Inspection on 21/11/05 for South View

This inspection was carried out on 21st 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.

Other inspections for this house

South View 21/06/07

South View 06/07/06

South View 14/06/05

South View 20/09/04

South View 26/04/04

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Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE South View South View Sandford Avenue Church Stretton Shropshire SY6 7AB Lead Inspector Terry Woods Announced Inspection 21st 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 South View DS0000020648.V252457.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. South View DS0000020648.V252457.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service South View Address South View Sandford Avenue Church Stretton Shropshire SY6 7AB 01694 723525 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) Mrs Catherine Elizabeth Vine Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (15) of places South View DS0000020648.V252457.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th June 2005 Brief Description of the Service: South View is a privately owned Care Home registered with the Commission for Social Care Inspection to provide a service for fifteen older people. It is a well-established home set in its own grounds and blending in with the local residences. South View is situated on the edge of Church Stretton. The home has been operating for over sixteen years and has become an integral part of the local community. The owner, Mrs Catherine Elizabeth Vine currently has day-to-day management responsibility for the Home and lives on the premises. A senior member of staff, Ms Grace Atkinson however, has recently been appointed by Mrs Vine to take over the home manager role following a trial period. The building has been extended and improved with the emphasis always being to avoid an institutional environment. There is an established staff group providing residents with consistency in a warm comfortable atmosphere. South View DS0000020648.V252457.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on the 21st November 2005 over four hours and was carried out as a routine announced visit. A full tour of the premises took place and a sample of two staff files and two residents’ care records were inspected. The majority of the residents, five of the staff on duty and two visitors were spoken to during the day. 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. South View DS0000020648.V252457.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 South View DS0000020648.V252457.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): 3&6 There is a clear assessment process in place to adequately inform the care planning process and provide staff with the information they need to satisfactorily meet residents’ needs. EVIDENCE: Generally prospective residents tend to be admitted to South View privately or through the hospital discharge process. Social worker involvement where appropriate is usually through the Older People’s team at Ludlow who complete a community care assessment or the single assessment documentation. The home has also developed its own resident needs assessment process. This is a needs led pre-admission assessment and a good example was seen concerning the most recently admitted resident. The document contains information concerning health care, social care and well being with a useful ‘getting to know you’ section. This is now being implemented and applied to all newly admitted residents in order to effectively formulate each individual’s plan of care. The home does not provide an intermediate care service South View DS0000020648.V252457.R01.S.doc Version 5.0 Page 8 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 There is a clear and consistent care planning system in place, which provides staff with the information they require to meet residents’ needs Staff are sensitive to the individual needs of each service user and meet these in a professional manner The medication process is a well-organised, safe and effective service for the benefit of those in residence EVIDENCE: The care planning system at the home is currently being reviewed. Examples of two plans of care were inspected and considerable improvement noted. The required information, which has always been available, is now being collated and organised into an acceptable working file format to provide detailed action or guidelines for staff to follow in order to deliver the required care. Good notes are being kept with regard to diet, weight monitoring, GP and District Nurse visits, medication and family visitors. Case tracking also South View DS0000020648.V252457.R01.S.doc Version 5.0 Page 9 demonstrated the appropriate use of community services to keep residents comfortable at the home throughout times of illness. It was reported by residents and visitors, which included one family member available on the day, that the care at South View to be of a high standard and delivered with kindness and concern for the residents’ well being. Further written feedback confirmed very satisfied relatives reporting a safe, comfortable and homely environment at South View. There are personal risk assessments completed which includes the recognition of individual abilities and strengths. This is particularly relevant concerning moving and handling and with regard to the use of the stairs by those accessing the first floor. Medication was observed being given with respect and records are well kept. A senior carer on duty administering medication at lunchtime was able to talk through the process confidently and report on the effectiveness of the system. South View DS0000020648.V252457.R01.S.doc Version 5.0 Page 10 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 & 15 South View provides a caring lifestyle in a homely setting for the people in residence. Meals at South View are of a good homely type offering both choice and variety and catering for special dietary needs. EVIDENCE: A midday meal was sampled by the visiting inspector and found to be wholesome and enjoyable. Residents were observed having their preferences met and staff provided assistance in eating where necessary. Special diets were seen being observed on the day. Three full meals are provided with an additional supper during the evening if required. Residents are consulted each morning with regard to their preferences from the menu. Beverages are available on request. There is fruit cordial drink available at all times and a fresh spring water dispenser to hand. The majority of residents reported that they are in touch regularly with friends and family members and spoke about their visitors coming to the home or to take them out during the day. One resident reflected on her weekend over lunch and initiated a conversation on the table about eating out locally, which was received well by the majority who are all from the Church Stretton area South View DS0000020648.V252457.R01.S.doc Version 5.0 Page 11 Residents have a unique ‘homely’ lifestyle at South View, which from their comments received, matches their expectations and preferences. A relative confirmed a welcoming environment and friendly atmosphere at South View and reflected on the excellent care and comfortable and homely way that it is delivered. Three residents were sitting knitting together and spoke of their enjoyment of making various items and of the conversations they had within the group. A craft activity morning has also been introduced which is popular with the residents. Glass painting and the making of Christmas cards were said to be enjoyable and rewarding. A hairdresser was in attendance on the day providing a valued service for the benefit of residents self esteem. Residents noticeable had a ‘feeling good’ factor about them afterwards and clearly enjoyed the weekly experience. Wherever possible residents are helped to exercise choice and control over their lives. They either handle their own financial affairs or are supported by their family to manage benefits. South View DS0000020648.V252457.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 The home has a satisfactory complaints system and there is evidence that residents feel that their views are listened to and acted upon. EVIDENCE: The home has a comments, compliments and complaints book for both residents and visitors’ use. Comments inserted were complimentary and demonstrated the residents’ and families’ appreciation of the care being provided at South View. The comments included items about kindness of the staff, caring, special memories and the warm welcoming atmosphere. Residents reported that both management and staff always listened to their views. It is noted that there were no complaints. The home subscribes to ‘Care Aware’ Advocacy Services for support for residents. A comprehensive handbook of the use of this service was on display in the reception area. Senior staff have previously attended a ‘Protection of Vulnerable Adults’ course at Ludlow College to provide them with the information required to follow procedures should residents be placed at risk. It was reported that further training is being organised in house for all staff and to be provided by Shropshire Partners in Care. South View DS0000020648.V252457.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, 21 & 26 The home continues to provide a homely, comfortable and safe environment for those in residence. EVIDENCE: The home has ample toilet, washing and bathing facilities throughout the building to meet residents’ needs. Access to the first floor is via a staircase turning through 180°. Adequate grab rails are provided for residents’ safety. This stairway is not suitable for all residents and it is inappropriate to accommodate people with mobility difficulties on the first floor. The home regularly monitors the first floor residents’ continuing mobility and risk assessments are in place covering the stair usage by each of those individuals. The premises were observed to be clean, hygienic and free from offensive odours. The home is routinely maintained, confirmed by well-kept records. An inspection of the utility area revealed that the floor and walls in the laundry have now been re-tiled bringing this facility up to a good standard of cleanliness. South View DS0000020648.V252457.R01.S.doc Version 5.0 Page 14 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 Staffing levels throughout the weekend have been reviewed due to the deteriorating health and increasing support needs of some residents. Since the last inspection the standard of vetting and recruitment practices has improved however all appropriate checks are still not being carried out, which is potentially leaving residents at risk. There are systems in place to provide staff with an initial induction to the home EVIDENCE: A record of staff on duty is kept by the home. The ratio of care staff to residents is determined according to assessed need. There are three - four staff on duty during the mornings and two - three throughout the afternoon and evenings, plus the proprietor. The arrangement at weekends has improved due to particular residents who have very high support needs, which it was previously reported, require two staff to attend to care at any one time. Throughout the weekend there are three staff on duty during the mornings and two - three throughout the afternoon and evenings, plus the proprietor. This is now seen to be sufficient given that there are also domestic duties to be carried out. Two staff files were inspected. The inspector found evidence of staff now receiving a full induction, which was confirmed in conversation with one individual. The staff member also confirmed that the there was a formal recruitment process however files revealed that the procedure is still not South View DS0000020648.V252457.R01.S.doc Version 5.0 Page 15 robust. References were not available within the two files, which could potentially put residents at risk. It is understood that two staff members may have been employed without references being taken up because they are ‘known’ to the owner. The manager showed a new reference request sheet, which she advised would be used for all new applicants. South View DS0000020648.V252457.R01.S.doc Version 5.0 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): 31, 33, 35 & 38 Management arrangements are in the process of review Formal staff support at South View is not offered in such a way as to benefit employees and ultimately enhance the service to residents EVIDENCE: The owner, Mrs Vine, has many years of experience in the care profession and of managing the home. However she has no desire to pursue further qualifications and as discussed during previous inspections has now appointed a manager for a trial period. The ‘manager’ has completed the ‘Registered Managers Award’, associated NVQ level 4 components and the NVQ assessor’s award. One a permanent decision has been made with regard to the appointment, the Commission for Social Care Inspection will be pleased to receive an application from the home for the registration of the manager. South View DS0000020648.V252457.R01.S.doc Version 5.0 Page 17 There is a process in place for staff to receive regular recorded supervision with topics that include the care of service users, the individual’s home life, performance targets and training needs. Records together with staff feedback confirmed that this is still not being carried out. The home has a policy concerning residents’ money and financial affairs. Residents either manage their own financial affairs or rely on family members for support. Record keeping is generally of a good standard at South View. Records inspected included resident files, staff files, medication, fire safety, visitors and food provided. South View DS0000020648.V252457.R01.S.doc Version 5.0 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 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 3 X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 3 South View DS0000020648.V252457.R01.S.doc Version 5.0 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 OP29 Regulation 19.1 Requirement Timescale for action 28/11/05 2. OP29 19.1 3 OP36 18.1.c.i The home is required to ensure that the current procedure for recruitment is robust The home is required to 28/11/05 obtain two written references requested through the postal system prior to making an appointment The home is required to 28/11/05 provide formal supervision to all staff six times per year (every 2 months) RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations South View DS0000020648.V252457.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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 South View DS0000020648.V252457.R01.S.doc Version 5.0 Page 21 - 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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