Inspection on 06/03/07 for The Shrublands Centre

This inspection was carried out on 6th March 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 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

The Shrublands Centre 19/11/09

The Shrublands Centre 09/10/09

The Shrublands Centre 27/09/07

The Shrublands Centre 19/10/05

The Shrublands Centre 23/06/05

The Shrublands Centre 01/02/05

The Shrublands Centre 20/09/04

The Shrublands Centre 20/01/04

Similar services:

Flint House

St Vincents

The Cotswold Home

Fairways

Newbeech House

Winton House

Treloar College

Rush Court

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

CARE HOMES FOR OLDER PEOPLE The Shrublands Centre Faringdon Road Cumnor Oxford Oxfordshire OX2 9QY Lead Inspector Jane Handscombe Unannounced Inspection 6th March 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Shrublands Centre DS0000013185.V333546.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. The Shrublands Centre DS0000013185.V333546.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Shrublands Centre Address Faringdon Road Cumnor Oxford Oxfordshire OX2 9QY 01865 865561 01865 861945 shrubopc@aol.com 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) Ms Jane Quartermain Lucy Dallimore Care Home 7 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (7), of places Physical disability over 65 years of age (2) The Shrublands Centre DS0000013185.V333546.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The total number of persons that may be accommodated at any one time must not exceed 7 The PD/E category refers to two named individuals over the age of 65. Date of last inspection 19th October 2005 Brief Description of the Service: The Shrublands Centre is a family owned and managed residential home for older people. The registered manager is Lucy Dallimore but Nigel Collins is undertaking the day-to-day management. The home is located in a rural location some 5 miles from the City of Oxford. All rooms are single, two of which have en suite facilities. There are two day rooms on the ground floor for service users use. There are pleasant gardens and an outdoor swimming pool for residents use during the summer months. The home is well supported by local GP’s and community nurses. The home is able to arrange transport for those residents wishing to attend appointments or visit family and friends. Residents are encouraged to take part in the day-to-day running of the home and to take part in any activities it provides. It does however respect the wishes of residents who do not want to participate. Previous feedback from residents, relatives and friends has been very positive about the home and its staff. Information about the service offered can be requested from the home if required. The weekly charges for this service range from £600.00 to £650.00 The Shrublands Centre DS0000013185.V333546.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’ which was undertaken on 6th March 2007. The inspection involved one inspector, which took place over eight hours. It was a thorough look at how well the service is doing. It took into account detailed information provided by the registered provider, and any information that CSCI has received about the service since the last inspection. The inspector asked the views of the people who use the services, staff members and other people seen during the inspection or who responded to questionnaires that the Commission had sent out. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. Comments received from residents during the inspection process included: ‘I’m very happy with my room and the care I’m getting’ ‘the staff are excellent’ ‘this is the best place around’ ‘they understand my needs’ ‘its always clean and tidy’ ‘I was very pleased to find this place…..it’s a very nice place to live’ Comments received from staff include: ‘the manager is very approachable and will deal with events appropriately’ ‘we get good support’ ‘we all work well as a team’ The inspector would like to thank the residents, their families, staff members and other health professionals for their time and assistance during this inspection The Shrublands Centre DS0000013185.V333546.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: There are a number of areas in which the home could improve upon, to ensure the health, welfare and safety of those using the service. Whilst the homes medication procedures were sound, the practice of recording the administration of medication were of a poor standard. The recording of the administration of medication must be adhered to at all times; keeping full records of what has been given, when and by whom. Poor maintenance of window restrictors could place service users at potential risk and therefore need attending to. In the interim, a risk assessment must be put into place detailing how any risks are to be dealt with. All service users care plans and staff personnel files must contain a recent Photograph. The Shrublands Centre DS0000013185.V333546.R01.S.doc Version 5.2 Page 7 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. The Shrublands Centre DS0000013185.V333546.R01.S.doc Version 5.2 Page 8 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 The Shrublands Centre DS0000013185.V333546.R01.S.doc Version 5.2 Page 9 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): 1, 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All prospective service users are provided with information about the home and the services it offers and undergo an assessment of needs, prior to being offered a place at The Shrublands. Intermediate care is not provided EVIDENCE: All prospective service users are provided with information about the services offered at The Shrublands and undergo an assessment of needs, to ensure their needs are identified and can be met appropriately. From the evidence seen by the inspector and comments received, the inspector considers that this service is able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. The Shrublands Centre DS0000013185.V333546.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users have an individualised plan of care, which sets out their health, personal and social care needs. Service users are treated with respect and their dignity is considered when delivering their care. Where appropriate, service users are able to maintain responsibility for their own medication within a risk management process. Procedures around the recording of the administration of medication are poor. EVIDENCE: All service users have an individualised plan of care, which is drawn up from an initial assessment of needs, detailing the action which need to be taken to ensure that the service users health, personal and social care needs are met. The Shrublands Centre DS0000013185.V333546.R01.S.doc Version 5.2 Page 11 Part of the inspection process involved the inspector case tracking three service users and looking at their care plans, assessments, reviews of care and their medication administration records. Of the three service users, one was able and chose to self administer their own medication within a risk management process. Lockable facilities had been provided for this residents use. Of the two remaining, it was found that the recording for the administration was of poor quality. Gaps were found within the medication administration records, with no coding system in use to explain as to why the medication had not been administered. Upon enquiry the inspector was informed that the medication had in fact been administered although the signing to evidence this was not present. The registered manager must ensure that staff adhere to the procedures for the safe administration and recording of medications at all times, to ensure the health, safety and welfare of those in their care. It was noted that one service users care plan failed to contain a recent photograph, which the manager assured would be added to the care plan accordingly. The home has good working relationships with the local GP’s and community health services and accesses them when appropriate. Evidence of any healthcare treatment received is contained within the care plans. Discussions with care staff evidenced that they were knowledgeable on privacy and dignity issues and this was evident throughout the inspection. Staff were observed to respect the residents’ right to privacy, dignity and independence and this was verified by service users. Feedback received from GP’s and Health and Social Care professionals who are in contact with the home was positive and indicates that they are satisfied with the overall care provided to the service users within the home. The Shrublands Centre DS0000013185.V333546.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Contact with family, friends and the local community is encouraged thereby maintaining important social links and support is given where required. Service users have opportunities to exercise choice and control over their lives, where able, to retain independence. Meals and mealtimes are well managed, ensuring that service users’ nutritional needs are met. EVIDENCE: Discussions with service users regarding the meals provided at Shrublands were all very complimentary. Service users enjoy the meals provided, which are cooked freshly on the premises, are nutritious and of good portion size. During the inspection, service users were enjoying their lunch, which consisted of baked ham, cabbage, carrots and new potatoes, followed by black forest gateau, which they were taking together and staff were seen to be attentive to their needs. The atmosphere was relaxed and unhurried. One service user The Shrublands Centre DS0000013185.V333546.R01.S.doc Version 5.2 Page 13 was observed to be taking their meal in a dining area off the lounge, which was acknowledged to be by choice. There was a menu observed to be on view for service users, however it is recommended that this be equally accessible for all service users and that larger print would enable those with visual impairments to afford equal accessibility to information posted on boards for residents use. Facilities are provided to enable service users to make drinks and snacks should they require. Activities are provided for residents; during the inspection, it was noted that residents were taking part in a cooking activity, in which they were baking a cake to be consumed later that day. Recreational activities provided for those who require include gardening, exercise classes, games, quizzes, Trips out to garden centres and local shopping centres. During the summer months residents are able to undertake swimming in the home’s outdoor pool. Residents are encouraged to maintain contact with family and friends and the local community. Whilst speaking with service users, the inspector was informed that some attend a local day centre during the week, where they enjoy meeting others and maintaining social links with the local community. A monthly communion service is provided at the home, for those who wish to attend. A regular hairdressing service is available within the home for those who require and a chiropody service is provided when required. Visitors are welcome at the home and residents can go out as they wish with family and friends. Whilst speaking with residents and from feedback gained from questionnaires sent out prior to the inspection it was acknowledged that residents are enabled to exercise choice over how they spend their day. One service user explained that the home was very accommodating; that some friends were coming to the home that evening for a game of bridge, which is enjoyed on a regular basis. The Shrublands Centre DS0000013185.V333546.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All service users are provided with a copy of the complaints procedure and feel confident in making a complaint if the need arose. The homes adult protection and whistle blowing procedures aim ensure that the risk of harm to service users is reduced. EVIDENCE: All those who responded via comment cards were aware of how to make a complaint or who to speak to if unhappy. No one indicated that they had needed to make any complaints and the pre-inspection questionnaire indicated that no complaints have been received at the home. Whilst enquiring into the procedures taken with regard to small concerns or ‘niggles’ that may be brought to the manager or staff members, it was explained that any concerns are dealt with immediately as they arise and service users themselves verified this. It was suggested that the service incorporate any concerns and the actions and outcomes be logged in the same manner as complaints. The Commission has, since the inspection received confirmation that this has been acted upon and any concerns are now logged in the same manner as complaints. The Shrublands Centre DS0000013185.V333546.R01.S.doc Version 5.2 Page 15 There are adult protection and whistle blowing procedures in place and some training has taken place on abuse awareness, with more planned for the coming year. Whilst speaking with staff members, it was apparent that they were aware of the procedures to follow should there be a suspicion or allegation of abuse. Since the last annual inspection the Commission has received no such notification of any concerns, allegations or instances of abuse and neither has the home itself, and no staff needed to be referred for inclusion on the Protection of Vulnerable Adults [POVA] list. The Shrublands Centre DS0000013185.V333546.R01.S.doc Version 5.2 Page 16 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, 23 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home provides comfortable surroundings, which are equipped to meet the residents needs. The home presents as clean, hygienic and free from any offensive odours throughout. Poor maintenance of window restrictors could place service users at potential risk. EVIDENCE: The Shrublands Centre DS0000013185.V333546.R01.S.doc Version 5.2 Page 17 Service users generally live in a safe well maintained environment, however it was noted that window restrictors to two rooms were broken which could compromise the safety of service users. The inspector was assured that these would be attended to. There is adequate provision of toilets, washing and bathing facilities throughout the home. The inspector observed that bedrooms were personalised with service users own belongings and adequate space is provided for the storage of their clothes and personal belongings. All rooms have call system with an accessible alarm facility, which allows residents to call staff in the case of an emergency. The home presented as clean and fresh throughout, which residents verified was always the case. The Shrublands Centre DS0000013185.V333546.R01.S.doc Version 5.2 Page 18 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 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home’s staffing levels appeared adequate to meet residents’ care needs. The home’s robust recruitment procedures ensure that residents are protected from the employment of unsuitable staff, although there was one instance in which it had not been followed appropriately. Staff receive the training necessary to ensure competency in meeting the residents’ needs however some training needs to be updated, to ensure that skills are refreshed. EVIDENCE: The recruitment of staff is thorough and a sample of staff files were viewed which showed that there are generally good systems in place. However, there was one instance in which only one reference had been sought for a member of staff working at the home. The inspector was assured that this would be rectified and a second reference be sought immediately. The inspector received evidence that the manager acted appropriately acting swiftly to gain a second reference and correct the shortfall. It was also noted that a recent photograph of staff members was not held on all files, for which a requirement has been made to address the shortfall. The Shrublands Centre DS0000013185.V333546.R01.S.doc Version 5.2 Page 19 The inspector was informed that all members of staff undergo induction training upon appointment to their posts, are provided with mandatory training and are offered ongoing training and support which equips them to meet the assessed needs of the residents within the home. Training records showed a mixed picture with some courses up-to-date and others needing refreshing, for example food hygiene, first aid and infection control. Until training has been brought up-to-date, standard 30 cannot be scored as fully met. Staff members are encouraged to undertake the National Vocational Qualification (NVQ) in care. 4 members of staff currently hold NVQ (National Vocational Qualifications) in care with a further member of staff participating in training for the NVQ qualification. Training for staff during the last twelve months has included manual handling, alert to abuse, health and safety and first aid. It was recommended that when recruiting new members of staff the reference request form be amended to request that referees include a company stamp or a form of evidence to highlight where and whom the reference has come from. The manager has since confirmed that the amendments have been made. The Shrublands Centre DS0000013185.V333546.R01.S.doc Version 5.2 Page 20 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, 36, and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Those living at The Shrublands are confident that the home is well managed and that they benefit from the management and the ethos of the home. The home is generally run in the best interests of the residents although procedures found in regard to the recording of the administration of medication and unrestricted windows could compromise their health safety and welfare. EVIDENCE: The registered manager has the necessary experience and training to manage the home appropriately. The Shrublands Centre DS0000013185.V333546.R01.S.doc Version 5.2 Page 21 The manager obtains feedback from residents and visitors when talking to them in the home, and has an ‘open-door’ policy that encourages people see her without the need to make an appointment. The home has a health and safety policy statement and provides training and equipment for staff. Safety checks relating to fire safety and infectious diseases are regularly carried out; the weekly fire panel checks were up to date and regular fire drills had taken place. Adaptations are in place to meet the needs of service users and assist with daily living tasks. Staff receive regular supervision, both formally and informally and receive an annual appraisal of their work. The registered manager does not act as appointee for handling service users financial affairs, this is undertaken by family members or representatives. Each service user is provided with a safe for the safe storage of any monies or valuables. The CSCI is notified under Regulation 37 of The Care Homes Regulations 2001 of any occurrence affecting the welfare of service users, and the manager and staff have an awareness of what events need reporting. Generally the service is run in the best interests of the residents, however poor record keeping around the administration of medication and unrestricted windows, do not serve the service users rights and best interests appropriately and could compromise their health, safety and welfare. The Shrublands Centre DS0000013185.V333546.R01.S.doc Version 5.2 Page 22 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 3 8 3 9 2 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 2 x x x 3 x x 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 3 x 2 The Shrublands Centre DS0000013185.V333546.R01.S.doc Version 5.2 Page 23 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 OP9 Regulation 13(2) Requirement The registered manager must ensure that staff adhere to the procedure for the recording of the administration of medications at all times, to ensure the health, safety and welfare of those in their care. The registered manager must ensure that a recent photograph and two written references are held on all staff personnel files. The registered manager must ensure that all staffs’ mandatory refresher training is up to date. The registered manager must ensure that the identified broken window restrictors are attended to or replaced, and a risk assessment put into place in the interim to ensure the health and safety of those in their care. Timescale for action 30/04/07 2 OP29 19 and Schedule 2 18 23 30/04/07 3 4 OP30 OP19 30/05/07 31/03/07 The Shrublands Centre DS0000013185.V333546.R01.S.doc Version 5.2 Page 24 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 OP9 OP15 Good Practice Recommendations Staff responsible for the administration of medication have sample initials next to their signature. It is recommended that notices/menus on display within the home, are provided in larger print to ensure accessibility to all residents The Shrublands Centre DS0000013185.V333546.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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 The Shrublands Centre DS0000013185.V333546.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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