential Home 09/11/04

Similar services:

Snydale Care Home

Abbey The

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Silverlea Residential Home 3 First Avenue Bradford Moor Bradford BD3 7JG Lead Inspector Steve Marsh Unannounced 9th June 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Silverlea Residential Home J52 J03 S61674 Silverlea V210093 090605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Silverlea Residential Home Address 3 First Avenue Bradford Moor Bradford BD3 7JG Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01274 661700 01274 660611 Mr Kevin Casey Miss Yvette S Barrow Care Home Only 35 Category(ies) of Dementia Over 65 (10) Old age (35) Physical registration, with number Disability Over 65 (3) of places Silverlea Residential Home J52 J03 S61674 Silverlea V210093 090605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 09/11/04 Brief Description of the Service: Silverlea Care Home is a large detached adapted property, located in the Bradford Moor area, overlooking the park and about one mile from the city centre. The home is registered to care for thirty five service users in a mixture of both single and double bedrooms, situated on all four floors of the building. The front door of the home is reached by a number of steps and therefore access is difficult for service users and/or visitors with mobility problems. There is however level access to the rear of the property, and a passenger lift available to all floors. Internally some areas of the home still require extensive refurbishment, although to meet present legislation the fire alarm systems has recently been replaced and the home has been completely rewired. Externally there is a patio area to the front of the property, which the service users are able to use during the summer months, and new outdoor furniture has recently been purchased. The home is on a main bus route from the city centre and there is street parking to the front of the property. Silverlea Residential Home J52 J03 S61674 Silverlea V210093 090605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first unannounced inspection for the year 2005/06, and was carried out by one Inspector over a period of approximately eight hours. The last inspection of this service was in November 2004 and the main purpose of this visit was to assess the homes progress in meeting the requirements and recommendations highlighted in the inspection report. The methodology used in this inspection included the examination of records, observation of work practices, discussion (group and individual) with service users, staff and management and a partial tour of the premises. Comment cards were provided for service users and/or relatives to enable them to share their views of the service with the Commission; comments received in this way will be fed back to the management of the home without revealing the identity of the respondents. Feedback relating to this inspection was given to Ms Yvette Barrow (registered manager) and Mr Kevin Casey (registered provider) at the end of the visit. The Inspector has visited Silverlea Care Home over a period of approximately four years and therefore drew on information already known about the home, when completing the report. Requirements and recommendations from this inspection are detailed at the end of the report. What the service does well: The home provides a safe and comfortable environment for the service users and all concerns/complaints received are taken seriously by the manager and acted upon. The manager and members of the staff team have a caring attitude, and the service users confirmed that staff are friendly, approachable and have a genuine understanding of their needs. The admission procedure for the home is thorough and the manager will not admit a service user unless she is sure that the staff team can provide the level of care/service they require. Silverlea Residential Home J52 J03 S61674 Silverlea V210093 090605 Stage 4.doc Version 1.30 Page 6 The service users health care needs are fully met and any problems are identified at an early stage and a referral made to the appropriate professional agency. What has improved since the last inspection? What they could do better: At the present time there appears to be a lack of teamwork at the home and while this is not affecting the standard of care/services received by the service users it is obviously having a detrimental affect on staff morale. The manager is however aware of the situation and is committed to resolving the matter as soon as possible. It is also apparent that the manager is completing the majority of care plans, etc in use at the home and there are concerns that in her absence the senior staff team would not be able to maintain the systems in place. The manager must therefore ensure that all members of the senior staff team become more involved in the care planning process. In addition, although the home has a robust staff recruitment and selection procedure, Criminal Record Bureau checks have still not been obtained for some long serving members of staff and therefore this matter must be addressed with some urgency. Please contact the provider for advice of actions taken in response to this Silverlea Residential Home J52 J03 S61674 Silverlea V210093 090605 Stage 4.doc Version 1.30 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Silverlea Residential Home J52 J03 S61674 Silverlea V210093 090605 Stage 4.doc Version 1.30 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Silverlea Residential Home J52 J03 S61674 Silverlea V210093 090605 Stage 4.doc Version 1.30 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3,4,5 Service users are provided with sufficient information to enable them to make an informed choice about the home. The admission process is good and includes introductory visits and trial periods if appropriate. EVIDENCE: The records examined provided evidence that pre-admission assessments are carried out, and the needs identified during this assessment are reflected in the individuals care plan. The majority of admissions are planned, although the home continues to respond to crisis situations and will take emergency admissions providing the staff team are able to meet their needs. In addition to the pre-admission assessment visit, service users and/or their relatives are also invited to visit the home prior to admission. This was confirmed by one relative, who had visited the home on behalf of her mother prior to her being admitted for a three-month trial period. The length of the trial periods are negotiable and take into account the individual’s personal circumstances and needs. Silverlea Residential Home J52 J03 S61674 Silverlea V210093 090605 Stage 4.doc Version 1.30 Page 10 As required in the last inspection report, the level of staff training has increased both to ensure that they are able to meet the needs of service users and for their own personal development. There does however appear to be reluctance by some members of staff to participate in the training programme, although the manager is dealing with this matter. Silverlea Residential Home J52 J03 S61674 Silverlea V210093 090605 Stage 4.doc Version 1.30 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 Records and report about the service users welfare are well documented and show that problems are identified early, and a referral made to the appropriate professional agency. The manager has established a good working relationship with other healthcare professionals and continues to build on this relationship for the benefit of both the service users and staff team. EVIDENCE: Care plans have been completed for all service users and cover all aspects of their welfare. Care plans are reviewed on a monthly basis or sooner if the needs of individual service users change significantly. Unfortunately only the manager and one other member of the senior staff team complete and review the care plans, however the manager is aware that it is important that other members of staff become more involved in the process. All the service users are registered with a general practitioner, and have access to the full range of NHS services. Silverlea Residential Home J52 J03 S61674 Silverlea V210093 090605 Stage 4.doc Version 1.30 Page 12 The manager has established good working relationships with other healthcare professionals and on the day of the visit the Inspector had the opportunity to have brief discussions with a district nurse, and a community psychiatric nurse who was holding a training session for members of the care staff team. Both professionals were happy with the standard of care provided at the home and the attitude of the staff team. In addition service users said that medical examinations were carried out in their own bedrooms, and assistance with personal care was always provided in a discreet and sensitive manner. The staff team also monitor the general health of service users taking longterm medication, and on reviewing the medication system in place no concerns were raised. Silverlea Residential Home J52 J03 S61674 Silverlea V210093 090605 Stage 4.doc Version 1.30 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,15 The level of organised activities and outings has increased since the last inspection visit and the home now attempting to provide a more stimulating environment for the service users. Service users are encouraged and supported to maintain contact with relatives and/or friends and visitors are welcome Meals appear nourishing, are well presented, and enjoyed by the service users. EVIDENCE: Activities/outings are arranged for the service users by a designated member of the care staff team either on an individual or group basis. Other members of the care staff team do however encourage the service users to participate in activities on a daily basis and the home has a selection of board games etc. Outings to places of interest are organised in line with the wishes of the services users, including trips to the garden centre, butterfly world, theatre etc. A number of service users said that the level of organised activities and/or trips had increased significantly in recent months, and they were looking forward to the warmer summer weather, so they could sit outside and watch the world go by. Silverlea Residential Home J52 J03 S61674 Silverlea V210093 090605 Stage 4.doc Version 1.30 Page 14 The service users confirmed that they can receive visitors in their own room if they wished to do so, and visitors/professional spoken to on the day said that they were always made to feel welcome and offered refreshment. The meals at the home where described by the service users as good both in quality and presentation, and they confirmed that an alternative was always provided if they did not like what was on the menu. The service users also said that hot and cold drinks are freely available to them both day and night. Staff/service users meeting are currently not held at the home, however it is the manager’s intention that they should started in the near future to enable them to participate more in the running of the home, organising social events and menu planning. Silverlea Residential Home J52 J03 S61674 Silverlea V210093 090605 Stage 4.doc Version 1.30 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 Service users and their relatives have their views listened to, complaints are taken seriously and prompt action is taken to resolve issues. The home has detailed complaint and adult protection procedures, and therefore service users can be sure that their rights are protected, and they are safe from any form of abuse. EVIDENCE: The home has a complaints procedure, and the service users confirmed that they felt able to approach the manager and/or other members of staff if they had any concerns. Three complaints have been received by the home since the last inspection visit and dealt with by the manager within the stated timescales. Policies and procedures are in place at the home in relation to adult protection and all members of staff have attended, or enrolled to attend an appropriate training course. Members of the staff team confirmed that they were aware of the homes policy on “whistle blowing” and a recent adult protection issue brought to the attention of the manager was dealt with promptly and in a professional manner. A policy document is also available in relation to handling the service users financial affairs, which precludes members of the staff team from involvement in the making of and/or benefiting from service users wills. Silverlea Residential Home J52 J03 S61674 Silverlea V210093 090605 Stage 4.doc Version 1.30 Page 16 Silverlea Residential Home J52 J03 S61674 Silverlea V210093 090605 Stage 4.doc Version 1.30 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,24,26 Although some areas of the building require refurbishment, the home still provides comfortable accommodation for the service users. However, the proprietor must continue with the refurbishment programme to improve the service users quality of life, and ensure that their health and safety is not compromised. EVIDENCE: The proprietor has recently had a new fire alarm installed at the home, the emergency lighting upgraded and all four floors of the property rewired. Internally some areas of the home including the bedrooms continues to require extensive refurbishment and a programme of work is planned to bring the accommodation up to the required standard. All the communal areas used by the service users are situated on the ground floor of the home and consist of four lounges, one of which is a designated smoking lounge and a dining room. The lounges and dining room and lounges were decorated and/or carpeted in 2003 and in general make pleasant areas for the service users to sit and relax. Silverlea Residential Home J52 J03 S61674 Silverlea V210093 090605 Stage 4.doc Version 1.30 Page 18 Attention is however required to the floor covering in the dining room, which is splitting at the seam and taped in places, and both the dining tables and the coffee tables in the lounge areas still require re-varnishing or replacing. The service users confirmed that they were able to personalise their bedrooms with their own possessions and were looking forward to the rooms being decorated. Appropriate locks still require fitting to some bedroom doors to ensure the service users right to privacy is not compromised, and this is presently being dealt with by the manager/proprietor. The laundry facilities are located on the lower ground floor of the home away from the areas occupied by the service users. The laundry room requires decorating and a new impermeable floor covering and this work is due to be completed as part of the planned programme of refurbishment. In addition the home still does not have a sluicing facility although the proprietor confirmed that as agreed either a sluice disinfector or a flushing sluice will be installed by the end of the year. On the day of the visit the standard of cleanliness throughout the home was good and no odour problems were noted. Externally there is a patio area to the front of the property and on the day of the visit a number of service users enjoyed sitting on the newly purchased garden furniture, enjoying the views over the park. Silverlea Residential Home J52 J03 S61674 Silverlea V210093 090605 Stage 4.doc Version 1.30 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29 Service users are supported and protected by robust recruitment and selection procedures, however the Criminal Record Bureau (CRB) checks must be carried out for all members of the staff team as a matter of priority. The manager is aware that teamwork is the key to providing quality care and while present problems within the staff team do not affect the care/services received by the service users, it is important that this matter is addressed and dealt with as soon as possible. EVIDENCE: Sufficient care and auxiliary staff are employed at the home both to meet the needs of the service users, and to ensure that the home is kept clean and their dietary needs met. A number of recent staff files were looked at and they contained all relevant information to ensure a safe recruitment procedure is in place However, a number of long serving members of staff still have not had a Criminal Record Bureau (CRB) check and therefore the manager must take steps to address this matter. Staff training continues to be actively encouraged at the home although as previously mentioned there appears to be some reluctance from one or two individual members of staff to take up training opportunities. In addition, members of staff spoken to on the day said that in their opinion some members of staff were not working as part of a team and while this is Silverlea Residential Home J52 J03 S61674 Silverlea V210093 090605 Stage 4.doc Version 1.30 Page 20 not affecting the standard of care/service provided to the service users it was affecting staff morale. On discussing the matter with the manager it was obvious that she was aware of the situation, and is to address the matter with the staff concerned and look at ways of team building. All members of staff providing personal care are over eighteen years of age and all senior members of staff are over twenty-one years of age as required to meet the National Minimum Standards. Silverlea Residential Home J52 J03 S61674 Silverlea V210093 090605 Stage 4.doc Version 1.30 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,35,38 The manager is competent, provides good leadership to the staff and ensures that the service users are protected and cared for correctly. Policies and procedures are in place to ensure the health and safety of the service users, visitors and members of the staff team. EVIDENCE: Ms Yvette Barrow is now the registered manager of Silverlea Care Home and she communicates a clear sense of direction and leadership to the staff team. Members of staff confirmed that she has an open and approachable style of management and since her appointment had provided more training opportunities. All members of the staff have annual appraisals and one-to-one formal supervision is usually carried with members of the care staff team on a two monthly basis. Silverlea Residential Home J52 J03 S61674 Silverlea V210093 090605 Stage 4.doc Version 1.30 Page 22 However, the manager confirmed that due to pressure of work, supervision is not at the present time being carried out in line with the National Minimum Standards, although regular meetings are held with groups of staff. All records required to be kept at the home including financial transaction sheets for the service users are well maintained, however the proprietor was again reminded that pocket money must be made available to them on a weekly basis, and not paid to them in arrears as shown on the transaction sheets. Health and Safety policies and procedures are available, and they are reviewed on a regular basis in line with changes in legislation and good practice guidelines. Some maintenance work still however requires completing at the home to ensure the health and safety of the service users and this work is highlighted in the statutory requirement section of this report. Silverlea Residential Home J52 J03 S61674 Silverlea V210093 090605 Stage 4.doc Version 1.30 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 4 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 2 x x x 2 x 2 STAFFING Standard No Score 27 3 28 2 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 x x 2 2 x 2 Silverlea Residential Home J52 J03 S61674 Silverlea V210093 090605 Stage 4.doc Version 1.30 Page 24 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP19 Regulation 23 Requirement The registered provider must continue the refurbishment programme in line with the agreed timesacles. The dining tables and coffee tables must be re-varnished or replaced as required. (outstanding from last inspection report -- timescale 31/03/05 not met). Attention is required to the floor covering in the dining room Appropriate locks require fitting to all bedroom doors. Double glazed window units must be replaced as required. (outstanding from last inspection report -- timescale 31/03/05 not met) . The laundry are requires refurbishing and a new impermeable floor covering. A sluicing facility must be provided at the home. At least 50 of the care staff team must have a NVQ at level two by the end of 2005. The registered manager must ensure that Criminal Record Bureau checks are obtained for all members of the staff team. J52 J03 S61674 Silverlea V210093 090605 Stage 4.doc Timescale for action 31/12/05 2. OP20 16 31/07/05 3. OP24 23 31/12/05 4. OP26 23 31/12/05 5. 6. OP28 OP29 18 19 31/12/05 31/07/05 Silverlea Residential Home Version 1.30 Page 25 7. OP35 16 8. OP36 18(2) 9. OP38 13 The registered provider must 31/07/05 ensure that pocket money is paid to the service users on a weekly basis. The registered manager must 31/07/05 ensure that formal care staff supervision is undertaken at least six times a year. All portable electrical appliances 31/08/05 must be tested annually. The registered provider must seek advice from the fire safety officer regarding the security of the main door of the property. The emergency call system requires servicing and a copy of the test certificate forwarded to the CSCI. (outstanding from the last inspection report -timescale 28/02/05 not met). RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP7 OP27 Good Practice Recommendations It is recommended that additional members of the staff team become involved in the care planning process. It is recommended that team building exercises are introduced at the home as a matter of priority. Silverlea Residential Home J52 J03 S61674 Silverlea V210093 090605 Stage 4.doc Version 1.30 Page 26 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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