Inspection on 19/12/05 for Silverways

This inspection was carried out on 19th December 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Silverways 20/09/07

Silverways 20/12/06

Silverways 03/06/05

Silverways 06/09/04

Silverways 26/04/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Silverways Silver Way Highcliffe Christchurch Dorset BH23 4LJ Lead Inspector Jo Palmer Unannounced Inspection 10:00 19 December 2005 th X10015.doc Version 1.40 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 DS0000020493.V250192.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 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. DS0000020493.V250192.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Silverways Address Silver Way Highcliffe Christchurch Dorset BH23 4LJ 01425 272919 01425 277981 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) Christchurch Housing Society Mrs Marie Madders Care Home 69 Category(ies) of Old age, not falling within any other category registration, with number (69) of places DS0000020493.V250192.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named person (as known by the CSCI) under the age of 65 may be accommodated to receive care. 3rd June 2005 Date of last inspection Brief Description of the Service: Silverways Nursing home was purpose built in 1985 and is situated in a quiet residential area of Highcliffe. It is set in one and half acres of gardens and provides facilities for 69 service users. The home is owned and managed by Christchurch Housing Society, a voluntary organisation registered with charitable status. The society was founded in 1946 to provide accommodation and care services for older people. Silverways has accommodation on the ground and first floors. The premises are divided into four wings which comprise of single and shared rooms, assisted bathrooms, showers and toilets and a hair dressing salon. Each wing has a communal lounge/dining area although dining space is limited. The use of two large, eight bedded bays is being reviewed, one is currently empty and occupancy of the second is currently low, the society plans to eventually house all residents in single or double rooms only. DS0000020493.V250192.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on two separate days, the first day being 19th December 2005 and lasting for four hours and thirty minutes, the second day on 4th January 2006 and lasting for two hours fifteen minutes. Marie Madders, registered manager, and the deputy manager were present and assisted with the inspection process. The purpose of this inspection visit was to monitor progress in addressing requirements and recommendations of the last inspection and to review practices in relation to some of the National Minimum Standards and outcomes for residents. Not all standards were assessed and the reader is referred to the previous inspection report which is available from the home or from www.csci.org.uk Over the two visits the inspector spoke with eleven residents, one relative, one care assistant, one trained nurse, the head of catering, the registered manager and deputy manager; took a tour of the home and examined relevant records. Registered to accommodate sixty-nine residents, sixty-two were accommodated at the time of the first inspection date. What the service does well: Resident’s needs are assessed before they move to the home to ensure they know, and the home knows that Silverways is suitable and able to meet those needs and provide an appropriate service. Following initial assessment, care plans are produced detailing the action staff need to take to meet resident’s individual health and welfare needs. Resident’s health and medical needs are well managed, visiting GP’s and other health and social care professionals are involved as required and residents and their relatives are consulted. Medication is managed in accordance with guidance from the Royal Pharmaceutical Society. Residents spoken with confirmed that they feel they are respected and treated well by a caring staff group. The provision of food is good with residents receiving three meals each day as well as regular supplies of drinks throughout the day. Menus demonstrated a variety of dishes and a visit to the kitchen identified that fresh produce is used. The homes complaints procedure is well managed and the home’s policies and procedures as implemented by staff aim to protect residents from any mistreatment. There are sufficient numbers of staff deployed throughout the home with a good ratio of trained nurses to care assistants. A significant number of agency DS0000020493.V250192.R01.S.doc Version 5.1 Page 6 staff are used to cover vacant shifts although Ms Madders confirmed that inconsistency is minimised by use of regular agency workers who know the home and residents. Recruitment is currently underway and two new staff have recently been appointed, it was evident that safe recruitment practices are used. Silverways is well managed by Christchurch Housing Society, which provides financial stability and sufficient insurance for the benefit of residents and the operation of the home. Residents personal finances are managed well where they or their relatives have requested assistance. What has improved since the last inspection? What they could do better: This inspection has identified three requirements to ensure resident’s health and welfare is protected by safe practice. • • • Care plans must identify the need for all treatments and care practices that are required in order to inform staff of the tasks necessary to meet resident’s needs including applications of prescribed creams. Staff fire training must be provided at regular specified intervals to ensure the safety of residents, staff and the premises. Fire fighting equipment must be checked to ensure it remains viable Recommendation has been made in line with good practice that records of balances of medication are carried forward to current records to enable more efficient audit. 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. DS0000020493.V250192.R01.S.doc Version 5.1 Page 7 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 Outcomes Statutory Requirements Identified During the Inspection DS0000020493.V250192.R01.S.doc Version 5.1 Page 8 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 the following standard(s): 3 & 4. Standard 6 is not applicable. The admission process allows for residents needs to be assessed prior to admission to the home and for assurances to be given to them that Silverways can provide the appropriate care and services. EVIDENCE: Resident care files examined detailed assessments of need identifying all a person’s health and welfare needs in order that the home can fully assess whether they are able to meet those needs in the right environment. Where residents have had an assessment undertaken by the local authority and primary care trust in relation to assisted funding, these assessments are available for staff reference and from which to formulate a plan of care. DS0000020493.V250192.R01.S.doc Version 5.1 Page 9 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 the following standard(s): 7, 8, 9 & 10 Care plans provide sufficient detail for staff to be aware of most of each resident’s health and welfare needs and how to meet them; care needs are reviewed appropriately. Systems are in place for resident consultation and participation in the assessment and care planning process and the deputy manager is working toward ensuring that all residents are consulted regarding their care needs. There are satisfactory arrangements for managing medication in the interests of residents. Resident’s rights are respected and their right to privacy is supported through care delivery, relationships with staff and confidential record keeping practices. EVIDENCE: Following assessment, resident’s care needs are detailed in a plan of care outlining for staff how needs are to be met. Care plans examined detailed most health and welfare needs of residents and a more detailed care plan is held in each resident’s room so care staff have information to hand. Examination of resident’s records demonstrate how care needs are met by staff on a daily basis, these records demonstrate the daily lives of residents at Silverways. One set of records however, and later apparent from a review of medication records, demonstrated that some residents are receiving treatment in the form DS0000020493.V250192.R01.S.doc Version 5.1 Page 10 of topical applications from care staff. There was no corresponding care plans identifying the need or frequency of this. Residents spoken with confirmed that staff in the home met their care needs appropriately although comment was made about the consistency of agency staff. A review of the home’s medication systems evidenced that correct procedures are adopted. Medicines are received from the dispensing pharmacist in 28-day blister packs following prescription from each resident’s GP and the amount of each medicine received is recorded. Medications administered for residents are accurately recorded and a disposal of medication record demonstrates that which is returned as no longer required. Where a supply of medication is held over for the next 28-day period where it is boxed in its original container, the amount carried forward is not recorded. Whilst this is not entirely necessary, it is recommended that a record of medicines carried forward is held in order that a clear audit trail of medicines held in the home can be made. Medication storage is secure and although no controlled drugs were held at the time of inspection, it was evident that appropriate separate storage was available and the controlled drugs register held previous entries demonstrating its proper use. Residents spoken with that were able to comment confirmed that a kind and caring staff group treat them respectfully; staff and residents were observed in their interactions to have mutually courteous relationships. DS0000020493.V250192.R01.S.doc Version 5.1 Page 11 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 the following standard(s): 15 The meals in this home are good offering both choice and variety and catering for special dietary needs. EVIDENCE: Residents spoken with confirmed that the provision of meals was good, that there was a plentiful supply and meals were well presented and appetising. One visitor spoken with confirmed this having been at the home with his relative during meal times. The Head of Catering was spoken with who confirmed the arrangements for provision of meals in the home. A four week rota is used from which to plan breakfasts, lunch and evening meal. The menu provides a set meal of the day and examination of this evidenced that a variety of meals are prepared. Separate menus are then prepared providing residents with a daily choice as an alternative from the set meal such as baked potato, salad, fish, omelette etc. There is also a choice of desserts; the dessert of the day as identified on the menu or a variety of ice creams, yoghurts, fruit, fruit salad etc. Care staff ask residents each afternoon what they would like the following day. Breakfasts consist of a choice of cereals, toast or cooked meal and the evening meal provides a variety of choices such as a light hot meal, soup, salad and sandwiches. A brief look at food supplies evidenced the use of fresh fruit and vegetables, a variety of meats, fish, dried, canned and packet goods. DS0000020493.V250192.R01.S.doc Version 5.1 Page 12 Silverways’ financial manager was spoken with briefly who confirmed that there was a generous budget for food supplies of £90000 per annum (for the registered number of 69 residents, this equates to £3.57 per resident per day which is above the industry average) DS0000020493.V250192.R01.S.doc Version 5.1 Page 13 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 the following standard(s): 16 & 18 Silverways adopts correct procedures to safeguard residents and ensure their concerns are listened to. EVIDENCE: The last inspection reported that correct procedures are in place regarding complaints and adult protection issues. It was evident that staff receive training in adult protection and Ms Madders confirmed that no complaints have been received. No complaints or incidents have been reported to the commission. In reviewing one resident’s care file, it was evident that a letter of complaint/concern had been sent to the home from a relative. The issues raised had been addressed sensitively and managed appropriately. The resident concerned was spoken with briefly and confirmed that the issue of concern was now resolved. DS0000020493.V250192.R01.S.doc Version 5.1 Page 14 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 the following standard(s): None of these standards were directly assessed during this visit although a tour of the premises to meet with residents evidenced that the home was clean, well lit and a comfortable temperature for the time of year. For more detail, the reader is referred to the inspection report dated 3rd June 2005. EVIDENCE: DS0000020493.V250192.R01.S.doc Version 5.1 Page 15 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 & 29 The deployment and number of available staff is sufficient to meet the current needs of the residents. residents are protected by safe recruitment practices. EVIDENCE: Three sets of staff rotas are used to ensure efficient deployment of staff around the home. The ground floor is staffed as one unit with two trained nurses on duty each shift and seven care assistants each morning, six each afternoon and three each night. Silverways is separated into two units on the first floor. Each of these units has one trained nurse on duty covering the three shifts and four care assistants each morning. One of the first floor units has three care assistants in the afternoon; the other unit has four care assistants in the afternoon. During the night shift there are four care assistants on duty over the two first floor units. During the week of the first date of this inspection, there were 74 shifts needing cover due to staff vacancies or absence; internal bank staff employed by Silverways to cover vacant shifts covered 41 of these. Agency staff covered the remaining 33 shifts. Ms Madders confirmed that there is some consistency among agency staff who know the home being deployed when needed. In addition to the above, the manager, deputy manager and administrative staff work varied times throughout the week. Two laundry assistants work from 8.00am to 4.00pm and the kitchen has a cook, assistant cook, general assistant and kitchen assistant on duty. DS0000020493.V250192.R01.S.doc Version 5.1 Page 16 There are current staff vacancies at Silverways; Ms Madders stated that recruitment had been poor although two new staff were in the process of being recruited during the week of inspection. Both these staffs files were examined and found to hold evidence that Ms Madders had started to make the appropriate recruitment checks including seeking two references for each staff member, checks against CRB and POVA* lists and other necessary documentation such as work permits. Ms Madders confirmed that these staff would not start employment until she was satisfied as to their suitability to work with the resident group. *CRB – Criminal Records Bureau POVA – Protection of Vulnerable Adults, a list of names of people held by the Secretary of State who have been considered unsuitable to work with vulnerable adults. DS0000020493.V250192.R01.S.doc Version 5.1 Page 17 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34, 35 & 38 Silverways remains financially viable with effective accounting and administrative procedures adopted by Christchurch Housing Society for the benefit of residents. Residents are assured of sound management of their personal financial interests. Inconsistent checking of fire equipment and infrequent staff fire training could compromise the otherwise good fire safety procedures that are in place to protect residents, staff and the premises. EVIDENCE: The home’s financial manager was spoken with briefly who confirmed the home’s continued viability through the Society. Appropriate levels of insurance are in place for the registered providers to meet their legal liabilities to residents, staff and third parties and for loss or damage to the assets of the business. DS0000020493.V250192.R01.S.doc Version 5.1 Page 18 Mr Joe Hickish, Responsible individual for Silverways stated that the Society holds a non-interest paying account, which is used for resident’s personal monies. The account operates by persons paying money in for their relative at the home, a cash amount is then provided to the manager, Ms Madders in order that residents can obtain money for their personal shopping needs and expenses. Records relating to these funds and transactions between the manager and the resident were seen and noted to be well maintained and accurate and with both parties signatures. Ms Madders confirmed that although only a small amount of cash is held, residents can have access to their total funds at any time should they so wish. Records seen relating to testing and maintenance of fire alarms, doors, emergency lighting and fire fighting equipment by contracted engineers were accurate; records relating to visual checking and testing of the alarms, doors, and emergency lighting by an appointed person employed by Silverways demonstrated these checks were carried out at the recommended intervals, the record of the internal check of the fire fighting equipment was not available, Ms Madders confirmed that this had not been recorded. Records relating to staff fire training evidenced that most staff have received fire safety and awareness training, including evacuation procedures at six monthly intervals, some staff had gaps in training in excess of six months. Guidance issued by the Commission currently states that night staff must receive training at three monthly intervals and that day staff must have this training at six monthly intervals. DS0000020493.V250192.R01.S.doc Version 5.1 Page 19 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X X X X X X X STAFFING Standard No Score 27 3 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X 3 3 X X 1 DS0000020493.V250192.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? no 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 Where service users are receiving treatment in the form of prescribed topical applications, there must be a care plan detailing the need for this and frequency of application in order to inform care staff of the care they are to deliver. Until further guidance is issued, all staff on day duty must receive fire safety training at six monthly intervals and night staff at three monthly intervals. The registered persons must ensure that a regular monthly check is carried out and records held relating to the visual checking of fire fighting equipment in the home to ensure extinguishers, fire blankets, hoses etc. remain viable and in their correct position. Timescale for action 1 OP7 15 30/04/06 2 OP38 23 30/04/06 3 OP38 23 30/04/06 DS0000020493.V250192.R01.S.doc Version 5.1 Page 21 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 Refer to Standard OP9 Good Practice Recommendations It is recommended that a record of the balance of medications held is carried forward to the current months administration record. DS0000020493.V250192.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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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