CARE HOME ADULTS 18-65
Swallowfields Care Centre Swallowfields Care Centre 45 Alexandra Road Epsom Surrey KT17 4DB Lead Inspector
Graham Cheney Unannounced Inspection 9th January 2006 10:00 Swallowfields Care Centre DS0000064389.V265307.R01.S.doc Version 5.1 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 Swallowfields Care Centre DS0000064389.V265307.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 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. Swallowfields Care Centre DS0000064389.V265307.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Swallowfields Care Centre Address Swallowfields Care Centre 45 Alexandra Road Epsom Surrey KT17 4DB 01372 720908 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) Leighton House Limited Christine Jane Tinson Care Home 8 Category(ies) of Learning disability (8), Physical disability (3) registration, with number of places Swallowfields Care Centre DS0000064389.V265307.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 15/11/05 Brief Description of the Service: Swallowfields Care Centre has been developed from a former residential care home, which was based on a large detached house. The home has eight single rooms, all with en-suite toilet and bath/shower facilities. The home offers residents 2 spacious sitting rooms, dining room and kitchen. Residents also benefit from the home’s specialist facilities, which include an occupational therapy room, which can be used for a wide range of therapies and life skills development, gymnasium and sensory room. Residents also have access to a good sized and secure garden to the rear of the property and there is ample off road parking to the front of the premises. Overall the home provides a good standard of accommodation for younger adults with needs in the learning and physical disabilities categories of registration. Swallowfields Care Centre DS0000064389.V265307.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the homes first statutory inspection (Statutory meaning legally required) although an additional inspection was undertaken on 15th November 2005 following a number of complaints. Reports of such visits are not published but are available on request to members of the public or other enquirers and the findings will be referred to within this report. The main purpose of this inspection was to follow up on the progress the service had made towards meeting the requirements of the previous visit and to meet the residents, two of whom had only recently been admitted. The first part of the inspection was taken up viewing staff files, staff rosters, care plans and other documentation. Prior to the visit on 15th November 2005 a member of staff had been dismissed and the registered manager and another staff member had resigned. The home’s care consultant has subsequently been appointed as manager and is to submit an application for registration. The manager’s name above is therefore incorrect and will be amended when a new manager is registered. What the service does well:
One of the concerns investigated at the time was that there were shifts when no female staff were on duty to support the female resident with personal care. Care staff files and rosters however confirmed that there was a female member of staff on duty at all times and this remains the case. Again there had been concerns that night staff arrangement were insufficient, however the evidence did not uphold such worries. Current rosters indicated that there were two staff on duty at night and at least one on a waking duty in case residents needed them. With three residents now living in the home the care staffing levels were indicated to be three staff on duty during the waking day and now two waking night staff. In addition the manager worked 9 to 5 Monday to Friday and provided team leader cover as required. In addition the service has recently appointed an art therapist and the responsible individual stated that they were hoping to appoint further specialist staff. Staff training was given a high priority within the service all staff having received medication training and mandatory (required) training planned. The management team demonstrated a firm commitment to NVQ training. Care plans based on person centred planning were in place for each of the residents. These have been subject to ongoing development as residents have settled and been reviewed in the home.
Swallowfields Care Centre DS0000064389.V265307.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better:
Overall the home provides a high standard of accommodation although there were two areas of concern which lead to requirements being made. These were concerns over the slope on the edge of the grassed area which could present a hazard to residents in that they might fall when using the garden. A cupboard was found to be in use for storing both COSHH (Control of substances hazardous to health) i.e. cleaning materials and foodstuffs, namely tea bags, porridge and other items. One of the concerns raised was that the home was attempting to admit outside their categories of registration. Whilst there was no evidence to support such an allegation the home were advised on the legal position and the home’s management gave assurances that all prospective residents with predominantly learning disability or physical disability needs. Swallowfields Care Centre DS0000064389.V265307.R01.S.doc Version 5.1 Page 7 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. Swallowfields Care Centre DS0000064389.V265307.R01.S.doc Version 5.1 Page 8 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 Swallowfields Care Centre DS0000064389.V265307.R01.S.doc Version 5.1 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 4 Documentation about the home such as its statement of purpose were submitted during the registration process and therefore not reassessed during this inspection. Evidence gathered during this inspection confirmed that the home has an appropriate procedure for admitting new residents in line with NMS 4. EVIDENCE: New residents are admitted to the home only after a number of day visits prior to a short stay, then admission of a temporary basis subject to review. Only one resident had been through the whole process with the review confirm that the placement had been successful One of the concerns raised previously was that the home was attempting to admit outside their categories of registration. The home’s statement of purpose was clear in this respect in that the home only provides a service for people with learning disability or physical disability needs, who may have associated mental health needs. Whilst there was no evidence to support such an allegation, the home were advised on the legal position and the home’s management gave assurances that all prospective residents would have assessed needs within the categories of registration. Swallowfields Care Centre DS0000064389.V265307.R01.S.doc Version 5.1 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 8 Evidence gathered from this inspection indicated that each of these standards was being met effectively. This gives confidence that each individual’s needs and aspirations were being recognised and met. Ongoing developments of care planning as residents become established should improve this further. EVIDENCE: Care plans based on person centred planning were in place for each of the residents. These have been subject to ongoing development as residents have settled and been reviewed in the home. Swallowfields Care Centre DS0000064389.V265307.R01.S.doc Version 5.1 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None assessed on this occasion. EVIDENCE: Swallowfields Care Centre DS0000064389.V265307.R01.S.doc Version 5.1 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Standard 20 was assessed on this occasion and in general the practice for administering medication complied with the Royal Pharmaceutical Society’s guidance, although a requirement was made, please see below. The home was in the main, therefore obtaining, storing, administering and recording medication appropriately. Evidence gathered on this inspection indicated that standards 18 and 19 were being met. Overall the home has taken steps to ensure that residents’ health care needs are maintained effectively. EVIDENCE: Medication was being appropriately stored and administration records observed to be accurately completed. One of the concerns investigated at the time was that there were shifts when no female staff were on duty to support the female resident with personal care. Care staff files and rosters however confirmed that there was a female member of staff on duty at all times.
Swallowfields Care Centre DS0000064389.V265307.R01.S.doc Version 5.1 Page 13 Also there had been concerns that night staff arrangements were insufficient, however the evidence did not uphold such worries. Rosters indicated that there were two staff on duty at night, one female and at least one on a waking duty in case residents needed them. Swallowfields Care Centre DS0000064389.V265307.R01.S.doc Version 5.1 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 Evidence gathered during this inspection confirmed that the home meets the assessed standards. This meant that the home was able to demonstrate that residents were being appropriately protected and that residents’ views were important and acted upon. EVIDENCE: This was the homes first statutory inspection (Statutory meaning legally required) although an inspection was undertaken on 15th November 2005 following a number of complaints. Reports of such visits are not published but are available on request to members of the public or other enquirers and the findings have been referred to within this report. Swallowfields Care Centre DS0000064389.V265307.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29 Swallowfields Care Centre was only registered in September 2005 and although based on a pre-existing, (before 2002) registered care home it meets all of the National Minimum Standards for premises. The evidence gathered during this inspection confirmed that the home provides a good level of accommodation appropriate to the needs of the current residents. EVIDENCE: Swallowfields Care Centre has been developed from a former residential care home, which was based on a large detached house. The home has eight single rooms, all with en-suite toilet and bath/shower facilities. The home offers residents 2 spacious sitting rooms, dining room and kitchen. Residents also benefit from the home’s specialist facilities, which include an occupational therapy room, which can be used for a wide range of therapies and life skills development, gymnasium and sensory room. Residents also have access to a good sized and secure garden to the rear of the property and there is ample off road parking to the front of the premises. Swallowfields Care Centre DS0000064389.V265307.R01.S.doc Version 5.1 Page 16 Overall the home provides a good standard of accommodation for younger adults with needs in the learning and physical disabilities categories of registration. There were two areas of concern, which lead to requirements being made. These were concerns over the slope on the edge of the grassed area, which could present a hazard to residents in that they might fall when using the garden. A cupboard was found to be in use for storing both COSHH (Control of substances hazardous to health) i.e. cleaning materials and foodstuffs, namely tea bags, porridge and other items. Swallowfields Care Centre DS0000064389.V265307.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 Evidence gathered during this inspection confirmed that the home meets each of the assessed standards. Staff on duty appeared to be enthusiastic and committed to supporting residents, with training and development being given a high priority. EVIDENCE: One of the concerns investigated previously was that there were shifts when no female staff were on duty to support the female resident with personal care. Care staff files and rosters however confirmed that there was a female member of staff on duty at all times. Also there had been concerns that night staff arrangements were insufficient, however the evidence did not uphold such worries. Rosters indicated that there were two staff on duty at night, at least one female and at least one on a waking duty in case residents needed them. With three residents now living in the home the care staffing levels were indicated to be three staff on duty during the waking day and now two waking night staff. In addition the manager worked 9 to 5 Monday to Friday and provided team leader cover as required. Swallowfields Care Centre DS0000064389.V265307.R01.S.doc Version 5.1 Page 18 The service has recently appointed an art therapist and the responsible individual stated that they were hoping to appoint further specialist staff. Staff training was given a high priority within the service all staff having received medication training and mandatory (required) training planned. The management team demonstrated a firm commitment to NVQ training. Swallowfields Care Centre DS0000064389.V265307.R01.S.doc Version 5.1 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 42, Evidence gathered during this inspection confirmed that, in general the home meets each of the assessed standards and was seen to be well run. However there were two health and safety concerns which needed to be addressed. EVIDENCE: Prior to the visit on 15th November 2005 the registered manager and two other staff had resigned. The home’s care consultant has subsequently been appointed as manager and is to submit an application for registration. The manager’s name above is therefore incorrect and will be amended when a new manager is registered. A cupboard was found to be in use for storing both COSHH (Control of substances hazardous to health) i.e. cleaning materials and foodstuffs, namely tea bags, porridge and other items. Swallowfields Care Centre DS0000064389.V265307.R01.S.doc Version 5.1 Page 20 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 X 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 X ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 3 28 3 29 3 30 X STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X X X X 2 X Swallowfields Care Centre DS0000064389.V265307.R01.S.doc Version 5.1 Page 21 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. 1 Standard YA42 Regulation Requirement Timescale for action 09/02/06 2 YA42 13(4)(a)(c) A risk assessment must be undertaken on the steep slopes of the edge of the grassed area at the rear of the home. Appropriate action must be taken to minimise the risk of residents falling. 23(2)(l)(5) The storing of both COSHH 09/01/06 (Control of substances hazardous to health) i.e. cleaning materials and food stuffs, namely tea bags, porridge and other items, must be discontinued from the date of the inspection. 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 Swallowfields Care Centre DS0000064389.V265307.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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