Care Home: Selkirk House

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What the care home does well One person who returned a survey told us "I can say without hesitation it [Selkirk House] is a marvellous place. I cannot fault it in any way. I just enthuse about it all the time." Two people told us in their surveys that all the staff are very caring. One person we spoke to told us that they would definitely recommend Selkirk House as "It would knock spots off other places". Five relatives returned surveys to us. They were all complimentary about the care and facilities provided at Selkirk House. Their comments included: "It does its best in all aspects. Everyone is teated as an individual." "Staff are constantly attending training sessions internally and externally and are always willing." "I have always been pleased with my [relative`s] care at Selkirk House." "responds to the needs of my [relative] both day and night. The room is always clean, her clothes are always clean and changed every day. Very well fed. The entertainment provided is excellent." As we toured the premises we observed daily life at Selkirk House. Staff were seen to be courteous and sensitive with people. Two people we asked told us that the staff listened and acted on what they say, and that the staff were available when they needed them. The care plans give a very clear description of each person`s needs and the action required by staff to meet these needs. This means that care can be given in a consistentmanner and if there are any changes in someone`s health or well being, this can be identified immediately. Selkirk House provides comfortable, self-contained accommodation that is decorated in a domestic style, well maintained and clean. All the rooms seen were personalised to suit individual preferences. The registered manager ensures that the management of Selkirk House creates an open, positive and inclusive atmosphere, and the home is run in the best interests of the people who reside there. Measures were put in place to address issues that were identified during our inspection either immediately or within days of our visit. What the care home could do better: Staff training must include the Mental Capacity Act and the Deprivation of Liberties Safeguards. This will ensure that all staff understand their roles and responsibilities to respond in a person-centred way to the people who use this service about making decisions, the use of restraint and the management of behaviour that presents a risk. We were informed by the registered manager that following our inspection, training was arranged for all care staff in June and July 2010. The collection of information for the purpose of monitoring a person`s health and well being should be undertaken with the Primary Care teams such as district nurse teams. This will ensure that care staff are not providing care and support that exceeds residential care expectations. It will also ensure that the people living at Selkirk House continue to retain the same rights of access to Primary Health care services that they would receive if they lived in their own home. Measures need to be put in place to minimise the risk of active and passive smoking by the people who choose to smoke in their rooms. Also measures that would mean other people are not affected by cigarette smoke. Any arrangements made for people to smoke at Selkirk house must be compliance with the smokefree legislation (July 2007). We were informed by the registered manager that following our inspection visit consultation with a surveyor was taking place to address this issue. The bathroom with the "Parker" bath should be furnished in such a way that it looks less clinical and more inviting. Random inspection report Care homes for older people Name: Address: Selkirk House Church Road Plymstock Plymouth Devon PL9 9BD three star excellent service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Megan Walker Date: 3 0 0 4 2 0 1 0 Information about the care home Name of care home: Address: Selkirk House Church Road Plymstock Plymouth Devon PL9 9BD 01752492850 01752480496 carolyn.kendall@anchor.org.uk www.anchor.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Carolyn Kendall Type of registration: Number of places registered: Conditions of registration: Category(ies) : Anchor Trust care home 39 Number of places (if applicable): Under 65 Over 65 39 39 39 dementia old age, not falling within any other category physical disability Conditions of registration: 0 0 0 Home may accommodate one extra named person making the total number of places 40. Numbers to revert to 39 when the named person leaves. Date of last inspection Brief description of the care home Selkirk House is situated in Plymstock close to local amenities and is one of the Anchor Homes Group of care homes for Older Persons. Selkirk House is registered to provide accommodation and personal care for up to 39 people of both sexes over the age of Care Homes for Older People Page 2 of 11 Brief description of the care home 65; a temporary condition to the registration allows for one extra person to be accommodated. People living in the home may have a varying degree of dementia and/or physical disabilities. Selkirk House is not registered to provide nursing care or intermediate care. Accommodation is offered on the 1st and 2nd floors of a 3-storey building with a shaft lift providing access to each floor. There are 35 single rooms all of which have en-suite shower rooms and a kitchen area, and four larger flats with a separate kitchen, lounge and bedroom. The home has two lounge rooms and a dining room. The garden offers seating areas and is accessible with ramps and handrails. People residing at Selkirk House are encouraged to maintain their gardening interests if they wish. The current weekly fees vary depending upon the care needs of each person and their chosen accommodation. Items such as chiropody treatment, personal toiletries, newspapers and magazines and transport costs are not included in the fees. Information relating to the services provided at Selkirk House and fees can be obtained directly from the home. Care Homes for Older People Page 3 of 11 What we found: This was a random inspection undertaken by one regulation inspector to check compliance with regulation. Selkirk House was lasted inspected on 13th June 2007 when it was rated Excellent. The fieldwork part of this inspection was unannounced and took place on Tuesday 27th April 2010 between 09:30 and 16:20, with a further planned visit on Friday 30th April 2010 for three hours. On our arrival on our first day the registered manager was away on a training course however the other staff members competently assisted with relevant information about the care provision and staffing aspects of this inspection. We met with the registered manager at the end of the same week to provide an opportunity for her to talk to us about the service, and to give feedback on the findings of our visit. We chose four people, both men and women, to look at their care files and care generally. We found that each care file seen stated the name by which the person preferred to be called. There was a full assessment of each persons care needs and instructions for staff about how to provide care. With the exception of one care plan because the person has not long moved into Selkirk House, we found that all the care plans were reviewed regularly, and more frequently if the person has a changing care need. A family member or representative is also invited if this is the persons wish. We found that information contained in personal care files confirmed that people living in the home have access to health care services such as doctors, dentists, chiropodists and opticians. Care staff can accompany individuals to appointments if this is the persons preference. We found the care plans had charts that would usually be kept by a care home providing nursing care. Care staff are held accountable for gathering information however there was no evidence to show that the care staff followed up on this information. We were concerned that there may be an over expectation on the care staff skills of knowing what and how monitor charts, and the expected outcomes. We raised this concern with the registered manager. We asked about the input by district nurses as usually they would take a lead responsibility for requesting the gathering and monitoring of such information. We were told that this is a generic form used across all the Anchor Houses, some of which provide nursing care. We were told that information is only collected if it is relevant, and for example, a persons weight would be monitored if there was a cause for concern, and regular weight checks would be undertaken with the persons consent. The registered manager agreed however that this was something that she could discuss with the Anchor Housing area manager as a possible training need for care staff. We observed a hand over between two team leaders changing shifts. We found that as part of their handover they double checked all the controlled medications and each signed it was correct. The medications were seen kept in lockable medication trolleys inside a lockable cupboard. The controlled drugs were seen kept in a fixed metal lockable cabinet in a lockable cupboard. We were told that there are eight team leaders, each with different principal responsibilities, and of which one team leader has responsibility for checking all the medications of the people who choose and are able to manage their own medications. Everyone has a lockable cupboard in their room for medications. We saw risk assessments and signed agreements on care plans of people who manage their own Care Homes for Older People Page 4 of 11 medications. We were also told that the Care Manager (deputy manager) oversees all the handling and administration of medications by the team leaders. She shadows them and undertakes competency assessments to ensure each team leader is still competent to continue administering medications. We found that Selkirk House employs an Activities Co-ordinator. The people we spoke to praised her enthusiasm and things that she arranged for them. One person told us about newspaper reading sessions that they find invaluable, cinema days, and chair aerobics:keeps us fit. Two people told us about a donkey that Selkirk House has adopted at the donkey sanctuary. He has been to visit everyone at the home. We were also told about tea afternoons that have now stopped, theme nights that had mixed reviews (some felt these are too frequent), and we had concerns from a couple of people about too much paperwork for the co-ordinator that meant recently there have been less activities. We briefly met the Activities Co-ordinator. We found that she was very enthusiastic about her work and what she is able to offer to people residing at Selkirk House. She is employed for 35 hours each week. On the day of our visit she was spending one to one time with individuals. We also observed two carers accompany a couple of people out to a local coffee shop. The registered manager told us that she encourages the care staff to take the time to sit and chat with people rather than focusing on time and tasks. One person talked to us about three members of staff whom they appreciated because they chatted. We made a tour of the premises. We found that Selkirk House is a purpose built three storey building. There is level access throughout the building. Corridors and doorways are wide enough for people who use wheelchairs or walking aids to move around the home easily. Bedrooms are on both the first and second floor levels. They all have en-suite facilities and a kitchen area. The majority are single occupancy studios however there are four larger flats that have a lounge with a kitchen area and a separate bedroom. We were told that people bring in personal items of furniture from their own homes with them. The rooms we visited were clean, well decorated and homely with items of personal furniture and most people had photographs and other personal items on display. Each room was decorated in a domestic style. All the rooms seen were personalised to suit individual preferences. All the bedrooms have safety latches on the windows. Access to the first and second floors is via stairs or using a shaft lift. On the ground floor is the reception, the administrators office, the laundry, the hair salon and the staff room. The people living at Selkirk House can book an appointment with the hairdresser who comes into the hair salon two days each week. The laundry room is large with two commercial washing machines and two commercial driers. On the day of our visit the laundry room was orderly and clean. On the first and second floors there is a choice of two sitting areas, one of which is also used as a cinema to show films on a large screen once a month. The furnishings were of good quality, comfortable and clean. There is a bathroom with a Parker bath. There is nothing else in this bathroom so it looks stark and clinical and a Parker bath does not look like a conventional bath that people would recognise. We discussed this with the registered manager who agreed that the room could be made to look more like a bathroom and more inviting. There are three additional toilets on both floors. There is a large dining room with large picture windows looking out on the garden and a large patio. Outdoor garden furniture and parasols were laid out for people to use. The garden paths are ramped and there is also level access on to the patio. Care Homes for Older People Page 5 of 11 We found that people residing at Selkirk House who choose to smoke can do so within the confines of their flat. We found that there is no provision of an extractor fan. The windows are restricted so the opening is limited meaning the room can quickly build up an excess of cigarette smoke. We received comments from other people living in the home. They told us that at certain times of the day the cigarette smoke could be smelt in the corridor and come into their rooms. We discussed this with the registered manager. She agreed to consult with the Anchor Housing head office to see what steps could be taken to minimise the risk of active and passive smoking by the people who choose to smoke in their rooms. Also measures that would mean other people were not affected by cigarette smoke. We asked the registered manager to ensure that the current arrangement is compliance with the smoke free legislation (July 2007). One person told us that there have been several changes to the staff team that they felt had upset the rhythm. We were also told that Amongst the new staff they are not gelling together. Frustrating at times. Its not comfortable here at the moment, generally they are very considerate but something is lacking at the moment. We asked the registered manager about the staff turnover. She confirmed that there has been a lot of change amongst the staff team over the past six months including staff shortages. She believes it is settling now and there is a full staff compliment. The registered manager suggested that more could be offered to the people residing at Selkirk House to address the affects on them of staff leaving. We looked at three staff files. These were all people who have been recruited since the last inspection. We found that they each had all the required checks completed. We also found that any new staff member is supplementary on the staff rota and they do not work alone until they have completed their induction period. We spoke to two staff members, one who is relatively new. They both confirmed that this is the policy at Selkirk House. What the care home does well: One person who returned a survey told us I can say without hesitation it [Selkirk House] is a marvellous place. I cannot fault it in any way. I just enthuse about it all the time. Two people told us in their surveys that all the staff are very caring. One person we spoke to told us that they would definitely recommend Selkirk House as It would knock spots off other places. Five relatives returned surveys to us. They were all complimentary about the care and facilities provided at Selkirk House. Their comments included: It does its best in all aspects. Everyone is teated as an individual. Staff are constantly attending training sessions internally and externally and are always willing. I have always been pleased with my [relatives] care at Selkirk House. responds to the needs of my [relative] both day and night. The room is always clean, her clothes are always clean and changed every day. Very well fed. The entertainment provided is excellent. As we toured the premises we observed daily life at Selkirk House. Staff were seen to be courteous and sensitive with people. Two people we asked told us that the staff listened and acted on what they say, and that the staff were available when they needed them. The care plans give a very clear description of each persons needs and the action required by staff to meet these needs. This means that care can be given in a consistent Care Homes for Older People Page 6 of 11 manner and if there are any changes in someones health or well being, this can be identified immediately. Selkirk House provides comfortable, self-contained accommodation that is decorated in a domestic style, well maintained and clean. All the rooms seen were personalised to suit individual preferences. The registered manager ensures that the management of Selkirk House creates an open, positive and inclusive atmosphere, and the home is run in the best interests of the people who reside there. Measures were put in place to address issues that were identified during our inspection either immediately or within days of our visit. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 7 of 11 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 8 of 11 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 18 13 You must ensure that all staff 04/06/2010 know about and have an understanding of the Mental Capacity Act and the Deprivation of Liberties. This will ensure that: The people who use this service are protected from abuse, or the risk of abuse, and their human rights are protected and upheld. The use of restraint is always appropriate, reasonable, proportionate, and justifiable to the individual. Deprivation of Liberty Safeguards are only used in the best interests of the person using this service, and in accordance with the Mental Capacity Act 2005. Care Homes for Older People Page 9 of 11 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 8 You should ensure that information gathered on care plans is for the purpose of promoting and maintaining an individuals health, and the person has access to health care services in accordance with guidance and legislation. You should ensure that bathrooms are less clinical and more homely. You should ensure that the home is kept free from offensive odours including cigarette smoke, and that systems are in place in accordance with relevant legislation and published professional guidance. 2 3 21 26 Care Homes for Older People Page 10 of 11 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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