Inspection on 13/04/06 for Swan House

This inspection was carried out on 13th April 2006.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Swan House 30/10/08

Swan House 06/11/07

Swan House 06/01/06

Swan House 10/01/05

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Swan House High Street Winslow Bucks MK18 3DR Lead Inspector Mrs Caroline Roberts Unannounced Inspection 13th April 2006 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 Swan House DS0000043246.V288686.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 House DS0000043246.V288686.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Swan House Address High Street Winslow Bucks MK18 3DR 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) 01296 711 400 www.heritagecare.co.uk Heritage Care Mrs Denise M Curtis Care Home 32 Category(ies) of Dementia - over 65 years of age (0), Old age, registration, with number not falling within any other category (0), of places Physical disability over 65 years of age (0) Swan House DS0000043246.V288686.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th January 2006 Brief Description of the Service: Swan House is a care home registered to provide care and accommodation for up to thirty-two service users, sixteen of whom have a diagnosis of dementia. The home is administrated by Heritage Care and is situated in the market town of Winslow in Buckinghamshire. Separately constructed on the same development, as Swan House is Swan Court, a facility for service users who do not require conventional residential care and support but who require a little support to remain independent in their own homes. Swan Court is separately managed to Swan House and the only common denominators between the two buildings being that they share the same provider, garden and that one of the night staff based at Swan House supports Swan Court for some of the night. Swan House is constructed over two storeys and service users live on one of two groups, depending on their specific needs. Both groups are fitted with communal lounges and kitchen/diners. Service users benefit from single room accommodation and these are fitted with en-suite facilities that consist of a walk in shower, toilet and hand washbasin. The home is within a short walk of the high street and there is relatively easy access to the towns of Bletchley, Aylesbury and Buckingham. The manager of Swan House has been in post since June 2004. Fees are 360.85 per week for the residential beds and 441.77 for the dementia care beds. Swan House DS0000043246.V288686.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the summary of the un-announced inspection carried out at Swan House on the 11th of April 2006. The majority of all inspections conducted by The Commission for Social Care Inspection will be unannounced. The lead inspector was Mrs Caroline Roberts. The inspection consisted of meeting with residents, staff and visitors, viewing records and documents pertaining to the provision of care and the running of the home. Evidence gained from this has formed the judgements for this report. The inspector toured the building, gaining permission from a number of residents to enter their bedrooms and viewing a further number from the doorway. The inspector met and discussed the inspection findings with the manager before leaving. The inspector found staff polite, helpful and welcoming, and would like to thank them for their co-operation and assistance throughout the course of the inspection. The inspector would especially like to thank the residents for their time and for allowing the inspector into their home. What the service does well: What has improved since the last inspection? Swan House DS0000043246.V288686.R01.S.doc Version 5.1 Page 6 Previous requirements from the last inspection have been met. The Organisations POVA trainer has developed a questionnaire for all staff to complete as part of the POVA training, 33 staff from the home have received POVA training since November 2006. 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. Swan House DS0000043246.V288686.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 House DS0000043246.V288686.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): 1,3,6 All of the assessments evidenced were completed fully and clearly demonstrated that the home was able to meet the identified needs of the individual prior to admission to the home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Intermediate care is not provided at this service. EVIDENCE: The home have an organisation generated pre admission checklist which is used for all admissions to ensure they can meet the needs of potential residents. A senior member of staff accompanied by a carer undertake the initial assessment and complete the neccesary paperwork. All of the beds in this home are part of a block contract with social services so assessments are conducted after receipt of a care service order/care plan from the allocated care manager. The home uses an initial checklist to ensure that prospective residents are given information about the home and that a keyworker is allocated to meet the individual upon arrival into the home. Swan House DS0000043246.V288686.R01.S.doc Version 5.1 Page 9 The pre-admission records were evidenced for 3 residents as part of the case tracking process. The personal history in each case tracked gave an insight into the past lifestyle of the resident. One resident confirmed that she had been given information about the home, which she found very informative. Swan House DS0000043246.V288686.R01.S.doc Version 5.1 Page 10 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 Care plans, healthcare and medication administration is efficently managed to ensure that the needs of residents are met. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home use an organisation generated care planning system, the standard of information within 3 of the care plans viewed was very good and clearly identified indivdual needs with action plans in place. The fourth care plan was for a resident who was admitted into the home 3 weeks prior to the inspection, it was disapointing to note that the care plan was still blank and the only information about the resident was the pre-admission assessment and care plan from the care manager. Residents and relatives are involved in the initial care planning stage. Residents spoken with said that their care needs are met and in ways they like. The home have a good relationship with visiting healthcare professionals and are fortunate to have the local doctors surgery just around the corner this is the only one in the village of Winslow and all of the residents are registered with this service, the doctor visits the home every Thursday for a routine surgery and as and when needed. The manager stated that the home have a Swan House DS0000043246.V288686.R01.S.doc Version 5.1 Page 11 very good relationship with the District Nurses who provide medical support to many of the residents in the home. Health and medical intervention sheets detail any visits regarding healthcare. Medication is well managed, with training provided for all staff prior to being allowed to take part in the medication administration process. Medication for the majority of residents is administered by staff and part of the lunchtime administration was observed. The case tracked residents Medication Administration Records (MAR) were correctly completed, no gaps and clear identification of medication that was given when required. All medications were stored in locked trolleys on the groups, with a treatment room provided downstairs. A reccomendation is served that each trolley is secured to the wall via the provided chain when not in use. Observation and comments made provide evidence that residents are afforded with privacy, dignity and respect. Swan House DS0000043246.V288686.R01.S.doc Version 5.1 Page 12 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, Residents interests and previous lifestyle are taken into consideration when developing care packages and contact with family and friends is encouraged. The food is well presented and appeared appetising and nutritious. Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: The home employs a dedicated activities organiser for 25 hours per week. A structured programme of activites is being formulated by the relatively new activities organiser, meetings are being arranged to include the views and wishes of the residents. Church services are aranged via the local church. Routines in the home are arranged around residents needs as much as possible. The home do not have restrictions on visiting hours, except visiting during the night would need to be pre-arranged and under exceptional circumstances. Family and friends can meet in residents own bedrooms or one of the lounges, family can stay for meals with prior arrangement. Residents and families are encouraged to manage their own finances, although the home do offer residents access to the resisdents saving scheme for small Swan House DS0000043246.V288686.R01.S.doc Version 5.1 Page 13 amounts of personal finance, for which procedures are followed including clear documentation and receipts for all expenditure. Most of the bedrooms in the home show that residents are able to bring items of their own furniture to personalise their rooms. Residents are involved in the care planning process. The home has 1 dining area on each of the groups both of which are pleasently decorated and offer ample room for the residents to ejoy the meal in a congenial setting. Meals can be taken in the residents own bedroom if wished. 3 cooked meals a day are offered with drinks readily made available. Menus are varied and reflective of the season. Swan House DS0000043246.V288686.R01.S.doc Version 5.1 Page 14 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 operates a transparent approach towards complaint investigation, the manager has a good knowledge of POVA procedures and has ensured that all staff have attended POVA awareness training. Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: No complaints have been received directly to CSCI about the service. One complaint has been received by the home in the period under review (3 months) Complaints are logged by the home and investigated fully with records maintained as was evidenced in viewing the one complaint received. The Complaints policy is available to residents and relatives. Monitoring of any complaints is conducted by the regional manager with a return sent to head office quartelty detailing any complaints made and action taken as a result. Local adult protection polices are in place and made available to staff. Heritage Care appointed its own POVA trainer in 2005 who is responsible for facilitiating this training across all of the homes. A requirement was served at the last inspection that all staff should receive this training, it has been confirmed that this has been done, since November 2005 a total of 33 staff have received this training, staff spoken with understood the meaning of POVA however, would benefit from having their roles clarified with regards to any investigation needed as a result of a POVA referrall. Swan House DS0000043246.V288686.R01.S.doc Version 5.1 Page 15 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 Residents live in a safe and very well maintained environment. Qulaity in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: Swan House is located on the High street in Winslow, with easy access to the local shops. The home was re-built 3 years ago and was constructed over two floors, the home consists of two groups both of which have 16 en-suited bedrooms a lounge diner/kitchenette and assisted bathrooms. Decor and soft furnishings, carpet and furniture throughout the home were of a good standard. Lighting is domestic in style. The homes laundry is situated on the first floor and is fitted with two industrial washing machines, which are fitted with sluicing facilities and two tumble dryers. The home has an infection control policy and training records evidenced that all staff receive training in personal care and infection control. The home uses the red bag system for segregating soiled and infected laundry. Swan House DS0000043246.V288686.R01.S.doc Version 5.1 Page 16 During the course of the inspection the home was free from offensive odours. Cleanliness throughout the home is of an exemlary standard. Swan House DS0000043246.V288686.R01.S.doc Version 5.1 Page 17 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 Staff are trained and competent and residents are in safe hands with suitable staff recruited. The staffing levels on the day of inspection were appropriate for the assessed needs of residents. Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: Staffing levels consist of two staff on the frail elderly group and three staff on the dementia care group plus a duty team leader throughout the waking day. At night between 9.30pm and 7.30 am the home have four waking nightstaff. Heritage Care provide extensive training for its staff, ensuring that mandatory training is completed by all staff. Evidence of this was seen during examination of the homes training logs and confirmation from staff. The foundation induction booklet is linked to TOPPS and organisation generated one completed induction booklet was seen for a newer member of staff. All of the Heritage Care homes in Buckinghamshire have access to a recruitment co-ordinator to assist with all recruitment issues. The files of 3 recently recruited staff members were examined and found to contain a completed application form, 2 references, CRB disclosure acknowledgement, proof of identity and copy of contract/terms and conditions. Swan House DS0000043246.V288686.R01.S.doc Version 5.1 Page 18 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 The home is well managed by an individual competent and experienced to run the home. Effective quality assurance aids the manager in the development of the home. Health and safety procedures in the home are well managed. Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: The manager is experienced in the management of services for older people she has worked in the social care sector for 24 years and previously was the deputy manager of swan house. Throughout the inspection process she was clearly able to demonstrate her knowledge of the client group. An organisational quality assurance tool is used in the home, this is conducted by other managers within Heritage Care, the action plan following the last quality assurance audit was viewed and a letter to residents and families from Swan House DS0000043246.V288686.R01.S.doc Version 5.1 Page 19 the Director of Older Peoples Services thanking them for their assistance with the audit and reporting back the strenghts and weaknesses of the service. The homes financial system is computerised with manual records maintained. The home retains all records of expenditure including reconciliation accounts. Service agreements are in place for safety testing of lifts, hoists, bath hoists, fire alarms, fire equipment, and electrical items for which records are maintained by the manager these include periodic internal Health & Safety checks of the home. Swan House DS0000043246.V288686.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 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 3 X 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Swan House DS0000043246.V288686.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? No 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 OP7 Regulation 15(1) Requirement The manager is required to ensure that all new residents care plans are developed immediately following admission and ongoing. Timescale for action 14/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard 9 Good Practice Recommendations The medication trolleys when not in use are secured to the wall using the chains provided. 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