Care Home: 3, Silverdale Street

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What the care home does well The systems in place provide continuous assessment of individual`s needs. Support workers are very knowledgeable about the needs of people using the service. Person centred plans are in place and individuals are supported to be as independent as possible. Health care needs are monitored and appropriate action is taken. People who use the service said `I really like living at Silverdale` `I am very happy here` I an very satisfied with the care I receive` People who live here make me happy and the staff are the best, they sort out any problems` Service users have a range of daily activities of their choice. Service users are supported to be included within the community and have built a positive relationship with others in the surrounding area. Photographic evidence is used within the homes work to demonstrate how people are supported with activities. Safeguarding procedures are in place and everyone said that `we feel safe` The home is maintained to a high standard and individuals have access to single rooms that reflect their personal preferences. Communal areas enable a range of activities to be undertaken within a family setting. The support workers show a high level of commitment to the work and bring a range of skills to support people using the service. Support workers are well trained and receive regular supervision. What has improved since the last inspection? The service continues to be monitored to develop the practices used at the home. What the care home could do better: The service at Silverdale is meeting national minimum standards and demonstrates that it exceeds in some areas. CARE HOME ADULTS 18-65 3, Silverdale Street Kempston Bedfordshire MK42 8BE Lead Inspector Judith Roan Unannounced Inspection 6th June 2008 2:00 3, Silverdale Street DS0000014969.V366123.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 3, Silverdale Street DS0000014969.V366123.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. 3, Silverdale Street DS0000014969.V366123.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 3, Silverdale Street Address Kempston Bedfordshire MK42 8BE 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) 01234 302432 caroline.jordan@mencap.org.uk Royal Mencap Society Andrew Charles Reeves-Smith Care Home 8 Category(ies) of Learning disability (8), Physical disability (8) registration, with number of places 3, Silverdale Street DS0000014969.V366123.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Mr Reeve-Smith must register, for and start work on gaining an NVQ 4 in care and management within six months of the date of this registration. 11th January 2007 Date of last inspection Brief Description of the Service: The service is provided by Mencap and the property owned and maintained, except for the maintenance of bedrooms, by Jephson Housing Association. 3 Silverdale Street is an extended Victorian semi-detached house in a residential area of Kempston. On the ground floor there is one bedroom, bathroom and the communal space consisting of a lounge and a kitchen/diner. There is an office/meeting room. Seven further bedrooms are on the first floor. The home is in walking distance of a range of local amenities, including shops, pubs, and places of worship, leisure facilities and a park. It is also close to the main bus routes between Kempston and Bedford. The charges were not checked at this inspection. 3, Silverdale Street DS0000014969.V366123.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for people who use the service and their views of the service provided. This process considers the services capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. The primary method of inspection used was ‘case tracking’ which involved selecting three people who use the service and tracking the care they receive through review of their records, discussion with them, the care staff and observation of care practices. We also received 6 surveys from people who use the service, three from their relatives and two from staff working at the home. One family member states that the ‘care is good, they keep on top of medical conditions and they keep me informed’ and another ‘our relative is happy, gets good support and lives a full life’. The Inspector also received questionnaires completed by relatives The questionnaires provided positive feedback of the quality of care and service. The homes registered manager also completed an Annual Quality Assurance Assessment (AQAA) a questionnaire required to be completed by CSCI. The inspection was unannounced and was undertaken during the afternoon and evening lasting five hours. What the service does well: The systems in place provide continuous assessment of individual’s needs. Support workers are very knowledgeable about the needs of people using the service. Person centred plans are in place and individuals are supported to be as independent as possible. Health care needs are monitored and appropriate action is taken. People who use the service said ‘I really like living at Silverdale’ ‘I am very happy here’ I an very satisfied with the care I receive’ People who live here make me happy and the staff are the best, they sort out any problems’ Service users have a range of daily activities of their choice. Service users are supported to be included within the community and have built a positive relationship with others in the surrounding area. 3, Silverdale Street DS0000014969.V366123.R01.S.doc Version 5.2 Page 6 Photographic evidence is used within the homes work to demonstrate how people are supported with activities. Safeguarding procedures are in place and everyone said that ‘we feel safe’ The home is maintained to a high standard and individuals have access to single rooms that reflect their personal preferences. Communal areas enable a range of activities to be undertaken within a family setting. The support workers show a high level of commitment to the work and bring a range of skills to support people using the service. Support workers are well trained and receive regular supervision. What has improved since the last inspection? 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. 3, Silverdale Street DS0000014969.V366123.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 3, Silverdale Street DS0000014969.V366123.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. JUDGEMENT – we looked at outcomes for the following standard(s): 2,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission process ensures that needs are assessed and that people using the service are fully involved within the process. EVIDENCE: People living at Silverdale have lived at the home since it was opened or for many years. It is evident from case records that a through assessment of need was undertaken at the time of admission to ensure that individual needs could be met. Files contain good information that has been gathered as part of the assessment process. This information is updated with ongoing work especially in relation to social and health care needs. Support contracts are clear, in an accessible format and agreed by people using the service. 3, Silverdale Street DS0000014969.V366123.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People using the service can expect that practices within the home promote their involvement and independence. EVIDENCE: Care plans in place for people using the service in an accessible format, person centred and reviewed on a regular basis. An annual review is undertaken with the funding authority. Regular meetings with individuals and their key workers in which care needs are reviewed ensure that there is continuous development. People spoken with during the inspection were very positive about living at Silverdale. They said that ‘we are happy’ and that ‘our views’ on how they are supported were respected. Feedback from families mainly confirmed that they pleased with how their son or daughter was being supported. Comments from two relatives however felt that there were shortfall at times in meeting needs. They considered that this was only when agency/bank staff were used and not so familiar with all of the needs for people using the service. In discussion with staff at the time of the inspection it was established that a staff vacancy had meant additional use of bank/agency staff which was not ideal. Interviews for support workers were planned for the following week. 3, Silverdale Street DS0000014969.V366123.R01.S.doc Version 5.2 Page 10 Outcomes for people using the service are good and that needs are being met within the systems in place at the home. In discussion with support workers it was evident they are very knowledgeable about the needs of individuals using the service. Support for service users enables them to develop their skills and participate in everyday activities that they previously were not able to achieve. Learning is achieved by the consistent approaches used by support workers and people using the service having access to and observing a broad spectrum of daily living activities. Risks within activities are considered on an individual basis and plans made to minimise these for each person. People using the service users are encouraged to be as independent as possible with appropriate support. In this way individuals are included within activities and not excluded because of any behaviour that may arise. 3, Silverdale Street DS0000014969.V366123.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,14,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Planned intervention enables, respects individual’s rights and supports people to develop personal skills and take opportunities for social and community activities. EVIDENCE: The inspector was shown computer records for individual and joint social activities. A weekly activities programme for each person is available that is updated to take into account of special events and wishes of people using the service. New activities are tried out to extend the choices and personal experiences. In meeting with people who use the service over their evening meal it was noted that people are supportive of each other and have good social relationships with others living at the home. Careful planning is undertaken for all activities to ensure that people using the service are protected and enjoy the experience. Activities are both planned and spontaneous and individuals felt that there was a wide range of opportunities available to them. Regular 3, Silverdale Street DS0000014969.V366123.R01.S.doc Version 5.2 Page 12 house meetings enabled people to contribute to the decision-making processes within the home. Records are made of these meetings. Experiences for people using the service users remain good and varied. Individuals are fully involved with day-to-day living tasks within the home and on their day at home are supported to maintain their rooms and undertake personal shopping, banking and other activities with 1-1 support. An agreed rota for meal preparation is in place with all people using the service choosing the menu at the regular house meetings. The teatime meal was freshly cooked by one of the people living at Silverdale with appropriate support from staff. The menu is recorded and indicates that it is balanced varied and healthy. Several people are positively supported to maintain a weight loss plan that is part of a health action plan with the health care professional team. One person was initially at home on the day of the inspection. They informed the inspector that they had been supported to do the agreed activities within their support plan. Other people living at Silverdale were at day centres, college or supported work placements. People using the service are fully involved with decision making for both individual and joint activities. Throughout the inspection the inspector observed positive work with people using the service that promoted their rights to make choices and enabled them to fully involved in community life. Feedback within the questionnaires from family members about the service provided was overall good. Families commented on how good the communication is with them and that they feel involved. One person using the service would like more staff so they ‘could go out more’ 3, Silverdale Street DS0000014969.V366123.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A trained staff team ensures that people using the service are supported in meeting their healthcare needs. EVIDENCE: People using the service users are supported to have regular health checks and there is evidence on files that GP, specialist, dentist and optician appointments are made. Personal support is provided in a discreet manner and with individual preferences being a top priority. The support plans are person centred and clearly state how people wish to be supported. Medical profiles have clear information given about individual’s health care needs. The files contained background information on specific medical condition that aide support workers understanding of the people’s. Several people living at the home are supported to be independent with medication whilst others need support. A good medication recording system is in place that demonstrates the path of medication coming into the home with safe administration and disposal. 3, Silverdale Street DS0000014969.V366123.R01.S.doc Version 5.2 Page 14 All incidents are recorded on file to show how support workers have reviewed practice to minimise future risks. Here necessary individuals have detailed plans that support their healthcare needs. Support workers were found to be fully aware of the details of these plans. People using the service were seen to use their files and were aware of their contents. 3, Silverdale Street DS0000014969.V366123.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service users are protected by policies and practices within the home. EVIDENCE: The organisation has comprehensive policies and procedures in relation to handling concerns and complaints made. In meeting with individual’s during the inspection they said that I would tell a member of staff if I was not happy’. When asked about safety several people said ‘I feel safe’. ‘Anyone coming to the door’ I would ask to see their identity card’. Support workers undertake safeguarding awareness training as part of their induction/ foundation training. The inspector was able to check out their understanding during the inspection. The questionnaires completed by families gave positive feedback about the support and were fully aware of the complaints policy and procedures if they needed to express a concern. The open approach of the staff enabled individual’s using the service and their families to feel comfortable if there was a need to make a complaint or express a concern. There have been no complaints since the last inspection. 3, Silverdale Street DS0000014969.V366123.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is maintained to a high standard, providing a warm and relaxed environment with good personal and communal space. EVIDENCE: There are adequate rooms to enable everyone to have their own personal space in the large converted dwelling. Individual rooms are personalised, comfortable and well maintained. People using the service are supported in maintaining their rooms to a high standard of cleanliness and safety. The home is well maintained and decorated to a high standard. There is a family size kitchen that is large enough for people to be assisted or sit comfortably and be part of meal preparations. A large dining area enables people to share meal times in a relaxed and warm environment. The communal space provides for individuals to undertake a range of activities within the house. The garden is to be developed to provide areas for relaxation and the growing of their own produce. 3, Silverdale Street DS0000014969.V366123.R01.S.doc Version 5.2 Page 17 Records demonstrate that health and safety checks are undertaken with people using the service to maintain a safe home. 3, Silverdale Street DS0000014969.V366123.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The trained, competent and supported staff team ensure that the service is professional and meets identified needs of people using the service. EVIDENCE: Recruitment procedures are robust as files seen contained all of the required documentation to confirm that security and employment checks had been undertaken. References and Criminal record Bureau checks were I place. People using the service and managers participate in the interview process for prospective staff. New support workers undertake an induction programme and work alongside experienced members of the team to gain full knowledge about the needs of people using the service living at the home. A student that was completing a placement at the home and they confirmed that they shadowed an experienced worker until they were competent and confident in providing the level of support required. Support workers are offered a range of opportunities to train. Almost 50 of the staff hold National Vocational Qualification (NVQ) at level two or above and one person is undertaking an NVQ at present. 3, Silverdale Street DS0000014969.V366123.R01.S.doc Version 5.2 Page 19 Supervision is available with the manager meeting with staff on a regular basis. The staff team also meet to discuss development and day to day management issues. The AQAA confirms the training and support undertaken within the home. ‘ All staff have met their targets for supervision meetings. Staff have had a least 6 meetings in the last 12 months. Staff are trained to the highest standard usually both internal Mencap and external training. All are up to date with relevant training. With the implementation of Continuous Professional Development, Mencap are now requiring managers to undertake annual updates of Safeguarding, moving & handling, medication assessment, family charter training and three monthly fire safety updates’. 3, Silverdale Street DS0000014969.V366123.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is effectively managed and ensures that people using the service receive a quality service where their views are respected and their safety is safeguarded. EVIDENCE: The Registered Manager effectively manages the home in the best interests of people living at Silverdale and the support workers. The AQAA states that ‘As a service provider, Mencap has a Continuous improvement framework that sets out how we promote and assure the quality of service to the people we support. This begins with the way we work with people everyday using person centred planning. We also have clearly defined processes for gaining feedback from service users and stakeholders, meeting our compliances, monthly monitoring visits and annual reviews of the service’. There is evidence in the way that staff work with individual’s who use the service and records at the home that supports this statement. Regular visits 3, Silverdale Street DS0000014969.V366123.R01.S.doc Version 5.2 Page 21 from the regional manage is part of the quality assurance within the organisation. Individual finances are recorded with two signatures and receipts. Several people using the service are fully involved with their finances and sign their own records. All health and safety checks required have been completed. 3, Silverdale Street DS0000014969.V366123.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 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 X 5 3 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 4 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 4 4 X LIFESTYLES Standard No Score 11 3 12 3 13 4 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X 3, Silverdale Street DS0000014969.V366123.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. 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. Refer to Standard Good Practice Recommendations 3, Silverdale Street DS0000014969.V366123.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 3, Silverdale Street DS0000014969.V366123.R01.S.doc Version 5.2 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. 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