CARE HOMES FOR OLDER PEOPLE
Somerforde Ltd 2-3 Forde Park Newton Abbot Devon TQ12 1DE Lead Inspector
Andrea Peryer Unannounced Inspection 8th February 2006 12:00 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 Somerforde Ltd DS0000064556.V284324.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. Somerforde Ltd DS0000064556.V284324.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Somerforde Ltd Address 2-3 Forde Park Newton Abbot Devon TQ12 1DE 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) 01626 361786 01626 366708 Somerforde Ltd Maureen Maclean Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24), Physical disability (24) of places Somerforde Ltd DS0000064556.V284324.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 9th November 2005 and 17th November Brief Description of the Service: Somerforde is a care home that provides service for older people and for older people with physical disabilities. Somerforde has 20 single bedrooms and two double bedrooms over two floors and all but four bedrooms have en-suite toilet facilities. The second floor is accessed through the homes passenger lift. The home is set in private grounds and overlooking the nearby park. The home is near to local shopping facilities and the centre of Newton Abbott. The home has several communal sitting areas and a large dining room. The proprietors currently live on the premises. Somerforde Ltd DS0000064556.V284324.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was carried out over a lunch- time into the afternoon, with the owners, who also act as the managers for the home, present throughout the visit. Residents and members of staff were part of the discussion about the home and four residents care was looked at in detail. A range of documentation was also considered throughout the inspection including care plans, financial records and staff records. Residents were spoken too in their private rooms or in the homes dining and lounge areas. What the service does well: What has improved since the last inspection? What they could do better:
To continue to progress the home must, as planned, extend initial and ongoing assessment records of residents needs and continue to introduce the new system of care planning the owners have been working on. When completed
Somerforde Ltd DS0000064556.V284324.R01.S.doc Version 5.1 Page 6 this will provide detailed consistent information on care needs improving communication and the care provided. The homes main corridors are carpeted with carpets that have been in place for a long time (prior to the owners taking over) and they let down the over all appearance of the home for visitors and new residents. The carpets are functional but are old worn and appear dirty although the home is actually very clean. These carpets must be replaced and this is becoming more of an priority as it has been required at past inspections to the home. The replacing of the carpet in the corridors will improve the environment in keeping with the rest of the home. The owners and the staff team have developed a range of policies and procedures and need to continue, as planned with the development a new quality assurance system and changing documents to improve communication, identify shortfalls and demonstrate how they address any action needed and continue to ensure the well being of residents and staff. 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. Somerforde Ltd DS0000064556.V284324.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 Somerforde Ltd DS0000064556.V284324.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): x Not assessed on this occasion. EVIDENCE: Somerforde Ltd DS0000064556.V284324.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 Resident’s health, personal and social care needs are fully met and this is clearly recorded in the individual residents plan of care, for most residents. Residents are treated with respect, care and sensitivity and their privacy is upheld, throughout their life at the home. EVIDENCE: Care planning and recording the care residents require and receive was a major focus of the last inspection and this inspection focused on how the home had proceeded with the plans to introduce the new system of care planning. Care planning has been an area that the owners have discussed at previous inspections and in attempts to improve in this area the owners have combined and refined individual folders for each resident, with a range of information in. Some of these folders have now been updated and extended using a mix of old and new information from a range of old and new documents. The system has extended some assessment information and made clear the care residents require and how the home meets the needs of the resident. This system has not yet been fully implemented for all residents and the owners and staff were aware of the need to continue to proceed with fully implementing the new care planning process. Somerforde Ltd DS0000064556.V284324.R01.S.doc Version 5.1 Page 10 The residents continue to praise the members of staff and the owners whom assist them with all areas of personal care, social and health care needs and that they were pleased with the care the homes staff and owners provided. Somerforde Ltd DS0000064556.V284324.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 Residents receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. EVIDENCE: The inspector spent some time in the homes kitchen observing staff and the homes owner/manager providing meals to service users. Over the lunch time period all the staff and the owner of the home were observed working together to ensure that every resident received the meal they wished to receive and the environment they had chosen. This meant that some residents shared a pleasant homely dining area while others chose to eat their meals later in the day or in their rooms. Staff were observed preparing each meal to meet the residents individual needs so that meal sizes, what was prepared and served at each meal was individualised for each resident. The staff worked together to ensure that all meals served were hot and were observed asking each resident if the meal was satisfactory or if they needed anything further. A number of types of drinks were observed to be offered to residents and residents were offered the option of sandwiches if they did not wish to have a hot meal. Residents spoken too confirmed that the meals in the home had steadily improved, so that meals had become more enjoyable and that they enjoyed using the dining area to share meals and socialise. The new care plan and assessment format includes nutrition, diet and residents choices. The kitchen was clean and tidy with a number of systems in place that showed the staff
Somerforde Ltd DS0000064556.V284324.R01.S.doc Version 5.1 Page 12 followed good hygiene and health and safety practices and staff have received training in Food Hygiene. Somerforde Ltd DS0000064556.V284324.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): x Not assessed on this occasion EVIDENCE: Somerforde Ltd DS0000064556.V284324.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): 19,26 On the whole, residents have access to safe, comfortable and well-maintained indoor and outdoor facilities. Resident’ rooms are comfortable, furnished with personal possessions and overall the home is clean, pleasant and hygienic. EVIDENCE: At the last inspection it was highlighted that the homes main corridors are carpeted with carpets that have been in place for a long time (prior to the owners taking over) and they let down the over all appearance of the home for visitors and new residents. The carpets are functional but are old worn and appear dirty although the home is actually very clean. At this inspection the owners had explored and chosen carpeting to replace this corridor carpeting at substantial expenses and discussion took place on how they intended to replace the worn carpet with minimum disruption to the residents. Overall the home continues to be well maintained clean and odour free, providing a comfortable, homely, personalised environment for residents with some areas of the home the owners are continuing to update.
Somerforde Ltd DS0000064556.V284324.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): 27,29,30 Resident’ needs are met by the numbers of staff and the skills of staff who are trained and competent to do their jobs. Residents are protected by the homes recruitment practices. EVIDENCE: The owners who also act as the managers for the home have introduced into the home a manager who is in the process of being registered with the Commission. This potentially gives the owners more opportunities for some time away from the home as they currently live on the premises and work as part of the staff team providing care, shopping, writing policies and supporting staff. The homes staff structure also includes senior carers and a deputy manager, who have been employed at the home for some time. Three staff files were examined and included Staff training and supervision records which have been extended since the last inspection with one member of staff taking a more active responsibility to ensure they are fully completed. The owners confirmed that the new documents are in the process of being completed for all staff. Completed police checks for all staff have now been completed and were available for inspection. Staff training records showed that staff had attended a range of training including manual handling training and staff completing NVQ’s in Care at levels two, three and four. Somerforde Ltd DS0000064556.V284324.R01.S.doc Version 5.1 Page 16 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): 35, Resident’s financial interests are safeguarded and the members of staff employed. EVIDENCE: The owners have a system of managing a small number of resident’s finances, (personal allowances) which includes recording of any items purchased on their behalf with receipts. This is a simple system the owners have used for years consisting of basic “log books” recording individuals finances coming into the home and items purchased on their behalf and small amounts of money kept securely. One resident prefers the owners to use a banking system to manage their finances and this had been discussed and agreed with the residents social services care manager and this is fully recorded and audited. Other resident’s finances are managed and controlled through the resident’s family or advocates and the homes service users guide also gives basic
Somerforde Ltd DS0000064556.V284324.R01.S.doc Version 5.1 Page 17 information on how the home deals with residents fees and finances and advocacy services. Somerforde Ltd DS0000064556.V284324.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 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 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x 3 x x x x x x 2 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x 3 3 x x Somerforde Ltd DS0000064556.V284324.R01.S.doc Version 5.1 Page 19 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 OP26 Regulation 23 Requirement As planned replace the floor covering in the main corridor areas of the home Timescale for action 02/05/06 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. Refer to Standard OP7 Good Practice Recommendations As planned, proceed with the changes to the care plan and assessments formats to ensure resident’s needs are fully recorded. Proceed with the planned refurbishment of all resident’s rooms. Proceed with changes to supervision of staff and how this is recorded. 2. 3. OP26 OP36 Somerforde Ltd DS0000064556.V284324.R01.S.doc Version 5.1 Page 20 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
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