Inspection on 19/12/05 for Swan Hill House

This inspection was carried out on 19th December 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

Swan Hill House 11/07/07

Swan Hill House 18/07/06

Swan Hill House 20/06/05

Swan Hill House 21/09/04

Swan Hill House 11/05/04

Similar services:

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 Swan Hill House Swan Hill Shrewsbury Shropshire SY1 1NQ Lead Inspector Terry Woods Unannounced Inspection 19th December 2005 09:30 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 Swan Hill House DS0000020728.V267045.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. Swan Hill House DS0000020728.V267045.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Swan Hill House Address Swan Hill Shrewsbury Shropshire SY1 1NQ 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) 01743 360803 01743 344351 Mrs Carol Daker Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (27), Physical disability (1) of places Swan Hill House DS0000020728.V267045.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home is registered for a maximum of 28 service users. The home may accommodate 27 Older Persons and one person with a physical disability under the age of 65 years who is named in the attached schedule (not to be displayed). 20th June 2005 Date of last inspection Brief Description of the Service: Swan Hill House is a privately owned Care Home registered with the Commission for Social Care Inspection to provide a service for 27 older people and one person with a physical disability under the age of 65 years. It is a well established home situated close to the centre of Shrewsbury Town. The Home is owned by Mrs Carol Daker. She is also the registered manager and has day-to-day management responsibility for the Home. The accommodation offers comfortable living facilities with an attractive enclosed and well-maintained garden. There is an established staff group providing service users with consistency in a warm comfortable atmosphere. Swan Hill House DS0000020728.V267045.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Inspection work undertaken by the Commission for Social Care Inspection is proportionate in relation to how a home has performed in the past. As Swan Hill House has a consistent history of providing a good service for people this inspection was brief and focused only on a small number of “key” areas of work including some minor shortfalls noted at the last inspection. This inspection took place on the 19th December 2005 over four hours and was as a routine unannounced visit. A full tour of the premises took place and the sampling of residents’ care records was carried out. Five of the staff on duty, nine of the residents and one visitor were spoken to during the course of the morning. What the service does well: What has improved since the last inspection? What they could do better: Record keeping concerning the administration of medication remains an issue requiring attention. There is a potential for mistakes to be made on the MAR sheets due possibly to a printing error by the pharmacy. This could have been Swan Hill House DS0000020728.V267045.R01.S.doc Version 5.1 Page 6 identified earlier by the home, had the misaligned layout been reported by staff or noted by senior staff, and action then taken to rectify the fault. A quality check is needed at the time of receiving medication from the pharmacy to ensure that the sheets are correct in future. 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. Swan Hill House DS0000020728.V267045.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 Swan Hill House DS0000020728.V267045.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): 3 The home has a satisfactory and functional admissions procedure providing an effective needs assessment and suitability evaluation for both privately funded residents and those placed by the local authority. EVIDENCE: All key standards were visited during the previous inspection and confirmed that in all cases, the structure of the home’s plan of care for the daily living of each person forms a natural assessment process to identify their individual needs. This is further complemented in some cases by a community care assessment or a hospital discharge document. However, following informal recommendations for improvement to the review of care needs process, together with the outcomes resulting from the admission to hospital of one resident, a new and more effective system has been introduced. Documentation confirms that this provides a formal way of continually reassessing resident’s health care needs. (See health and personal care section) Swan Hill House DS0000020728.V267045.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, 9 & 10 There is a clear and consistent care planning system in place with a review system to adequately provide staff with the information they require to satisfactorily meet residents’ needs The completion of records for the administration of medication remains unacceptable and could potentially place residents at risk EVIDENCE: Within the care plans inspected there is good evidence of maintained health care for residents with clear notes being kept. A senior staff member spoken with at the previous inspection talked confidently through the process and explained the system of recording changes and performing monthly reviews to ensure that residents’ information is always current. The inspector recommended that some thought be given to developing this process to provide staff with the most current health care information about residents which is easy to read and act upon, particularly during times of illness or concern for their well being. Swan Hill House DS0000020728.V267045.R01.S.doc Version 5.1 Page 10 Recent events have prompted the introduction of a staff observations book, which is a welcomed addition to the home’s documentation. This provides a formal medium for staff to immediately record their observations. Team leaders are then required to record the action to be taken and have the responsibility for its implementation. This is currently being piloted with the intention of introducing staff to the system, stressing its importance and then to develop the practice through the care planning working document. Early indications are positive and records show that residents are clearly benefiting from this action. One resident spoke of coming into the home because she was finding it difficult to cope in her own home and was very complimentary of the service and care that she was receiving at Swan Hill. Two further residents spoken with together said that the staff are kind and helpful and felt that they are treated well and with respect at the home It was reported that all staff involved with the administration of medication have completed a Certificate in the Safe Handling of Medication course. One member of staff is still not completing record sheets correctly at the time of the administration of medication and gaps are being left with no explanation reported. It is noted however that the MAR sheets provided by the pharmacy are not being printed correctly. The dates do not line up with the block areas for signatures and consequently enables the potential for errors to be made. A senior member of staff visited the pharmacy during the inspection, made them aware of their printing error and produced a new sheet correctly aligned. Assurances were given that the sheets will be correct in future. Swan Hill House DS0000020728.V267045.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 Meals at Swan Hill House are of a good homely type offering both choice and variety and catering for special dietary needs. EVIDENCE: The inspector did not join in with the midday meal on this occasion however through observations and talking with residents it was clear that the lunch was wholesome and enjoyable. The menu for the day’s lunch and tea is set out on a board each morning for residents to see. The kitchen was observed to be clean and well organised. The Environmental Health Officer has visited recently and found the provision to be satisfactory. The cook was busy preparing menus and organising the shopping list for the Christmas week, which included providing for those with special dietary needs. A lunch buffet party is being arranged for Christmas Eve and all relatives of residents are invited to attend. The home is also open to visitors throughout Christmas Day, which includes joining their relatives for any of the meals. Residents reported that beverages are available on request and this was seen being put into practice. A preparation area operated by two domestic assistants is provided for this purpose. Swan Hill House DS0000020728.V267045.R01.S.doc Version 5.1 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): 18 The arrangements for the protection of residents from abuse are satisfactory EVIDENCE: There has been one recent incident, referred to the Protection of Vulnerable Adults process, which questioned the level of care afforded to a resident admitted to hospital. It expired that the home was not at fault and that the individual concerned had been cared for appropriately. However, records could have been better and immediate steps were taken by the owner to improve the system. The information to accompany a resident to hospital has been restyled, along side the process for reviewing health care, to ensure that information about residents’ changing needs is always current and well documented. (See health and personal care section) The majority of staff have also completed ‘Protection of Vulnerable adults’ training, which includes ‘training for managers’ by senior staff. Swan Hill House DS0000020728.V267045.R01.S.doc Version 5.1 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): 23 & 26 The home continues to provide a good quality, comfortable and safe environment for those in residence. EVIDENCE: There has been no change in the environment since the last inspection. Residents continue to confirm that they were very comfortable in their rooms and have everything that they need. One resident at the previous inspection requested that her door be ‘wedged’ open due to the hot weather. Another resident at this inspection made a similar request due to him feeling claustrophobic. The home has recognised that this is an ongoing issue for some residents and advice has been sought with regard to fitting devices linked to the fire alarm to enable this to happen in safety. As a result four residents’ doors will shortly be fitted with appropriate magnetic ‘holders’. The home was clean and fresh throughout. Issues around incontinence and unwanted odours are being managed well. A ‘Fresh air’ machine has been Swan Hill House DS0000020728.V267045.R01.S.doc Version 5.1 Page 14 purchased to purify and sanitise the air, which is assisting residents to generally enjoy a pleasant and hygienic environment. Swan Hill House DS0000020728.V267045.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 & 30 There is a stable staff group working positively and enthusiastically to provide the residents with a quality of life that meets their individual requirements and aspirations EVIDENCE: Through conversation and observation it is clear that adequate staff are on duty at all times to meet the needs of the residents. The names of the staff on duty throughout the day are also set out on a board in the reception area. Staff records were not inspected on this occasion however they previously showed that the home’s recruitment procedure is robust in that all the required checks are carried out on each individual before they are allowed to start work with the residents. Staff on duty confirmed that they all attend mandatory training including fire safety, moving and handling, food hygiene and where appropriate the safe handling of medicines. Very good values were demonstrated by staff members whilst assisting residents in their daily activities. Swan Hill House DS0000020728.V267045.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 There is a system in place to safeguard residents’ financial interests EVIDENCE: Residents are able to take advantage of the ‘house bank system’ that is in place at the home. An amount is set aside by Swan Hill and payments are made to residents at their request. A record is kept and monies signed for and the outstanding balances are billed to the family member responsible for managing their money. The system provides a good service to residents without the complexities of handling any individual’s personal finances. Swan Hill House DS0000020728.V267045.R01.S.doc Version 5.1 Page 17 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 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 X X X X 3 X X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X X Swan Hill House DS0000020728.V267045.R01.S.doc Version 5.1 Page 18 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 OP9 Regulation 13.2 Requirement The home is required to ensure that all records for the administration of medication are completed correctly at all times Timescale for action 21/12/05 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 Swan Hill House DS0000020728.V267045.R01.S.doc Version 5.1 Page 19 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 Swan Hill House DS0000020728.V267045.R01.S.doc Version 5.1 Page 20 - 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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