Inspection on 22/02/06 for Silvermead

This inspection was carried out on 22nd February 2006.

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. 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 01/11/05

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 Unannounced Inspection 22 February 2006 09:30 nd Silvermead DS0000003518.V264945.R01.S.doc Version 5.1 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.V264945.R01.S.doc Version 5.1 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.V264945.R01.S.doc Version 5.1 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.V264945.R01.S.doc Version 5.1 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 1st November 2005 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.V264945.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection commenced at 0930. A variety of records and documents were examined, and a tour of the building was undertaken, and all bedrooms were seen. Discussions were held during the inspection with two members of staff and two service users, the Manager and the Provider. What the service does well: What has improved since the last inspection? What they could do better: Large amounts of cash must be kept in individual interest bearing savings accounts and not in the home. Risk assessments must be completed for all Silvermead DS0000003518.V264945.R01.S.doc Version 5.1 Page 6 individual radiators or hot surfaces and covers fitted if necessary. Window restrictors must be fitted to upstairs windows. Individual Contracts/statements of terms and conditions should be signed by the service users or their representatives. The damp area in one of the bedrooms should be repaired, as should the missing tile in one bathroom because of the sharp corners that are exposed. Care staff numbers should be reviewed with regard to the needs of the current service users to ensure that individual identified care needs are met at all times. The quality assurance system needs to be further developed. 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.V264945.R01.S.doc Version 5.1 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.V264945.R01.S.doc Version 5.1 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): 1,5 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 needs. EVIDENCE: There have been no new admissions since the last inspection in November 2005. Each service user had a written contract or statement of terms and conditions with the home on file. However, not all of these had been signed and agreed with the service user or their representative. The home has a statement of purpose and a service users guide. Silvermead DS0000003518.V264945.R01.S.doc Version 5.1 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): 6,7,8,9,10 Staff at Silvermead will assist service users to be as independent as possible with daily living tasks. Service users will be encouraged to safely participate in all aspects of life in the home. EVIDENCE: All care plans have been recently reviewed by the Manager and now contain detailed information regarding each of the service users care needs and how the home will meet these. It was clear that the home had liaised with health and social care professionals, and families to obtain information. Risk assessments were contained on files for individual service users, as were guidelines for managing individual needs and behaviour management. Each service user had a nominated key worker and their roles and responsibilities were documented. Although many service users have limited verbal communication the manager confirmed that every effort is made by staff to establish individual wishes and preferences. Records are kept securely in a locked cabinet. Staff are made aware of confidentiality issues in their induction period. Silvermead DS0000003518.V264945.R01.S.doc Version 5.1 Page 10 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): 12,15. Service users can enjoy a range of activities that are available at the home. Family involvement at Silvermead is encouraged and welcomed. EVIDENCE: Service users take part in a range of different activities in and out of the home. Some of the service users attend local authority day centres, although from 2007 these services will no longer be available, and this will have staffing implications for Silvermead. Currently the service users are encouraged to have hobbies, and evidence of one service users interest in making model cars was seen, and they have the use of a shed in the grounds to pursue this hobby. Leisure activities include bowling, cinema and one service user is attending a computer course. There is not a formal activity programme in the home as the Manager believes that the service users undertake the activities offered when it is their choice to do so. Service users are encouraged to maintain contact with their families, and staff assist service users to send greetings cards, letters and visits from families and friends are welcomed. Silvermead DS0000003518.V264945.R01.S.doc Version 5.1 Page 11 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 Personal care at Silvermead is given to service users in the manner they prefer. Medication is safely managed and administered at Silvermead. EVIDENCE: Care plans documented individual preferences regarding personal care, and any moving and handling preferences. One service users personal file was examined and evidenced that the home is meeting their health needs regarding the management of epilepsy. Liaison had been made with appropriate health professionals, and a seizure chart had been kept. It was documented that due to weight loss, food intake was being monitored. The home has recently had input from the challenging behaviour service regarding the management of a service users behaviour that challenges the service. This has resulted in a plan for the staff about how to manage the behaviours. Staff have received training regarding epilepsy and autism. Documented evidence was seen of service users visiting the General Practioners and dentist. None of the current service users are able to self medicate. Medication is safely stored in the home and there is a policy and procedure for the administration of medicines. Records on the day of the inspection were accurate. Silvermead DS0000003518.V264945.R01.S.doc Version 5.1 Page 12 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 Silvemead has a robust complaints policy and procedure that service users felt able to use. For service users financial protection individual interest bearing savings accounts should be opened. EVIDENCE: The Manager confirmed that no complaints have been received at the home since the last inspection. No complaints have been received by the Commision for Social Care Inspection in the last six months. The home has a comprehensive complaints procedure, and service users spoken to were aware of how to complain, and to whom. The home has policies and procedures regarding the protection of vulnerable adults. The home has a missing persons procedure that staff spoken to were aware of. The Provider at Silvermead manages the finances of ten of the service users. A clients account has been set up at the bank, that individually details service users finances. The manager now retains receipts for individual purchases there is records regarding details of a service users spending, that has an audit trail. The Provider is responsible for paying the charge on the clients account. It is not an interest bearing account. The service users disability living allowance is retained by the Provider, and used to finance the minibus and the use of taxis. Families have agreed to this. There are no savings accounts available to service users and the home retains monies and then informs families if the amount is excessive. It is a requirement that individual interest bearing savings accounts are opened for service users, and that large amounts of cash are not stored in the home. Silvermead DS0000003518.V264945.R01.S.doc Version 5.1 Page 13 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): 24,25,27,30 Silvermead is generally decorated and furnished to a good standard. It was clean and warm on the day of the inspection and the grounds are accessible and pleasant. Generally Silvermead provides a safe environment for service users, with the exception that one bedroom window is not fitted with a window restrictor. EVIDENCE: Since the last inspection a new boiler has been fitted in the home. On the day of the inspection the home was found to be clean, warm and generally well decorated. Service users said that they liked their bedrooms. The dining room has wooden stools to sit on at the dining table, although the Manager stated that service users can have chairs if they requested them. Service users spoken to said that they were happy to use the stools, and did not think that they were uncomfortable. The walkway between the main house and the annexe has not yet been covered to provide shelter in inclement weather. Bedrooms are individually decorated and service users confirmed that they had been consulted in choosing colours and redecorating their bedrooms. One bedroom has some small areas of damp on the outside wall. All bedrooms have hand wash basins. Bathrooms were found to be clean and contain soap and hand towels. One bathroom had a tile adjacent to the bath missing. The top Silvermead DS0000003518.V264945.R01.S.doc Version 5.1 Page 14 bathroom does not have a lock. The gardens are pleasant and fully accessible to service users. Silvermead DS0000003518.V264945.R01.S.doc Version 5.1 Page 15 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): 32,34. Care staff numbers should be reviewed in view of the identified care needs of service users. The home has a robust recruitment procedure and this offers protection to service users. The staff team are committed and caring and appropriately skilled to provide care to service users. EVIDENCE: Staff rotas evidenced that there is always two staff members on duty from 0700-1100, three from 0900-1600 on weekdays only and two from 1600-2300 and at night there is one waking staff member and one sleeping. At weekends there are two staff members on duty from 0700-2300 unless activities are planned, and the manager stated that additional staff could be brought in. Due to the increasing needs of one service user, their challenging behaviour and need for regular 1:1 staffing input inside and outside of the home, it is recommended that this level of staffing in the home be reviewed. Staff undertake the cooking and the cleaning in the home. Staff have received appropriate training and confirmed when spoken with that they felt that they had received adequate training and skills in order to competently work with the service users. The home has a robust recruitment procedure, and the three staff files that were examined evidenced two references, CRB checks and proof of identity had been obtained. Service users spoken with stated that they thought the staff were kind and always helped them. Silvermead DS0000003518.V264945.R01.S.doc Version 5.1 Page 16 Silvermead DS0000003518.V264945.R01.S.doc Version 5.1 Page 17 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): 37,39,42 The home is competently managed. In order to ensure the safety of service users, window restrictors must be fitted to windows above ground level. Most health and safety topics are well managed. EVIDENCE: The Manager and Provider at Silvermead have many years experience of working with people who have a learning disability. A quality assurance system is still being developed, and questionnaires have just been sent out to seek the views of service users and their families. Fire prevention logs evidenced that checks of fire prevention equipment have been carried out. Staff received fire prevention training in December 2005. An accident book is kept and was found to be accurate and well recorded. Not all radiators are covered. Risk assessments must be updated. Not all windows have window restrictors fitted. Silvermead DS0000003518.V264945.R01.S.doc Version 5.1 Page 18 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 Standard No Score 1 3 2 x 3 x 4 x 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 x 23 2 ENVIRONMENT Standard No Score 24 2 25 3 26 x 27 2 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 2 33 x 34 3 35 x 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 x LIFESTYLES Standard No Score 11 x 12 3 13 x 14 x 15 3 16 x 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 2 x X 2 x Silvermead DS0000003518.V264945.R01.S.doc Version 5.1 Page 19 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. 2. Standard YA26 YA23 Regulation 13 12,17,20 Timescale for action Window restrictors must be fitted 22/02/06 to the first floor windows. Large amounts of cash belonging to service users must not be kept on the premises, individual interest bearing savings accounts must be opened. The Provider must update risk assessments for individual radiators and fit covers if necessary. 30/04/06 Requirement 3. YA42 13 30/04/06 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 YA5 YA26 Good Practice Recommendations Service users or their representatives should sign the contracts/statement of terms and conditions between themselves and the home. The damp areas in one bedroom should be repaired. DS0000003518.V264945.R01.S.doc Version 5.1 Page 20 Silvermead 3. 4. YA27 YA39 The missing tile adjacent to the bath should be replaced. The homes quality assurance system should be further developed to ensure a system of monitoring, action and review of the quality of care provided at the home. Staffing numbers should be reviewed and this should be documented to evidence that current care staff numbers on duty are able to meet the current service users care needs. 5. YA32 Silvermead DS0000003518.V264945.R01.S.doc Version 5.1 Page 21 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. Extracts may not be used or reproduced without the express permission of CSCI Silvermead DS0000003518.V264945.R01.S.doc Version 5.1 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!