Inspection on 29/11/05 for Sylvan House

This inspection was carried out on 29th 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 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

Sylvan House 09/02/10

Sylvan House 10/11/09

Sylvan House 09/06/09

Sylvan House 03/06/08

Sylvan House 25/10/07

Sylvan House 25/05/06

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Sylvan House 2 - 4 Moss Grove Prenton Wirral CH42 9LD Lead Inspector Les Hill Announced Inspection 29th November 2005 09:15 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 Sylvan House DS0000064575.V263197.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. Sylvan House DS0000064575.V263197.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Sylvan House Address 2 - 4 Moss Grove Prenton Wirral CH42 9LD 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) 0151 608 1401 Prime Care (UK) Ltd Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22) of places Sylvan House DS0000064575.V263197.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th July 2005 Brief Description of the Service: Sylvan House is a large converted property situated in the Prenton area of Birkenhead, Wirral. It is close to local shops and bus routes to towns on the Wirral and to Liverpool. The home offers care and support to 22 residents who are over the age of 65years. Accommodation is provided on two floors with passenger lift and stair access. The home has a number of shared bedrooms. On the ground floor there are two sitting areas and a separate dining room, some bedrooms, an adapted bathroom and WC’s. Outside the home there are garden areas and some parking spaces. Adaptations to assist residents who have a disability are in place. Basement areas in the home are used for the office, a staff room, laundry, the boiler and storage. Prime Care UK Ltd bought the home on 12th August 2005. The new homeowner has begun the process of improving assessment and care planning arrangements and has undertaken some refurbishment of the premises. Further improvements are planned. Sylvan House DS0000064575.V263197.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection of Sylvan House was undertaken on Tuesday 29th November 2005 over a period of 4 hours. It involved the examination of records, a tour of the building, meeting with the homeowner and manager and talking with 10 residents and two visitors. The inspection was part of the Commission’s responsibility to visit and report on each registered care home on two occasions each year. What the service does well: What has improved since the last inspection? What they could do better: A requirement has been made for the home’s manager to register with CSCI. Recommendations have been made to support the continued development of assessments, care plans and risk assessments. Developments in staff training opportunities have been explored by the new owners and are supported trough recommendations by the inspector. Additionally the opportunity for staff to receive one-to-one professional supervision is raised in the report. Sylvan House DS0000064575.V263197.R01.S.doc Version 5.0 Page 6 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. Sylvan House DS0000064575.V263197.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Sylvan House DS0000064575.V263197.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5 and 6 Prospective residents have the information they need to make an informed choice about the home. Work had begun to improve the pre-admission assessment processes. EVIDENCE: The new homeowner and the manager have produced a statement of purpose and a service users guide that contain all the matters identified in Schedule 1 and standard 1.2 of the National Minimum Standards, Care Homes for Older People. The home has admitted one resident since the new owners took over the home in August 2005 and a contract/terms and conditions of residency is in place. The homeowner was advised that he should issue all of the residents with a new contract to confirm their terms and conditions of residency with Prime Care UK Ltd. The home’s manager is in the process of introducing new assessment and care planning documentation into the home. The procedures are to be refined but it Sylvan House DS0000064575.V263197.R01.S.doc Version 5.0 Page 9 was evident that an assessment had been completed in conjunction with the new resident. Once the manager is comfortable with the process she intends to carry out a new assessment on all of the residents in Sylvan House using the same documentation. The inspector spent some time talking with residents and with some visitors to the home. All of them were complimentary about the care and support provided at Sylvan House. Improvements to the assessment and care planning documentation and to other records in the home will support the home’s statement of purpose. The inspector was satisfied that the home is able to meet the needs of all residents currently living in Sylvan House. The new manager encourages prospective residents and their families to visit the home and to spend time there before making a decision to move in. The homeowner also supports the opportunity for residents to live in the home for a while before they decide to stay. The home is not contracted to provide Intermediate Care. Sylvan House DS0000064575.V263197.R01.S.doc Version 5.0 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 and 11 Improvements are being made to the written care plans and risk assessments. The health care needs of residents were given appropriate priority. EVIDENCE: In spite of requirements to improve the quality of assessment and care planning documentation, the previous owners of Sylvan House had not managed to produce a clear and supportive system to help staff in their dayto-day work with residents. The new manager has begun the process of building upon assessments (identified in standard 3) to produce more detailed care plans that include information about needs and the ways in which they should be supported, for the new resident admitted to the home. Early observations suggest that with some more detailed recording, the documents will become a working tool for staff. It will be important to ensure that any potential risks are identified and that detailed risk assessments are included with the care plan. However, the inspector was confident that a committed staff team was providing intuitive care and support. All of the residents are listed with a GP practice and receive support from the district nursing service when this is necessary. The home has links with a local Sylvan House DS0000064575.V263197.R01.S.doc Version 5.0 Page 11 dentist and optician and uses the advice and support of the continence adviser when appropriate. A chiropodist visits every six weeks or so and residents can receive foot care for which there is a small charge. None of the residents has a pressure sore. The home is receiving good advice and support from a local pharmacist who provides tablets in “blister” packs. He has also provided training for staff in the management of medicines. A sample check of the medicines kept at the home was undertaken during the inspection and confirmed that on the whole they were being managed effectively. The only matter that was brought to the attention of the manager was the need for a proper “Controlled Drugs” cabinet to be provided, that meets with the requirements for safe practice and is permanently fixed to the wall. Some of the residents are able to manage their own medicines. A risk assessment was in place but needed to contain more detailed information to confirm the resident’s ability to manage the medicines and the provision for safe storage within the resident’s own room. From observations of staff working with residents, from discussion with staff, residents and relatives the inspector was satisfied that the privacy and dignity of residents is supported and that they are treated with respect. Staff knocked on bedroom doors and waited for a reply before entering and shared bedrooms had curtain screening to assist privacy. The manager had discussed with the new resident/their relative what should happen at the time of death and this was recorded on the resident’s care file. Sylvan House DS0000064575.V263197.R01.S.doc Version 5.0 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 and 15. Residents are able to make decisions about their everyday lives and are supported to maintain social interests. EVIDENCE: Two of the residents are able to go out from the home and relatives or friends take others out from time to time. All of the residents are encouraged to make decisions about their own lives. They can choose when to get up and what time they go to bed, whether to spend time in their own room or in one of the communal rooms in the home and they have a choice of food at mealtimes. The home is equipped withy TV and radio/music systems and has a range of board games that residents can use. One of the care staff is particularly interested in arranging activities and takes the lead in setting up Bingo, foot spa and “beauty” sessions, periods of light exercise and other parties, outings or games. The home has links with a local library and a selection of books, many in large print, are changed on a regular basis. Most of the residents have a TV in their own bedroom. Visitors are welcomed at any time and residents can meet with them in their own room or in one of the communal spaces around the home. Sylvan House DS0000064575.V263197.R01.S.doc Version 5.0 Page 13 The chef maintains high levels of cleanliness in the kitchen and prepares a range of meals including special diets. Residents have a choice of cooked or plain breakfasts, a cooked or cold midday meals and a cooked or cold teatime meals. The home’s menu identifies a range of different foods that should appeal to older people. However in discussion with residents and in feedback on pre-inspection questionnaires a number of residents indicated some dissatisfaction with the food. The homeowner and the manager agreed to meet with the residents to explore their concerns about the food and to make any arrangements necessary to ensure improved levels of satisfaction. Sylvan House DS0000064575.V263197.R01.S.doc Version 5.0 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, 17, 18 and 19 The new homeowner is open to receive concerns and complaints. Training in adult protection is essential for the manager and staff. EVIDENCE: The home has a complaints policy and procedures in place that comply with the principles of good practice. No formal complaints have been lodged with the home or with CSCI since the inspection in July 2005. All of the residents are included on the Electoral Register and have the opportunity to vote in national and local elections. The home has policies and procedures in place to protect residents from abuse and encourages staff to raise any concerns about the vulnerability of residents in the home. The previous inspection report identified that staff had not been provided with any relevant training in adult protection matters. The new homeowner and the manager are to attend a POVA training event and the manager has arranged for staff to receive formal training in adult protection and other matters but some of this may be early in the New Year. Sylvan House DS0000064575.V263197.R01.S.doc Version 5.0 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, 20, 21, 22, 23, 24, 25 and 26. Residents live in a safe and well-maintained environment. EVIDENCE: Sylvan House is a converted property with a small purpose built extension. It is situated in a quiet road in a residential area of Prenton, Wirral. The home is generally well maintained but the new owner has plans, in the short term, to improve the decoration and replace some of the furnishings. Work has already commenced with the redecoration of the dining room and the replacement of curtains in the lounge. The large lounge is separated into two sitting areas each with a TV. It looks over the front of the home and is close to the dining room and to WC’s. A smaller quiet lounge is located in the extension to the main building and holds the library books but the room is rarely used unless residents have visitors and choose to remain downstairs. Sylvan House DS0000064575.V263197.R01.S.doc Version 5.0 Page 16 Resident’s bedrooms are light and airy and furnished in a domestic style. Some redecoration of bedrooms has also begun. Adequate storage is available for residents clothing and most have chosen to fill their rooms with cherished possessions. Residents can choose to hold a key to their own bedroom. Each of the residents has a lockable drawer in which they can keep personal items of value. In double rooms, curtain screening is provided for privacy. The home is centrally heated throughout and individual radiators have thermostats. A number of radiators are not protected to prevent residents from resting against the hot surface. However, the new homeowner is in the process of purchasing appropriate protective casings. A new central heating boiler has been installed. Aids and equipment to assist residents with a disability are provided. There is ramped access to the front door of the home and two of the bathrooms are fitted with a bath hoist. Laundry facilities are located in the basement and the washing machines are fitted with an appropriate sluice facility. Policies and procedures are in place around infection control. On the day of this inspection the home was clean and there were no offensive odours anywhere in the building. Sylvan House DS0000064575.V263197.R01.S.doc Version 5.0 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 and 30 Staffing levels are adequate for the current group of residents. Improvements have been made to the staff recruitment and selection procedures. EVIDENCE: The home is staffed by 2 carers with the manager until 5.00pm Monday to Friday and by two carers in the evenings and at weekends. At night there is one wakeful member of staff and one member of staff sleeping in, and “on call”. Ancillary staff are employed to carry out domestic, cooking and maintenance tasks. Because many of the residents are self-caring or require minimal assistance, the staffing levels are adequate, however, the homeowner will need to ensure that staffing levels are kept under review. The home employs 11 care staff excluding the manager. Of these 3 have an award at NVQ level 2 or above in care and a further 4 staff are working towards the award at NVQ level 2. The inspector sampled three staff files. The new homeowner had made improvements to the recruitment and selection procedures and the files for new employees contained al the required information. Confirmation of CRB and POVA clearances was in place for all staff. Sylvan House DS0000064575.V263197.R01.S.doc Version 5.0 Page 18 Induction training within the home was being recorded and the home’s manager has been in contact with training organisations to provide a range of basic and further development training opportunities for staff. Copies of certificates gained through training were evidences on some of the files. Sylvan House DS0000064575.V263197.R01.S.doc Version 5.0 Page 19 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, 32, 33, 34, 35, 36, 37 and 38. Sylvan House is run in the best interests of residents. EVIDENCE: The new homeowner has appointed a manager to run the home but an application for her to be registered has not yet been forwarded to CSCI. The previous owners had lived on site and had developed a strong relationship with all of the residents. The new owners and manager took over in August 2005 and are working hard to build up confidence and trust with the resident group. Residents and relatives who spoke with the inspector said that they missed the previous owner but were pleased with the ways in which the new owner and manager were providing their support. It was clear from discussions with the homeowner and manager that they are keen to ensure residents are given choices and that they feel able to raise any Sylvan House DS0000064575.V263197.R01.S.doc Version 5.0 Page 20 concerns. The manager had attempted to hold a resident’s meeting but only one resident had indicated a willingness to participate. They assured the inspector that they would continue to involve residents in decisions about the day-to-day events in the home. The new owners had provided CSCI with information about the company’s finances prior to registration in August 2005. All matters were in good order. The manager holds personal allowances for three residents. Records identifying deposits and spend were examined and found to be in order. Receipts or resident’s signatures were being obtained appropriately. Professional staff supervision has been introduced to the home but is in its early stages. The fire alarm system is checked weekly and following a fire safety check, 20 new smoke detectors and 5 new heat detectors were fitted. The new homeowner has introduced his own polices and procedures some of which will be examined in more detail at the next inspection. A tour of the building confirmed that safe working practices were being observed and records were being kept to confirm that equipment was being serviced on a regular basis. Sylvan House DS0000064575.V263197.R01.S.doc Version 5.0 Page 21 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 3 2 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 3 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 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 3 3 2 3 3 Sylvan House DS0000064575.V263197.R01.S.doc Version 5.0 Page 22 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 OP31 Regulation 9 Requirement The registered provider must ensure that the person appointed to manage the home is registered with the Commission for Social Care Inspection Timescale for action 28/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP3 OP7OP9 Good Practice Recommendations The manager should develop and improve the assessments of residents admitted to the home. The manager should ensure that the work to develop care plans is progressed and that risk assessments are completed in detail for all areas where a risk is identified. Risk assessments for residents who self-medicate should include environmental factors and the safety of other residents. An approved “Controlled Drugs” cabinet should be provided and fitted according to instructions. Training should be provided for staff to ensure they have basic and continuing instruction in all matters relevant to their work with older people. DS0000064575.V263197.R01.S.doc Version 5.0 Page 23 3 4 OP9 OP30 Sylvan House 5 OP36 The recently introduced staff supervision arrangements should ensure that all staff are provided with one-to-one meetings with the manager or a senior member of staff not less than six times each year. Sylvan House DS0000064575.V263197.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 Sylvan House DS0000064575.V263197.R01.S.doc Version 5.0 Page 25 - 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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