Inspection on 17/01/07 for Sylvandale

This inspection was carried out on 17th January 2007.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Sylvandale 14/09/07

Sylvandale 15/02/06

Sylvandale 20/10/05

Sylvandale 07/03/05

Sylvandale 24/01/05

Sylvandale 17/02/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Sylvandale 191 Spital Road Bromborough Wirral CH42 2AF Lead Inspector June Beaver Key Unannounced Inspection 17th January 2007 11:00a Sylvandale DS0000035841.V308734.R01.S.doc Version 5.2 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 Sylvandale DS0000035841.V308734.R01.S.doc Version 5.2 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. Sylvandale DS0000035841.V308734.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sylvandale Address 191 Spital Road Bromborough Wirral CH42 2AF 0151 334 0142 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) suesimpsonwirral.gov.co.uk Metropolitan Borough of Wirral Susan Lovato (registration pending) Care Home 23 Category(ies) of Learning disability (23) registration, with number of places Sylvandale DS0000035841.V308734.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. To accommodate 5 (five) named people over the age of 65 in the category of Learning Disability (LD). 15th February 2006 Date of last inspection Brief Description of the Service: Sylvandale is a purpose built unit, owned and managed by Wirral Social Services. The unit was opened in 1986 to accommodate up to 24 residents with a learning disability. The unit is located in a residential area and is within a 15-minute walk of Bromborough village, which has a range of facilities including a Post Office, banks, shops, pubs and other town amenities. The home is also easily accessible by bus and train. The accommodation at Sylvandale is provided in four units. Each of the units have their own kitchen/dining area, lounge and all bedrooms are single occupancy. At present the home provides accommodation for 22 residents. Sylvandale DS0000035841.V308734.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced site visit to the premises which lasted approximately 5 hours and was part of a key inspection. During the visit three service users were spoken to as well as four members of staff. The Manager prior to the visit completed a pre-inspection questionnaire and the information it contained was verified on the day by looking at the records and documentation available at the home. There were some requirements and recommendations made during this visit which relate to documentation and the premises. What the service does well: What has improved since the last inspection? What they could do better: Service users files from each of the four units were examined. Some of the care plans in each file were very well documented and some of them needed updating. The information in them varied, some were brief others contained a lot of relevant information. A requirement has been made at the end of this report to make sure all care plans contain relevant up to date information about service users needs. Some areas of the home are in need of redecoration and refurbishment especially in Poppy House. The grounds are also in need of a tidy up as there were parts that were overgrown and covered with leaves and weeds. Sylvandale DS0000035841.V308734.R01.S.doc Version 5.2 Page 6 The staffing levels are high however there is a heavy reliance on agency staff. Where possible the home will use the same agency and staff that know the service users however it can be unsettling for service users not to have a stable workforce. 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. Sylvandale DS0000035841.V308734.R01.S.doc Version 5.2 Page 7 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 Sylvandale DS0000035841.V308734.R01.S.doc Version 5.2 Page 8 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): 1, 2 and 4. Quality in this outcome area is good. This judgement has been made using all available evidence including a visit to the service. The Statement of Purpose and service user guide contained sufficient information to enable service users and their families to make an informed choice regarding the suitability of the service. EVIDENCE: The Statement of Purpose and Service User Guide are very detailed and informative and give prospective service users and/or their relatives a good overview of the home, the accommodation, the staff and qualifications, the meals, social activities, contact numbers for the registered owners and what to do if there are any concerns/complaints about the service. A comprehensive and detailed pre-admission assessment process is in place. The homes manager carries out assessments once a referral has been made by social services. Mental health, cognitive abilities and compatibility with existing residents are included in the assessment. Staff members have substantial experience in communicating in various ways including makaton and other picture based communications. Admission is needs led and both parties are given time to settle and adjust before making any commitment. Service users are offered the opportunity of Sylvandale DS0000035841.V308734.R01.S.doc Version 5.2 Page 9 test driving the home prior to commitment and can visit the service as often as they need before making up their mind whether it is the right place for them or not. All service users have contracts on file signed by relevant parties giving clear details of the terms and conditions of residency. Sylvandale DS0000035841.V308734.R01.S.doc Version 5.2 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, 7 and 9. Quality in this outcome area is adequate. This judgement has been made using all available evidence including a visit to the service. Care planning and reviews are not always done consistently. Staff in the care home encourage service users to follow an independent lifestyle which includes making decisions and taking responsible risks. EVIDENCE: Service users files from each of the four units were examined. Some of the care plans in each file were very well documented and some of them needed updating. The information in them varied, some were brief others contained a lot of relevant information. A requirement has been made at the end of this report to make sure all care plans contain relevant up to date information about service users needs. All service users have a health passport which contains relevant medical information and accompanies service users when keeping an external appointment. Several files examined had not been updated in respect of visits Sylvandale DS0000035841.V308734.R01.S.doc Version 5.2 Page 11 by specialist staff and basic observations such as weights. A requirement has been made at the end of this report to make sure all service users documentation is consistent and up to date. A requirement has been made at the end of this report to make sure all service users documentation is consistent and up to date. The majority of service users at Sylvandale have been there a long time and it was clearly evident that staff have the knowledge/information to provide the assistance and communication skills required to support residents to do their own shopping for clothes, items for their rooms and other articles. Discussion took place regarding the suitability of the home for one of the service users as the Manager had asked for a review of his placement. Arrangements have been made to find a more suitable placement as his needs have changed and he requires nursing care in the meantime this service user is having one to one supervision throughout the day to make sure all of his needs are met and he is supported by the community nurses. Sylvandale DS0000035841.V308734.R01.S.doc Version 5.2 Page 12 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): 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using all the available evidence including a visit to the service. Service users are encouraged to make choices and decisions for themselves and are able to enjoy a stimulating lifestyle with a variety of activities. Service users are encouraged to use local amenities and services and are provided with the opportunity to engage in leisure activities outside the home. EVIDENCE: The majority of residents attend various day centres on a full or part-time basis. Service users regularly visit local café’s and pubs accompanied by staff. The service users are well accepted in the local community and staff talked to on the day of the visit stated that they have never come across a problem or any sort of hostility towards their clients. Home skills are encouraged e.g. washing and feeding and an individual home skills plan is detailed in the individual care plan. All the units are equipped with a kitchen and basic facilities and kitchen skills are encouraged subject to appropriate risk assessments. Sylvandale DS0000035841.V308734.R01.S.doc Version 5.2 Page 13 The home has an activities room which contains a snooker table, games and a television. The room however is in need of some refurbishment as it appeared quite bare and not user friendly. The Manager stated that she would like the room divided as currently service users who wish to watch the T.V. in this room are disturbed by the noise from the snooker table. On the day of the site visit most of the service users had gone out to either one of the day centres or on an activity with members of staff therefore it was not possible to view a meal. Through looking at the menus and talking to service users and staff, evidence was provided that a lot of thought is given to nutrition and service users are supplied with a varied diet that included fresh fruit and vegetables. Friends and family can visit when they wish and on the day of the site visit some service users had visitors who spoke well of the care their relatives received and spoke highly about the care staff. Sylvandale DS0000035841.V308734.R01.S.doc Version 5.2 Page 14 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 and 20. Quality in this outcome area is good. This judgement has been made using all available evidence including a visit to the service. Service users physical and emotional health needs are fully met in a flexible and sensitive way that maximises resident’s privacy, dignity and independence. Medication management is in accordance with current good practice guidelines and helps safeguard the service users. EVIDENCE: The majority of service users require assistance with personal care in varying degrees. Documented daily routines and diary sheets clearly evidence the individualised nature of personal care given. The Manager and staff confirmed the fact that the home has a good relationship with G.P.’s and the community nurses and other health care professionals will visit as and when required. Visits by doctors and members of the multidisciplinary care team are recorded in the care plans. A staff member will accompany service users to hospital appointments if their relatives agree. Sylvandale DS0000035841.V308734.R01.S.doc Version 5.2 Page 15 There have been changes to the medication practices since the last inspection to ensure all medication is given safely and recorded correctly. The home now uses a pharmacist who is familiar with the service users needs and is very proactive within the Primary Care Trust. On the day of the site visit, the pharmacist was in a meeting with the Manager and Service Manager to discuss the best way of using “homily medicines” such as paracetamol or cough linctus to avoid over prescribing but ensure there was enough stock for when needed. Two members of staff administer medication in all of the four units. The medication administration records for each service user contain signed consent forms and their photograph for identification purposes. Information supplied by the community nurses regarding giving some “occasional use” medication was also kept in the file. There is a safe return of medication procedure in place so that there is no unwanted medication kept on the premises. The pharmacy driver who collects the unused medicines signs the returns book. As many of the service users attend day centres, separate packs of medicines are ordered that contain sufficient medication to last the day without them having to take their monthly supply out of the home. There is also a good home leave system in operation which again ensures sufficient stocks are always left in Sylvandale. Sylvandale DS0000035841.V308734.R01.S.doc Version 5.2 Page 16 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 and 23. Quality in this outcome area is good. This judgement has been made using all available evidence and by a visit to the service. Sylvandale has a satisfactory complaints system and policies in place to help ensure that residents are protected from harm or abuse. EVIDENCE: There have been no complaints since the last inspection. The complaints leaflet provided for service users was in picture format and “easy read” writing. The leaflet contains pictures of either a sad or happy faces and yes or no tick boxes. Questions such as “has this upset you” relating to pictures showing noise, meals, money or somebody getting hit were shown. The Manager stated that any complaints would be treated seriously, however where possible the home would try to resolve any issues locally before proceeding to a more formal level. Staff are given training during their induction programme on adult protection issues to ensure that they recognise the different forms of abuse. There are no outstanding adult protection issues at the home. Sylvandale DS0000035841.V308734.R01.S.doc Version 5.2 Page 17 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 and 30. Quality in this outcome area is poor. This judgement has been made using all available evidence including a visit to the home. The standard of décor and furnishings is poor in some areas of the building and is not conducive to a homely, comfortable and safe environment. EVIDENCE: The home is comprised of four units which share a common courtyard. On the day of inspection the area of the courtyard was very untidy with overgrown weeds and dead leaves which may represent a slip hazard should service users go outside. The standard of furnishings and decoration in resident’s bedrooms was varied. Due to behavioural issues some rooms are decorated and furnished to a basic standard whilst others are highly personalised with linen and soft furnishings chosen by the residents themselves. The decoration in general throughout the home is looking tired and worn and the home would benefit from a significant redecoration programme. Sylvandale DS0000035841.V308734.R01.S.doc Version 5.2 Page 18 The Manager stated that a mini refurbishment programme had been promised by Wirral Social Services Estates Department but had not been informed what this entailed. Poppy House was particularly in need of some redecoration and refurbishment work as the communal rooms, the service users bedrooms and the kitchen were in a poor state. It is important that service users surroundings and living space are homely and well maintained. The service is required to ensure that a programme of refurbishment is commenced within the timescales given at the end of this report. Sylvandale DS0000035841.V308734.R01.S.doc Version 5.2 Page 19 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 and 35. Quality in this outcome area is good. This judgement has been made using all available evidence including a visit to the service. There are sufficient numbers of competent, qualified staff to support and meet the needs of residents. EVIDENCE: Individual staff files were seen and contained the information required to ensure that all staff are thoroughly vetted before employment. CRB check reports are sent directly to the Wirral Social Services Personnel Department who then write and inform the registered manager. A copy of this letter is kept on the individual staff file. The present staffing levels ensure service user needs are met and that their lifestyles and social activities are promoted however there is a considerable reliance on agency staff due to staff sickness. The Manager states the home recognises the problem and there is to be a work force review in the near future. The home provides staff with a wide range of appropriate training which includes NVQ training (National Vocational Qualification) to level 2 & 3. There are fifteen staff members who have completed an NVQ 2 course with a further Sylvandale DS0000035841.V308734.R01.S.doc Version 5.2 Page 20 six staff members nearing completion. Two members of staff have level 3 with 3 others doing the course. One of the team leaders has finished a level 4 course (NVQ) and another has started it. All staff are given regularly one to one supervision and a record kept of each session. Sylvandale DS0000035841.V308734.R01.S.doc Version 5.2 Page 21 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, 39 and 42. Quality in this outcome area is good. This judgement has been made using all available evidence including a visit to the service. The Manager is competent and has the skills necessary to manage the home in an efficient manner whilst developing good working relationships with staff, visitors and the service users. EVIDENCE: The Manager has been in post since November 2006. She has a great deal of experience in caring for service as she has a nursing background. She also has a social work qualification and has been registered as a manager for the Commission for Social Care Inspection for nine years in a residential care home for older people. An application to register as manager for this home is pending. Staff spoken to during the inspection spoke well of the style of management in evidence at the home and stated that the Manager was very supportive. On Sylvandale DS0000035841.V308734.R01.S.doc Version 5.2 Page 22 the day of the visit the interaction between the Manager and the service users was observed to be very relaxed and natural. There was evidence that staff meetings take place giving staff the opportunity to raise any matters regarding the running of the home and there was evidence that service users’ and their families were given questionnaires asking them for their opinion on the standards at the home. The service is supported by a Service Manager who visits monthly and send a copy of the monthly audits to the Commission for Social Care Inspection. The certificates of worthiness required by registration for gas, fire equipment, water temperature, hoist and lifts were available and up to date. The portable appliance testing had not been done and the electrics service was overdue. The weekly fire alarm tests had not been done consistently. A requirement has been made to make sure all health and safety tests are carried out regularly and any problems dealt with to make sure service users are not put at any risk. A random check of the service users personal allowance was carried out and found to be correct. The home does not hold a lot of money for service users as this is held in their accounts with Social Services and can be accessed at any time. Sylvandale DS0000035841.V308734.R01.S.doc Version 5.2 Page 23 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 3 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 3 ENVIRONMENT Standard No Score 24 2 25 x 26 x 27 x 28 x 29 x 30 2 STAFFING Standard No Score 31 x 32 3 33 2 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 2 x Sylvandale DS0000035841.V308734.R01.S.doc Version 5.2 Page 24 YES 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 YA6 Regulation 15(2) Requirement The registered manager must ensure that all care plans are reviewed regularly and kept up to date The registered person must ensure that all parts of the home are kept clean and reasonably decorated The registered person must ensure that a programme of maintenance and refurbishment is produced and implemented. The registered person must ensure that all health and safety checks are carried out in accordance with Schedule 3 of the Care Home Regulations. Timescale for action 31/03/07 2. YA24 23(2)(d) 30/04/07 3. YA24 23(2)(d) 30/04/07 4. YA41 17(3)(b) 31/03/07 Sylvandale DS0000035841.V308734.R01.S.doc Version 5.2 Page 25 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 Sylvandale DS0000035841.V308734.R01.S.doc Version 5.2 Page 26 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 Sylvandale DS0000035841.V308734.R01.S.doc Version 5.2 Page 27 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!