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Inspection on 09/11/05 for Somerforde Ltd

Also see our care home review for Somerforde Ltd for more information

This inspection was carried out on 9th November 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The service provides a good standard of care, with residents personal and health needs being met sensitively by a well- established trained and supported staff team. The residents enjoy a flexible lifestyle, in which staff support residents to maintain contact with friends and family and pursue activities and interests in the home and local community. The owners and staff have a commitment to constantly improving the environment and services for residents which is reflected in their determination in improving recording systems such as care plans and assessments of residents needs. Improving these documents will improve communication in the home and make clear what staff must do to meet resident`s needs.

What has improved since the last inspection?

The owners have continued with the refurbishment and redecoration of some areas of the home, improving the appearance of individual residents rooms and lounge areas. The owners have continue to improve and extend policies and procedures in a number of areas including staff supervision, individualised training records for staff and changing care plan systems. This will be of long term benefit for staff and residents as it will improve communication, improve staff and residents relationships, make clear residents needs so that staff can meet those needs.

What the care home could do better:

To continue to progress the home must, as planned, extend initial and ongoing assessment records of residents needs and introduce the new system of care planning the owners have been working on. When completed this will provide detailed 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. A priority for the owners of the home is ensuring that all staff have completed current criminal records and protection of vulnerable adults checks, as some staff had continued to fail to provide the information necessary for the home to complete checks. This puts residents at risk from staff who may not be suitable to work with vulnerable people. 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.

CARE HOMES FOR OLDER PEOPLE Somerforde Ltd 2-3 Forde Park Newton Abbot Devon TQ12 1DE Lead Inspector Andrea Peryer Announced Inspection 9th November 2005 and 17th November 2005 10:00 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.V269582.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. Somerforde Ltd DS0000064556.V269582.R01.S.doc Version 5.0 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.V269582.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22/02/05 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.V269582.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out over two visits to the home, with the owners, who also act as the managers for the home, present throughout the day. 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, policies, procedures, fire logs and accident records. Residents were spoken too in their private rooms or in the homes dining and lounge areas. The home has also submitted a pre inspection questionnaire to the Commission Prior to the inspection, which gives information about the home including staff rosters, menu plans, lists of training and some of the changes in the home. The Commission also received Feedback cards from relatives and residents. What the service does well: What has improved since the last inspection? The owners have continued with the refurbishment and redecoration of some areas of the home, improving the appearance of individual residents rooms and lounge areas. The owners have continue to improve and extend policies and procedures in a number of areas including staff supervision, individualised training records for staff and changing care plan systems. This will be of long term benefit for staff and residents as it will improve communication, improve staff and residents relationships, make clear residents needs so that staff can meet those needs. Somerforde Ltd DS0000064556.V269582.R01.S.doc Version 5.0 Page 6 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. Somerforde Ltd DS0000064556.V269582.R01.S.doc Version 5.0 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.V269582.R01.S.doc Version 5.0 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): 3,6 Residents move into the home after having his or her needs assessed and after being reassured their needs will be met. The home does not provide intermediate care. EVIDENCE: The owners have developed an assessment form which the owners confirmed was completed on or before residents moved into the home. The owners plan to extend this document as the homes initial and ongoing assessment record of residents needs. Along side this document the owners were able to produce copies of assessments and care plans completed by social services representatives and for one resident, district nurses notes and plans. One resident and their representative confirmed that they had an opportunity to visit the home before making a commitment to stay and as part of that visit they had a chance to talk about the residents needs and the services the home provides. Somerforde Ltd DS0000064556.V269582.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, Resident’s health, personal and social care needs are fully met, however this is not as clearly recorded in the individual residents plan of care, as it could be. 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 this inspection with the inspector revisiting the home on the owners’ request to re-look at revised draft care plans. The owners also sent in care plan drafts for the inspector’s consideration shortly after the inspection demonstrating the owner’s commitment to improving in this area. 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. The proposed system will take information from these folders, will extend assessment information and make clear the care residents require and how the home meets the needs of the resident. Discussion also took place on training for staff in this area and the owners had compiled a draft guidance policy outlining for staff the care planning process. Somerforde Ltd DS0000064556.V269582.R01.S.doc Version 5.0 Page 10 The current records do show some of the care residents receive and some professional input from outside of the home such as district nurse visits. Residents confirmed that staff 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.V269582.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, Residents maintain contact with their family and friends and the local community and their lifestyles match what they prefer and met their interests and needs. EVIDENCE: Residents spoken too consistently said that the homes staff made an effort to meet any request to attend events or have family visit and that they have choices in how they spend their time. The inspector spoke to one relative who was enjoying afternoon tea with the resident in the resident’s private room. The residents spoken too confirmed that the routines in the home are changed to meet the needs of the resident for example one resident had really enjoyed a stroll across the park opposite with one of the staff and this had been a spontaneous request made by the resident as the weather had improved, which staff had been happy to help with. Staff also described changes in routines in providing personal care so that a resident could visit professionals outside of the home, without being concerned at not having the opportunity to have a bath or shower. Somerforde Ltd DS0000064556.V269582.R01.S.doc Version 5.0 Page 12 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 Complaints are listened too, taken seriously and acted upon and the home protects service users from abuse. EVIDENCE: Residents consistently said that they felt able to raise any concerns of any kind with the homes owners and the homes senior staff. The feedback cards received by the Commission includes a section on complaints and the cards indicated that the residents knew who to go to if they were unhappy with the care provided. The home has a range of policies and procedures on how to deal with possible abuse and a complaints procedure is included in the homes service users guide. Training for staff includes NVQ’s in care at levels 2,3 and 4 all of which include training on identifying abuse and the home has internal training in the form of a video to raise staff awareness and to make sure that they would alert the owner of any concerns about the treatment or care of residents. Somerforde Ltd DS0000064556.V269582.R01.S.doc Version 5.0 Page 13 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: Since purchasing the home the owners have invested in large areas of the home including the refurbishment of a bathroom to create functional and attractive shower facilities, which staff confirmed had been a success for some of the residents who found the shower facilities an easier more comfortable option than a bath. The owners have also re-organised the laundry area and invested in health and safety checks such as electrical equipment checks and guarding radiators. The owners have also continued to refurbish resident’s rooms as they become available and update communal areas with new décor and furnishings. Somerforde Ltd DS0000064556.V269582.R01.S.doc Version 5.0 Page 14 However, 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. In the same way a small number of the residents rooms that have not yet been decorated or refurbished require the owners to invest in replacing furnishings and redecorating. The owners are aware of the work required and is on their to do list, which was discussed with the inspector. Somerforde Ltd DS0000064556.V269582.R01.S.doc Version 5.0 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): 27,28,29,30, 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 not protected by the homes recruitment practices. EVIDENCE: The owners also act as the managers for the home are considering the management structure of the home and introducing a manager who would be registered with the Commission. This would potentially give 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. The homes pre-inspection questionnaire lists a range of training staff have completed including manual handling, first aid, basic food hygiene and dealing with violence or aggression. The manager and owner said they valued training for staff and have plans to continue a range of training through, induction, supervision of staff and NVQ training. This was also demonstrated in newly developed training plans for each member of staff, which shows staff receiving a range of training including NVQ in care at levels 2,3, and 4. When talking to the owners and the staff it is clear that they have a detailed knowledge of the residents care needs and of residents likes and dislikes. Somerforde Ltd DS0000064556.V269582.R01.S.doc Version 5.0 Page 16 Three staff folders were examined (with two folders continuing details of new staff ) and these folders included a application form, references, interview notes and confirmation of criminal records checks. Discussion took place on ensuring that all staff have completed current criminal records and protection of vulnerable adults checks, as some staff had continued to fail to provide the information necessary for the home to complete checks. This was also discussed at the previous inspection and although the staff are not currently working at the home these checks must be completed for all staff. Somerforde Ltd DS0000064556.V269582.R01.S.doc Version 5.0 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): 31,33,36, 38 Residents live in a home, which is run and managed by persons who are fit to be in charge and residents benefit from their leadership and management as the home is run in the best interests of residents. Overall the health, safety and welfare of residents and staff are promoted and protected. EVIDENCE: The owners have a range of a practical skills, experience and regular updating on courses such as manual handling to ensure good standards of care for residents. Staff and residents said that they benefited from the owners ’ leadership styles in the home, describing a friendly, relaxed atmosphere. The owner and senior staff are proceeding with the supervision and appraisal of all staff. This is being completed by focusing on the care of individual residents, identifying any areas of concern with the staff and focusing on improvements Somerforde Ltd DS0000064556.V269582.R01.S.doc Version 5.0 Page 18 through a named key worker system, which is a system of making one member of staff responsible for one or more resident for making sure their overall care needs are met. The format being used to record these discussions could be extended to focus on the staff needs as well as the residents such as training needs. This will help to capture the full support staff received from the homes senior staff and owners. Discussion took place on how the owners and the staff team have developed a range of policies and procedures and on the development a new quality assurance system to ensure the well being of residents. Somerforde Ltd DS0000064556.V269582.R01.S.doc Version 5.0 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 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X 3 X 3 Somerforde Ltd DS0000064556.V269582.R01.S.doc Version 5.0 Page 20 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 2 Standard OP26 OP29 Regulation 23 19 Requirement Replace the floor covering in the main corridor areas of the home Ensure that all staff have current criminal checks and that staff do not work at the home until outstanding criminal checks are received at the home. Timescale for action 02/04/06 04/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard OP7 OP26 OP36 OP38 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. Proceed with the development of a quality assurance system Somerforde Ltd DS0000064556.V269582.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Somerforde Ltd DS0000064556.V269582.R01.S.doc Version 5.0 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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