Inspection on 24/01/07 for Solden Hill House

This inspection was carried out on 24th January 2007.

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 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

Solden Hill House 07/01/09

Solden Hill House 30/01/06

Solden Hill House 16/06/05

Solden Hill House 20/12/04

Solden Hill House 04/10/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Solden Hill House Banbury Road Byfield Daventry Northants NN11 6UA Lead Inspector Ms Sarah Jenkins Key Unannounced Inspection 24th January 2007 08:30 Solden Hill House DS0000012913.V324029.R01.S.doc Version 5.2 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 Solden Hill House DS0000012913.V324029.R01.S.doc Version 5.2 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. Solden Hill House DS0000012913.V324029.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Solden Hill House Address Banbury Road Byfield Daventry Northants NN11 6UA 01327 260234 01327 263840 info@soldenhillhouse.co.uk 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) Solden Hill House Limited Mrs Averil O`Hare Care Home 21 Category(ies) of Learning disability (21) registration, with number of places Solden Hill House DS0000012913.V324029.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. To include 1 existing service user with an additional Mental Disorder MD. No further service users over 65 may be accommodated in the home. No service users other than the one named may be admitted in the category of MD The ground floor bedroom to be used only for existing service users who become ill and are unable to mount the stairs. In the unlikely event that the service user requires this room in excess of twenty eight (28) days the Commission for Social Care must be notified. A total of 21 service users from the age of 18-65 years in the category of LD may be accommodated in the home. 2 of these 21 may be named service users who are over 65 years. No one may be admitted to the home in the category of LD when there are already 21 service users in this category in the home. 31st October 2006 5. 6. 7. Date of last inspection Brief Description of the Service: Solden Hill house is situated in a rural location, just outside the village of Byfield to the southwest of Northamptonshire. The Village is accessible by public transport, although visitors may find the journey difficult, as public transport is infrequent. The home has its own transport, and service users can access the village facilities, as well as the facilities of the nearby towns of Daventry and Banbury. The home is one of two owned by Solden Hill house Ltd and is managed by Mrs A. OHare. The home provides personal care and support for 21 residents with learning disabilities. The premises are set in their own grounds and split into two self-contained houses, Solden and Apps house. Each house provides a communal lounge and a separate dining room. Both houses have kitchen facilities. Solden Hill house has workshops and day centre accommodation including a large communal area, used as a dining area for all the residents attending the day centre facilities during weekdays, and for other activities during the evening and at weekends. There are extensive well-maintained and attractive grounds that are fully accessible to residents. Solden Hill also contains office accommodation for the administrative section of the organisation. Solden Hill House DS0000012913.V324029.R01.S.doc Version 5.2 Page 5 Details of the home can be obtained from the Registered Manager in the form of the Statement of Purpose and Service Users Guide. Fees range from £736 £1040 for newly admitted service users. Solden Hill House DS0000012913.V324029.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for Service Users and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. The primary method of inspection used was ‘case tracking’ which involved selecting 3 service users and tracking the care they receive through meeting with the service users, a review of their records, discussions with the care staff and observation of care practices. The Inspector visited during the early morning period to observe practices by staff and to meet with service users. Service users have Learning disabilities, but most of the people that the Inspector met with were able to communicate effectively. The Inspector also undertook observations of care practice, and service users’ relationships with staff to establish their levels of contentment with their lifestyles and routines. The Inspector spent two hours preparing for the inspection through a review of the previous history, and six hours at the home. Thirteen comment cards have recently been received from relatives and carers and all were positive. Many of these feedback forms were particularly complementary about all aspects of service users care at the home. Unfortunately the comment cards from service users were not available at the time of the inspection, although it is understood that many service users filled these in and they were sent to the Commission for Social Care Inspection. The homes Self Assessment questionnaire also informed the Inspection. What the service does well: The atmosphere of the home is calm and nurturing, and conducive to service users happiness and wellbeing. Service users are all recognized and treated as individuals and are complimentary about the care received. The grounds and buildings of the home provide a beautiful and peaceful environment, and give service users a variety of places in which to spend their time. Solden Hill House DS0000012913.V324029.R01.S.doc Version 5.2 Page 7 Activities and daily routines are planned around the wishes and interests of the individual service users. Skilled, trained and police checked volunteers are recruited to enhance the possibilities of providing one to one work and activities. The staff at the home are well supported by the organization, which shows a commitment to professionalism, development and good outcomes for service users. 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. The summary of this inspection report can Solden Hill House DS0000012913.V324029.R01.S.doc Version 5.2 Page 8 be made available in other formats on request. Solden Hill House DS0000012913.V324029.R01.S.doc Version 5.2 Page 9 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 Solden Hill House DS0000012913.V324029.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users’ admission to the home is supported through thorough and flexible processes that ensure that service users will benefit from the placement and that the home can meet their needs. EVIDENCE: The admission records of a service user admitted since the last inspection showed that all aspects of the potential service users care needs had been explored and recorded prior to admission, and that relatives had been supported to visit and discuss aspects of care. Arrangements were fully flexible and met with the service users needs enabling a smooth transition from the previous placement. Solden Hill House DS0000012913.V324029.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are enabled to enjoy a full and stimulating lifestyle with a variety of choices available to them. They are enabled to take reasonable risk in pursuit of their independence. EVIDENCE: Service users care plans are full of relevant information and this is easily accessible. Service users assessed and changing needs are known and understood by staff whose response is timely and appropriate. Service users spoke positively about the care that they received and there was evidence that they are appropriately involved in their care plans and are enabled to attend their reviews if they wish. Solden Hill House DS0000012913.V324029.R01.S.doc Version 5.2 Page 12 It was evident from records and from observations of care practices that staff are alert to and explore service users choices and wishes. Service users show confidence that they will be heard, and were happy with the care given by staff. Risk Assessment is appropriate and enables service users to take reasonable risks in pursuit of a good quality of life. There continues to be a shortfall on some documentation evidencing the dates of review and update, however there was no evidence at this inspection that any of the content of the care plans or risk assessments were actually out of date. Solden Hill House DS0000012913.V324029.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are very happy with their various lifestyles. Activities and daily routines are planned around their wishes and interests. EVIDENCE: The Registered Manager confirmed that the home has a positive relationship with the local community, and that activities outside the home have increased over recent months. Several service users have recently achieved roles in the local village theatrical show. The Inspector spent some time talking to service users before they commenced their daily activities and without exception there was an air of happiness and enthusiasm about their plans for the day. There was evidence of a wide variety of activities and that these were geared to individual interests. Two service users were going to a London show accompanied by staff on the Solden Hill House DS0000012913.V324029.R01.S.doc Version 5.2 Page 14 day of the inspection. The staff confirmed that they are able to give equal support to service users both within and outside of the home, by working to a flexible staff rota, which revolves around residents social needs. Items made in the large craft centre areas were displayed around the home. The dining room area also doubles as a theatre with proper lighting and a curtained stage. This area can also be used as a games room. A recent dance production by service users was evidenced in the photographs on the wall in this area. The Home has a policy of open visiting and residents confirmed that families could visit at any time. Communication and links with families and friends are actively maintained. Some service users confirmed that they go home for weekend stays on a regular basis. Service users are fully involved in the running of the home and are included according to their abilities in a “jobs rota”. Service users were observed to take a pride in completing these jobs well. The menu is decided following consultation with the service users. There was evidence from the menu that service users are provided with healthy nutritious food. Service users said that they enjoyed the food, and staff said that service users are also enabled to “eat out” sometimes. The variety of food is good, home cooking and healthy eating predominates although other foods are also available, such as burgers and chips. At the time of the inspection service users were enjoying breakfasts of their choice. Solden Hill House DS0000012913.V324029.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal and healthcare support is generally good, and service users physical and emotional needs are well met. However medication processes need to be improved to safeguard good outcomes for service users. EVIDENCE: The care plans contain detailed information about the health needs of each individual. There is evidence that advice and input is sought promptly and appropriately from relevant specialists. Service users said that they have regular check ups with their doctors (this was confirmed by staff to be at least 6 monthly) and that they get on well with staff from the local surgery. The Inspector had a chance to meet with the visiting chiropodist. He informed the Inspector that foot care for service users had improved since he started visiting, as more and more service users were confident to use the service, and staff were enabled to discuss things with him and follow professional advice. Solden Hill House DS0000012913.V324029.R01.S.doc Version 5.2 Page 16 Staff have a proper regard for service users privacy, comfort and dignity, and were observed to be sensitive to service users choices, spoken and unspoken, and to their feelings. The management of medication needs some improvement. Advice was given that there are risks in the practice of putting important instructions to staff on “post it” stickers in the medication folder. Nomad containers should accurately describe the contents so that staff may check properly at the point of administration. Occasionally records are not properly maintained, as staff sometimes feel too busy to fill in the Medication Administration Sheets at the time the medication is administered, in accordance with the procedure. One record of antibiotic medication showed several gaps in administration and the Registered Manager agreed to ensure an audit/ investigation was undertaken to check that the service user had actually been given this medication, and to follow up issues with staff. General advice was also given, for example to implement medication profiles for each service user. Solden Hill House DS0000012913.V324029.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are protected by the quality of professionalism and the observation and listening skills of staff. EVIDENCE: Complaints are properly recorded in the homes complaints log and in accordance with procedures. There has been one formal complaint made to Commission for Social Care Inspection since the last inspection, but on investigation this was not substantiated. Interviews with staff evidenced their awareness of safeguarding issues, and their understanding of service users vulnerability. A staff member had raised an issue of concern with the Registered Manager shortly before the inspection and appropriate action had been taken. The Registered Manager has a good understanding of processes and keeps appropriate records. Procedures are available for staff and information therein is readily accessible. It is the inspector’s judgement that the ethos of empowerment and the good listening skills of staff pre-empt serious complaints. Service users were seen to be confident in approaching staff with their problems and staff were alert and responsive to any signs of distress or discontent among service users. Solden Hill House DS0000012913.V324029.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Service users home is homely, clean, comfortable and well maintained, suiting their needs and lifestyles. EVIDENCE: The environment of this Registered Home consists of two areas. Apps House is a modern, purpose built, bright and spacious home with 10 service users. Solden Hill is the original old building, including Administration areas, and is spacious and full of character, it houses 11 service users. Both buildings are set in beautiful grounds and look out on open countryside. At this visit the Inspector reviewed most of the communal areas and three bedrooms. There was also an opportunity to speak with the maintenance man. Contractors were in the process of decorating the old building and painting was in progress. The Solden Hill House DS0000012913.V324029.R01.S.doc Version 5.2 Page 19 home appeared to be in a state of good repair and was pleasantly furnished and decorated. The home was seen to be clean comfortable and well maintained throughout. Solden Hill House DS0000012913.V324029.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are well supported by suitably trained and experienced staff. EVIDENCE: Staff were seen to be competent and appropriately trained, and said that they felt well supported by the Registered Manager and by the organization in their duties. Staff showed sensitivity and understanding of service users’ needs and an attitude of professionalism. Observations of their working practices showed that they had warmth and proper respect for service users. Recruitment processes were discussed with the Registered Manager, and the records of a staff member appointed since the last inspection were reviewed. There was evidence of thorough and professional recruitment and induction processes and appropriate checks undertaken by the organization. The organization has an ongoing programme of training for staff that enables them to follow up their own training interests as well as undertake coretraining courses. Solden Hill House DS0000012913.V324029.R01.S.doc Version 5.2 Page 21 There has been an increased uptake by staff recently in starting their National Vocational Qualification training. Service users were seen to be confident in staff and had good relationships with them. Service users individual means of communication were well understood by staff. Safe practice was discussed with the Registered Manager, in relation to the numbers of staff on duty first thing in the morning at Apps House. At the time of the inspector’s arrival there was one person on duty and a second staff member on back up sleep in. A number of service users were having breakfast but this was not fully supervised as the staff member who was essentially managing on her own, was also away from the area for extended times whilst assisting other service users with their early morning routines. Advice was given that the specific needs of service users required that they be fully supervised at mealtimes and this was agreed by the Registered Manager who said that often there were 2 staff on duty but that she would ensure the implementation of two staff on duty at all times. Solden Hill House DS0000012913.V324029.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Management of the home is effective and responsive, and service users thereby benefit from a well-run service. EVIDENCE: The Registered Manager has a wealth of experience in caring for people with learning disabilities. Discussions with staff indicated that the manager was always approachable and responsive to both staff and service users. The Registered Manager is in the process of taking the Registered Managers award and every effort should now be made to complete this. Solden Hill House DS0000012913.V324029.R01.S.doc Version 5.2 Page 23 Progress has been made in designing formats for Quality Audit, and the Registered Manager hopes to fully implement this shortly. There was evidence of the organization undertaking systematic review of the Health and Safety aspects of the running of the home and no evidence of any shortfalls at the time of the inspection. Solden Hill House DS0000012913.V324029.R01.S.doc Version 5.2 Page 24 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 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 2 34 3 35 x 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 4 13 3 14 x 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 x x x x 3 x Solden Hill House DS0000012913.V324029.R01.S.doc Version 5.2 Page 25 No 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 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 Refer to Standard YA20 YA33 YA37 Good Practice Recommendations Medication profiles should be developed for service users. Care should be taken to ensure service users are properly supervised at mealtimes in accordance with individual need. The registered manager should aim to complete the Registered Managers award. Solden Hill House DS0000012913.V324029.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Solden Hill House DS0000012913.V324029.R01.S.doc Version 5.2 Page 27 - 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. 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