Inspection on 21/10/05 for Simonsfield

This inspection was carried out on 21st October 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 but made no statutory requirements on the home.

Other inspections for this house

Simonsfield 08/07/08

Simonsfield 14/02/08

Simonsfield 29/10/07

Simonsfield 22/01/07

Simonsfield 21/10/04

Simonsfield 26/04/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Simonsfield 1a Sunbury Road Liverpool Merseyside L4 2TS Lead Inspector Les Hill Announced Inspection 21st October 2005 09:30 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 Simonsfield DS0000059308.V251353.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 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. Simonsfield DS0000059308.V251353.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Simonsfield Address 1a Sunbury Road Liverpool Merseyside L4 2TS 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) 0151 260 7918 0151 260 0319 European Wellcare Homes Ltd Diane Moon Care Home 36 Category(ies) of Old age, not falling within any other category registration, with number (36) of places Simonsfield DS0000059308.V251353.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 36 nursing beds and 36 personal care in the overall number of 36 One named adult (18-64 years) may be accommodated This service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 23rd June 2005 Date of last inspection Brief Description of the Service: Simonsfield is registered with CSCI to provide care and support for 36 residents under the category of old age, not falling within any other category (36). Some additional conditions of registration are in place. The home is located in a residential area near to Stanley Park and is close to local amenities and bus routes. The home is centrally heated, spacious and generally well maintained. There are several sitting areas for residents to socialise, sit quietly or entertain visitors and friends. A separate smoking lounge is provided. A hairdresser visits the home on a weekly basis and a visiting chiropody service is available. Community based health services are accessed according to need. The home employs an activities organiser on two afternoons each week. Simonsfield DS0000059308.V251353.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection of Simonsfield was undertaken on Friday 21st October 2005 over a period of 4 hours. It involved the examination of some records, a tour of the building and meeting with 4 residents. The manager had completed a pre-inspection questionnaire to provide essential information about the current situation in the home. This inspection was undertaken as part of the Commission’s responsibility to visit and report on each registered care home on two occasions each year. What the service does well: What has improved since the last inspection? 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. Simonsfield DS0000059308.V251353.R01.S.doc Version 5.0 Page 6 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 Simonsfield DS0000059308.V251353.R01.S.doc Version 5.0 Page 7 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): 1, 2, 3, 4, 5 and 6. Potential residents have the information they need to make an informed choice about the home. Comprehensive assessments were being undertaken as a basis for care practices in the home. EVIDENCE: The home’s statement of purpose was examined at the CSCI inspection in June 2005. Since that time there have been no major changes in the home and no changes to the document. The document gave full information about the services provided at Simonsfield and the arrangements for care. The inspector examined the care files for three residents in the home. Two were recent admissions and one had been in the home for some time. The assessments contained useful information about the resident’s needs and the levels of assistance they required. The inspection report prepared in June 2005 recommended that the registered person should consider the appropriateness of maintaining the dual registered status of the home as no trained nurses (except for the registered manager) Simonsfield DS0000059308.V251353.R01.S.doc Version 5.0 Page 8 were employed. Wellcare has responded to confirm that they wish to retain the dual registration so that they have the option of returning to provide nursing care at some time in the future. The Commission has accepted that position on the basis that no resident identified with a nursing care need is admitted to, or maintained in the home, until a full compliment of trained nurses at a level approved by the Commission is in place to provide the medical care and support necessary. Potential residents and their families are invited to visit the home and to spend some time there before making a decision to move in. They are also able to spend some time living in the home before making a decision to stay. The home is not contracted to provide intermediate care. Simonsfield DS0000059308.V251353.R01.S.doc Version 5.0 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 and 11. Care plans seen were not presented in sufficient detail for staff to follow. Medicines in the home were being managed safely. Residents were being supported with dignity. EVIDENCE: Individual plans of care evidenced on the files examined during the inspection were not presented in sufficient detail for staff to follow. Some continued the process of assessment with further information about need rather than the actions required from staff to provide appropriate levels of support. The care plans should also record that they have been reviewed monthly and any changes required should be clearly presented. The home has good links with local GP’s, district nurses, the continence adviser and tissue viability nurse. A chiropodist visits every six weeks and the home has access to a dietician when required. Links have been made with an optician but there have been some difficulties experienced in accessing an NHS dentist. Examination of the medicines in the home confirmed that they were being managed appropriately. None of the current residents has responsibility for Simonsfield DS0000059308.V251353.R01.S.doc Version 5.0 Page 10 managing their own medication. Staff who administer medicines have been provided with training. Staff were observed to knock on residents bedroom doors before entering. Residents were dressed appropriately and were complimentary about the support provided by staff. A pleasing feature of Simonsfield is that staff spend time sitting with groups of residents. Information is maintained for some residents about what they wish to happen at the time of their death. It is recommended that the manager should maintain this information for all residents in the home. Simonsfield DS0000059308.V251353.R01.S.doc Version 5.0 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): 12, 13, 14 and 15 Residents are encouraged to exercise choice and control over their lives. EVIDENCE: Routines of daily living are flexible and residents can choose where and how they spend their time in the home. A number of small sitting areas are provided, one of which is designated as the smoking room. An activities organiser is employed to work in the home on two afternoons each week. She arranges activities in the home and trips out to local pubs and other places of interest. Some of the residents had been on a narrow boat and this trip is always well supported. Care staff accompany residents on outings and will also arrange activities when the activities organiser it not in the home. Arrangements for the Christmas celebrations are well under way. It is planned that residents will go out to the local cricket club for a meal and a date has been set for the Christmas party. Visitors to the home are welcomed at any time. Residents can meet with their visitors in their own rooms or in one of the communal lounges. Simonsfield DS0000059308.V251353.R01.S.doc Version 5.0 Page 12 The home’s menus were provided prior to the inspection. They identified that a range of foods were being provided and that a balanced diet, with foods that appealed to the current resident group, was being prepared. Residents who do not like the main meal are offered an alternative and special diets are provided as necessary. Two residents who spoke with the inspector were very complimentary about the variety and the quality of food served in the home. Simonsfield DS0000059308.V251353.R01.S.doc Version 5.0 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, 17 and 18. Residents are protected from harm. EVIDENCE: The home’s complaints procedures are evidenced in the statement of purpose that is kept in the entrance to the home. The procedures encourage residents or their relatives to complain if they feel the need to do so. Information about the role of CSCI in complaints is provided. One complaint had been received since the inspection in June 2005. The matter had been dealt with appropriately and within the homes 28day time scale. The home has contact numbers for advocacy services that are available to residents. All residents are listed on the Electoral Register and are supported to vote in local and national elections if they choose to do so. The manager told the inspector that resident’s meetings are held from time to time, although minutes from the last meeting could not be located. Matters discussed are usually around the home’s menus, activities on offer and entertainment/parties although residents can raise any other matters concerning the day-to-day running of the home. The home has policies and procedures in place in relation to adult protection. “Whistle Blowing” and dealing with aggression. The home is anxious to ensure Simonsfield DS0000059308.V251353.R01.S.doc Version 5.0 Page 14 that all residents are supported safely and encourages the raising of concerns by residents, staff or visitors. Simonsfield DS0000059308.V251353.R01.S.doc Version 5.0 Page 15 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): 19, 20, 21, 22, 23, 24, 25 and 26. Residents live in a safe and well-maintained environment. EVIDENCE: Simonsfield is a purpose built care home that is appropriately fitted out to meet the needs of older people. Accommodation is provided on three floors with lift and stair access. Outside space is limited. The front car park is used in the summer months for parties and for residents who wish to sit outside. An ongoing programme of maintenance is in place and the home shares a handyperson with other homes in the European Wellcare Group. New carpeting has been fitted to the first floor corridors. Some large cracks in the wall of one stairwell were noted and the problem was already being addressed. There were no other outstanding repairs or matters of particular concern. The handyperson was on site during the inspection and the manager agreed to raise one or two minor matters directly with him. Simonsfield DS0000059308.V251353.R01.S.doc Version 5.0 Page 16 All communal areas of the home were clean and well kept though some redecoration will be required in the near future. One of the dining room chairs was broken and the manager put it to one side with the intention of having it removed. Bathrooms and WC’s in the home were clean and there were no offensive odours present. Resident’s bedrooms seen during the inspection were appropriately fitted out with domestic style furniture. Residents are encouraged to bring some treasured possessions with them to personalise their own room. Specialist moving and handling equipment is provided and there are general adaptations throughout the home to assist residents to maximise their independence. Simonsfield DS0000059308.V251353.R01.S.doc Version 5.0 Page 17 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, 28, 29 and 30. Residents are protected by the home’s recruitment and selection procedures and are supported by trained staff. EVIDENCE: Staff rotas provided prior to the inspection showed that five care staff are on duty each morning and that four care staff are on duty from 2:00pm until 8:00pm when the night staff take over. Three care staff work through the night. The manager’s hours are provided over and above the normal rota arrangements. Additional catering, cleaning and laundry staff are in post. Of the 17 care staff in post 12 have an award at NVQ level 2 or above in care. The home is therefore exceeding the standard of 50 care staff with NVQ level 2 or above. The inspector examined the personnel files for three members of staff. Each contained an application form and two references. Confirmation was also included that CRB and POVA checks had been carried out. European Wellcare has its own induction programmes for new staff and provides ongoing training. Adult protection and fire awareness training are routinely provided and specialist training is arranged as and when necessary. Copies of certificates gained by members of staff are kept on their file. Simonsfield DS0000059308.V251353.R01.S.doc Version 5.0 Page 18 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): 31, 32, 33, 34, 35, 36, 37 and 38. The day-to-day management of the home is efficient and supportive of residents. Further discussions are needed around the management of resident’s finances. Staff supervision processes are in need of development. Health and safety matters are given appropriate attention. EVIDENCE: The home’s manager is a Registered General Nurse (RGN). She was previously employed as deputy manager and has worked as a senior carer in Simonsfield for a number of years. She is currently working for the Registered Managers Award at NVQ level 4. During the course of this inspection staff were observed to get on with their work without having to refer to the manger for guidance and direction. Residents told the inspector that they are well looked after in the home and that the staff are caring and helpful. Simonsfield DS0000059308.V251353.R01.S.doc Version 5.0 Page 19 Monthly Regulation 26 Monitoring reports are undertaken by the organisation and a copy of the report is forwarded to the Commission. In the June 2005 CSCI inspection report a requirement was made to ensure residents with small amounts of money deposited with the organisation received any interest payable. Interest was being accumulated and given to the home to spend on all the residents. Since that inspection the organisation has arranged for its managers to speak with residents and their families and to ask if they would sign a form confirming their agreement to interest earned on small amounts of savings being paid to the home for the benefit of all residents. This arrangements remains in breach of Regulation 20 of the Care Home Regulations 2000 and the matter will be taken up with European Wellcare outside of this inspection report. Although the manager told the inspector that one-to-one supervision was taking place with staff this could not be confirmed through written notes on the member of staff’s own file. The manger should ensure that formal one-to-one supervision takes place; that a record of the session is made and kept on file. The home’s manager told the inspector that policies and procedures had been reviewed on 26/09/05. A new folder containing al the organisations policies and procedures relevant to the home were available in the manager’s office. A record is maintained of the PAT tests carried out on all smaller electrical items. The manager also keeps a file that records the regular testing of equipment. The Gas installation was tested on 07/06/05 and the lifts on 19/09/05. Tests are planned on the electrical wiring systems and the portable moving and handling devices. The handy person caries out weekly checks on the emergency call system and the hot water temperatures. He also tests the fire alarm on a weekly basis. Accounts to establish the continued financial viability of the home were not seen but the Commission has not been made aware of any matters that would affect the ongoing operation of the home. Simonsfield DS0000059308.V251353.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 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 4 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 2 2 3 3 Simonsfield DS0000059308.V251353.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? Yes 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 7 Regulation 15 Requirement The registered manager must ensure that a plan of care is written for each resident in the home that details how his or her needs will be met. The registered person must review the arrangements for paying interest on residents savings where the capitol is less than £1,000 The registered manager must ensure that staff are appropriately supervised and that a record is made of each one-to-one meeting. Timescale for action 30/11/05 2 35 20 30/11/05 3 36 13(2) 31/12/05 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 11 Good Practice Recommendations The registered manager should record the wishes of residents for actions to be taken at the time of their death. Simonsfield DS0000059308.V251353.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 Simonsfield DS0000059308.V251353.R01.S.doc Version 5.0 Page 23 - 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. 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