Inspection on 01/11/05 for Silvermead

This inspection was carried out on 1st November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Silvermead 18/10/06

Silvermead 22/02/06

Silvermead 18/01/05

Silvermead 28/10/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Silvermead 262 Fort Austin Avenue Crownhill Plymouth Devon PL6 5SS Lead Inspector Tina Maddison Announced Inspection 1st November 2005 09:30 Silvermead DS0000003518.V263578.R01.S.doc Version 5.0 Page 1 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 Silvermead DS0000003518.V263578.R01.S.doc Version 5.0 Page 2 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 Adults 18-65. 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. Silvermead DS0000003518.V263578.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Silvermead Address 262 Fort Austin Avenue Crownhill Plymouth Devon PL6 5SS 01752 709757 01752 700830 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Eileen Isobel Barker Care Home 13 Category(ies) of Learning disability (13) registration, with number of places Silvermead DS0000003518.V263578.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Service Users with a Learning Disability who may also have a Physical Disability Age 18-65yrs One Named Service User over the age of 65 Date of last inspection Brief Description of the Service: Silvermead is a care home providing personal care and accommodation for thirteen adults aged 18-65, with learning disabilities, who may also have a physical disability, although the home is not adapted for anyone with a mobility difficulty. The home is privately owned by Mrs Barker. Silvermead is located in the residential area of Crownhill, Plymouth and is close to local shops, facilities and amenities. The home was opened in 1986 and consists of a detached two storey house and a single storey annexe which is not attached to the house. There are nine single bedrooms, three of which have en suite facilities and two of these have en suite baths. In addition to the en suite facilities there are three bathrooms and four toilets. On the ground floor there are separate lounge and dining rooms. The home has a large attractive garden that is well maintained and easily accessible. Silvermead DS0000003518.V263578.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection commenced at 0930 and finished at 1430. A pre inspection questionnaire was received prior to the inspection, and two feedback cards from families of service users were received and positive feedback was received. Discussions were held during the inspection with two service users and two members of staff, as well as the Registered Provider and Manager. A tour of the building was undertaken, and documents and records for a variety of topics were inspected. What the service does well: What has improved since the last inspection? A door to an en suite facility has been altered and now shuts properly. An electrical wiring certificate has been obtained, and the fire alarm system is now tested on a weekly basis. Fire safety training for staff has been implemented every six months for day staff and every three months for night staff. ‘Hold open’ devices have been fitted to doors in the home to ensure that door wedges are not now used. Silvermead DS0000003518.V263578.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Silvermead DS0000003518.V263578.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Silvermead DS0000003518.V263578.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,5. Prospective service users are able to use an appropriate and comprehensive service users guide and statement of purpose to help to enable them to be sure that Silvermead will be able to meet their care needs. EVIDENCE: The home has a statement of purpose and service users guide. The home has produced the service users guide in large print and has contacted speech and language therapists to discuss other appropriate formats. No new service users have been admitted since the last inspection. The home could evidence that service users needs are met by documenting individual care needs and how these will be met at the home. It was also evident from discussion and observation that the staff team were aware of how to communicate and interact with service users. All service users had a contract from the Local authority on file. Silvermead DS0000003518.V263578.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9. Service users can be assured that staff will enable them to be as independent as possible, and they will be encouraged to safely participate in all aspects of life in the home. EVIDENCE: Service users plans were comprehensive and detailed, covering all areas of health and welfare. However, not all care plans were documented as being regularly reviewed. Files contained risk assessments as well as guidelines for managing individual needs. Service users files evidenced that service users are enabled to take responsible risks, and these had been assessed and risk management strategies were in place. Each service user has a nominated key worker and their roles and responsibilities were documented. Although some service users have limited communication, the Manager confirmed that every effort is made by staff to enable the service users to make decisions about their lives. The Registered Provider stated that Service users personal money is now kept in an individual account, not in the homes business account. However documents were not available at the time of the inspection to evidence this, and Mrs Barker has agreed to forward these to The Commission for Social Care Inspection. The Provider retains the mobility element of DLA as a contribution towards the cost of transport and taxis. This is agreed with the Silvermead DS0000003518.V263578.R01.S.doc Version 5.0 Page 10 service users and their families. Service users personal allowances must be administered in a system that has a clear audit trail, as this is not happening at present. Discussions with service users and staff, as well as observation indicated that service users were consulted and did participate in the day to day running of the home, but the level of involvement depended on individual abilities. Silvermead DS0000003518.V263578.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,16,17 Service users can enjoy a range of social activities that are available for all. Personal development is encouraged, enabling service users to maintain their independent living skills. Meals provided at Silvermead are nutritious and varied. EVIDENCE: Discussions with service users and the staff and Manager indicated that personal development opportunities are encouraged. Service users were enabled to participate in personal shopping, cooking and domestic tasks if they wanted to. Activities outside of the home are also facilitated, including enabling services, attendance at day centres and music therapy sessions. Service users are also enabled to find appropriate jobs or continue their education, depending on individual wishes and skill levels. Leisure activities available include bowling, swimming, cinema trips and trips to the local pub. Evidence of individual hobbies was apparent in service users bedrooms, and one service user enjoys making model cars, and has the use of a shed in the grounds to pursue this hobby. Service users confirmed that they enjoyed the meals provided, and menus evidenced that a choice is offered. Snacks and fruit are available throughout the day and evening. Records are kept of meals taken. Silvermead DS0000003518.V263578.R01.S.doc Version 5.0 Page 12 The Provider emphasised that the home has a policy of healthy eating to help to maintain the health of the service users. Silvermead DS0000003518.V263578.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20. Service users can be assured that staff will treat them with respect and their personal care needs will be given in the way that they prefer, and that individual health care needs will be met. EVIDENCE: Service users files contained details of moving and handling preferences. Visits from health professionals are documented and are made in private, although staff are always on hand to facilitate communication. The home regularly liaises with the challenging behaviour services and the speech and language specialists. Service users are mostly registered with the local GP surgery, although they can register with a GP of their choice. Evidence was seen of visits to the dentist and optician. Healthy eating is encouraged. None of the service users are self medicating at present. The home has a medication policy and procedure and staff have received appropriate training. Medication records were accurate and well kept. Silvermead DS0000003518.V263578.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23. Service users can be confident that their concerns will be listened to, taken seriously and acted upon. The homes vulnerable adult procedure is robust which will ensure the protection of service users at the home. EVIDENCE: The Manager confirmed that the home has not received any complaints this year. The home has a comprehensive complaints procedure, and service users spoken to were aware of how to complain and to whom. The home also has comprehensive policies regarding the protection of vulnerable adults. The home has a missing persons procedure. Silvermead DS0000003518.V263578.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29,30. Silvermead is generally decorated and furnished to a good standard. It is very clean and warm, and the grounds are accessible and very pleasant. Overall this creates a comfortable environment for service users. Window opening restrictors must be fitted to upstairs windows. EVIDENCE: The premises and grounds are accessible to service users, and on the day of the inspection the home was found to be comfortable, warm, generally well decorated and clean and light. There were no offensive odours. The dining room has wooden stools to sit on at the dining table, although service users can have chairs if requested. Service users spoken to stated that they were happy to use the stools and did not think that they were uncomfortable. The walkway between the annexe and the main house has not yet been covered to provide shelter in inclement weather. All service users bedrooms are individually decorated and service users confirmed that they had been included in choosing colours and redecorating their bedrooms. One bedroom had some small areas of damp on the outside wall. All bedrooms have hand wash basins. Bathrooms and toilets were lockable and could be opened from the outside in an emergency. One bathroom had a tile adjacent to the bath missing and this should be replaced. Kitchen and laundry facilities are satisfactory. Two Silvermead DS0000003518.V263578.R01.S.doc Version 5.0 Page 16 bedrooms on the first floor did not have window restrictors fitted to the windows. Silvermead DS0000003518.V263578.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36. Care staff numbers are adequate to meet the care needs of the service users. The home has a robust recruitment procedure, and this offers protection to service users. There is a consistent staff team who are committed, caring and appropriately skilled to provide care to service users. EVIDENCE: The Manager confirmed that there was always two staff members on duty from 0700 – 1100, three from 0900-1600 on weekdays only, two from 1600-2300 and at night there is one waking and one sleeping staff member. At weekends there are two staff members on duty from 0700-2300 unless activities are planned. Care staff carry out all domestic tasks in the home. The staff and manager confirmed that two staff at weekends is adequate for the needs of the present service users because if additional activities are planned, then additional staff would be available. These staffing levels must be kept under review and increased in accordance with the needs of the service users if necessary. All staff receive job descriptions that define their roles and responsibilities. An induction period is offered to new care staff. The homes recruitment procedure is robust, and staff files evidenced that two references are always obtained prior to employment, and all staff have current CRB checks on file. Training opportunities are offered to staff, and these include NVQ training, health and safety, first aid and infection control training. Silvermead DS0000003518.V263578.R01.S.doc Version 5.0 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The home is competently managed. Health and safety topics are a priority in the home that will ensure the safety of service users. EVIDENCE: The Manager of Silvermead has many years of working with people that have a learning disability, and from discussion with staff and service users, is clearly highly thought of at the home. A quality assurance system is still being developed, and it is hoped that this will be implemented in the near future. Questionnaires seeking the views of the service users and their families have been produced. The fire log book showed that overall checks and tests of fire equipment have been carried out. Temperatures of fridges, freezers and hot food are documented. An electrical wiring certificate has been obtained. Hot water outlets have been risk assessed. Most of the radiators have been guarded, and risk assessments have been carried out. Risk assessments have also been carried out for all safe working topics. Not all windows have window restrictors fitted. All accidents and incidents have been recorded, and reported to the Commission for Social Care Inspection. The gas boiler was inspected by an engineer in October 2005, and Portable electrical testing has taken place. Silvermead DS0000003518.V263578.R01.S.doc Version 5.0 Page 19 Lines of accountability in the management structure are clearly understood by service users and staff. Silvermead DS0000003518.V263578.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 x 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 2 3 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 2 2 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 x 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Silvermead Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 2 3 3 3 x DS0000003518.V263578.R01.S.doc Version 5.0 Page 21 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. Standard Regulation Requirement Timescale for action 1 2 YA26 YA16 13 20 3 YA7 12,17,20 Window restrictors must be fitted 30/12/05 to the first floor windows. Documents evidencing that the 30/12/05 service users money is no longer paid into the homes business account and is now paid into the service users individual bank accounts must be forwarded to The Commission of Social Care Inspection. A system to evidence a clear 30/01/06 audit trail for service users money must be implemented. 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 3 4 Refer to Standard YA3 YA26 YA27 YA39 Good Practice Recommendations Care plans should be regularly reviewed and these reviews documented. The damp areas in one bedroom should be repaired. The missing tile adjacent to the bath should be replaced. The homes quality assurance system should be further DS0000003518.V263578.R01.S.doc Version 5.0 Page 22 Silvermead developed to ensure a system of monitoring, action and review of the quality of care provided at the home. Silvermead DS0000003518.V263578.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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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