CARE HOMES FOR OLDER PEOPLE
Sheridan Care Home (The) 14 Durlston Road Parkstone Poole Dorset BH14 8PQ Lead Inspector
Trevor Julian & Catherine Churches Unannounced Inspection 20th November 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 Sheridan Care Home (The) DS0000065206.V320881.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 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. Sheridan Care Home (The) DS0000065206.V320881.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Sheridan Care Home (The) Address 14 Durlston Road Parkstone Poole Dorset BH14 8PQ 01202 735674 F/P01202 735674 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) RYSA Ltd Mr Reshad Koussa Care Home 23 Category(ies) of Dementia - over 65 years of age (23), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (23) Sheridan Care Home (The) DS0000065206.V320881.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 9th June 2006 Brief Description of the Service: The Sheridan cares for up to 23 people, who may have dementia or mental health problems, in an attractive converted house. It is set in a residential part of Poole in Lower Parkstone. The home has a large paved car parking area and a garden to the rear. The accommodation for residents in the home is over the ground and 1st floors with a passenger lift between. There are a variety of aids and adaptations around the building to allow residents to move about more independently. There are 19 single rooms and two doubles, fourteen of which have en suite facilities. There are additional communal toilets and bathrooms around the home. In June 2006 the weekly fee levels were between £461-490. Sheridan Care Home (The) DS0000065206.V320881.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The unannounced inspection was carried out by Trevor Julian and Catherine Churches and it took place on Monday 20th November 2006 between 10:00 and 13:00. The purpose of the visit was to monitor standards and to check on progress made with requirements and recommendations from the previous inspection 9th June 2006. Information was gathered through discussion with the residents, staff and Mr Koussa, the home’s manager. Further information was gained through the examination of records and a tour of the premises. What the service does well: What has improved since the last inspection?
This was the inspector’s second visit to the home; both were aware of the efforts of the owners and staff to improve the service and to develop a more person centred approach to the case of people with a diagnosis of Dementia. Sheridan Care Home (The) DS0000065206.V320881.R01.S.doc Version 5.2 Page 6 The care plans showed improvements and the records showed the care tasks completed for the individual residents. The staff were developing methods to encourage and improve the appetites of the residents. Finger foods were available to encourage independence. Improvement had been made to the premises. Lighting in the ground floor hallway had been improved and the heating system upgraded. The external paintwork had been repainted and the windows repaired. Mr Koussa had started to review the qualifications of the overseas staff; as a result, two members of staff were due to start NVQ level 3 in February 2007. Written confirmation of the equivalence of overseas qualifications was being obtained for two members of staff and the deputy manager was in the process of completing NVQ level 4. 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. The summary of this inspection report can be made available in other formats on request. Sheridan Care Home (The) DS0000065206.V320881.R01.S.doc Version 5.2 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 Sheridan Care Home (The) DS0000065206.V320881.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home carries out assessments to ensure that the needs of the prospective resident can be met within the home. EVIDENCE: The files of three residents were examined. One file was for a new resident. Mr Koussa had completed and signed the pre-admission assessment prior to admission. The information provided basic information on the care needs and social history. Sheridan Care Home (The) DS0000065206.V320881.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans were in place to ensure that the staff were aware of how to meet the individual residents’ care needs. The health needs of the residents were met with support from the community healthcare teams. The policies and procedures for administration of medication was managed in such a way as to protect the residents. The residents were treated with dignity to ensure their basic rights were respected. Sheridan Care Home (The) DS0000065206.V320881.R01.S.doc Version 5.2 Page 10 EVIDENCE: In a sample of three files, care plans were in place and these included two with Social Services assessments. There was evidence of agreement with the residents’ representatives. The care plans provided information on how assessed needs were to be met and the recommended topics were covered. Since the last inspection, Mr Koussa had been developing social histories in order to try to develop meaningful activities. The care records showed the tasks undertaken to meet the assessed needs. There was evidence of regular reviews however the changes noted in the reviews were not always transferred to the care plan. On admission the weight charts were set up and recorded monthly thereafter. The files seen showed steady weights. In the file of a resident who had become increasing frail the staff recorded fluid intake. In the daily record there was also evidence of good palliative care. Staff were alert to the risk of pressure ulceration and turning charts had been used. The records showed good communication between the home, local GP surgeries and community nursing teams. The medication in the home was securely stored. The records contained good information on allergies and there were copies of photographs of individual residents in order to help ensure the medication was administered to the correct person. None of the residents managed their own medication. During the visit, a positive rapport was noted between the residents and staff. The staff were seen assisting residents with food and drink in a discreet and supportive manner. Sheridan Care Home (The) DS0000065206.V320881.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The activity programme encouraged the to participate in social activities and helped to promote mental and physical stimulation. The home actively welcomed the involvement of friends and family to maintain residents’ sense of inclusion and involvement. The residents were encouraged to make decisions and choices in order to help maintain as much independence as their circumstances allow. The home was developing menus, including snacks, to improve the diet of residents with poor nutritional. Sheridan Care Home (The) DS0000065206.V320881.R01.S.doc Version 5.2 Page 12 EVIDENCE: During the visit one person told the inspector that the home allowed him a good degree of choice in his daily life, he also commented that other residents needed and received much more help and support from the staff. Residents were encouraged to join in the regular activities in the home; these included move to music, word games, movies, crafts, bingo, sensory sessions; birthday celebrations include a cake to mark the occasion. Communion was offered monthly; there were plans for the Christmas celebrations including a carol concert and a party for residents and visitors. The activity programme and menus were displayed in the dining room. There were photographs around the home of residents enjoying the activities arranged. Mr Koussa had recently attended an international conference on Dementia Care and was looking to develop care within the home and to improve person centred care practice. No visitors were seen in the home during this visit however during the previous inspection people commented that they could visit the home whenever they wished. One person was travelling to attending a funeral for a family member. They were escorted by a member of staff as it was quite a distance. Mr Koussa said there had been no additional charge made for this service. People with dementia often have poor appetites. The home had been trying out ways to improve food intakes. On the day of the visit residents were given potato fritters during the mid morning which appeared to be well received by the residents. Food records were maintained and showed the breakfast, lunch and teatime meals taken. The home had a system for monitoring the residents’ weight monthly. Food stocks were good and the weekly delivery was received during the inspection. Mr Koussa said that perishable items were restocked during the week, as needed. Sheridan Care Home (The) DS0000065206.V320881.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. In order to help to protect the residents the home had openly published procedures for responding to complaints and allegations of abuse. EVIDENCE: The home had a copy of the complaints procedure displayed in the entrance hall it was also seen in the residents’ rooms visited. One resident commented that he was able to raise concerns with the staff. Mr Koussa had recently attended a local authority Adult Protection training event. The home had a policy for responding to signs and allegations of abuse. The whistle blowing policy had been updated to include contact details for the Commission. Sheridan Care Home (The) DS0000065206.V320881.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Improvement to the home had helped to enhance the comfort and safety of the residents. The premises were clean and tidy and there systems in place to manage infection control to help maintain residents’ safety. EVIDENCE: Work had been completed to improve the lighting in the ground floor hallway; as had the remedial work on the central heating. All new radiators had low surface temperatures to reduce the risk of burns; in other rooms visited the radiators had been covered. The external paintwork had been repainted and the windows repaired.
Sheridan Care Home (The) DS0000065206.V320881.R01.S.doc Version 5.2 Page 15 All areas of the home were clean and well presented. The cleaner takes pride in her work and ensures that each room is cleaned daily. Gloves and aprons were in use to assist in infection control. The home had contracts for trade and clinical waste disposal. Sheridan Care Home (The) DS0000065206.V320881.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staffing levels were appropriate to allow the home to meet the needs of the residents. The home had started to develop a training programme to ensure the staff had the required skills. The recruitment procedure helped to ensure the residents were cared for by suitable staff. EVIDENCE: At the time of the visit there were three carers on duty, the deputy manager and a cleaner. The cook was not available and Mr Koussa was making alternative arrangements. At the time of the visit, staffing levels were appropriate to the needs of the residents. Since the last inspection there had been minimal changes to the staffing team, this had improved the consistency and continuity of care. Since the last inspection Mr Koussa had started to ensure that the overseas staff employed in the home had the required level of training. As a result, he
Sheridan Care Home (The) DS0000065206.V320881.R01.S.doc Version 5.2 Page 17 had identified two members of staff to start NVQ 3 in February 2007. The deputy manager was starting NVQ level 4. The previous recommendation is repeated for consideration at future inspections. New staff undergo induction training provided by the local authority with certain aspects covered in house to meet the revised Skills for Care requirements. The file of one new recruit was examined it showed that the Criminal Record Bureau and POVA checks had been obtained. It was noted that there was only one reference on file, Mr Koussa said the second had not been returned in spite of repeat requests; however, these requests were not documented. The home also had a volunteer who assisted in the kitchen on occasion a CRB check had been obtained. Sheridan Care Home (The) DS0000065206.V320881.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a settled management team providing a stable structure and continuity for the residents. The home has a system for seeking the views of the residents and others in order to help run the home in the residents’ best interests. The home protects the residents from financial abuse by not being involved in their financial matters. Safety procedures and systems were in place for the protection of residents, staff and visitors. Sheridan Care Home (The) DS0000065206.V320881.R01.S.doc Version 5.2 Page 19 EVIDENCE: Mr Koussa advised the inspectors that he had nearly completed his NVQ 4 registered managers’ award. His deputy was also completing the award. Since the last inspection he had attended several training events in order to maintain and update his knowledge with best practice ideas for the care of people with a diagnosis of Dementia. Mr and Mrs Koussa have operated the home for a number of years. The home carries out annual quality assurance surveys. The results are contained in a folder in the main hallway along with the resulting development plan. Mr Koussa did not manage the finances for any of the residents any additional expenditure was billed to the person responsible for the individuals’ finances. Fire records showed training, fire precaution and equipment servicing were up to date. The fire risk assessment had been reviewed in July 2005 and Mr Koussa was completing a new revision to incorporate recent changes in legislation. Sheridan Care Home (The) DS0000065206.V320881.R01.S.doc Version 5.2 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 X X 3 X X X 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 2 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 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Sheridan Care Home (The) DS0000065206.V320881.R01.S.doc Version 5.2 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. Standard Regulation Requirement Timescale for action 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. 3. 4. Refer to Standard OP7 OP15 OP28 OP29 Good Practice Recommendations The care plan should be updated once a review has identified changes to care needs. The food records should include any prepared snacks taken by the residents. It is recommended that 50 of care staff have an NVQ qualification in care at level 2 or equivalent, by 2005. The registered person should ensure that where references for new staff are not forthcoming that records are maintained showing the action taken and that alternative sources are considered. Sheridan Care Home (The) DS0000065206.V320881.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Sheridan Care Home (The) DS0000065206.V320881.R01.S.doc Version 5.2 Page 23 - 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!
