Care Home: Smalley Hall Residential Home

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What the care home does well There are suitable arrangements in place to ensure prospective residents are assessed prior to the admission being agreed. Suitable arrangement to meet residents healthcare needs were in place and where referral for specialist advice and intervention had been identified this had been swiftly completed. Residents were given a choice of food at each meal and they told us food was of a good standard. Their decision where they ate their meals was respected. One survey told us `residents always look well cared for and the care staff are always pleasant to residents and visitors`. General feedback from some of the surveys indicated resident were `happy with everything`. The home has established quality assurance systems in place which actively ask residents through meetings and surveys what they think about the service being offered. What the care home could do better: Care plans in place were basic and lacked personalisation which would enable staff to be aware of the choices, preferences and abilities of the resident. They did not detail the support that people needed with their medication or assess the persons ability to consent and understand the medications they were taken. Updated legislation such as the Deprivation of Liberty Safeguards and the Mental Capacity Act had not been applied within the service. Staff were about to receive training but were not yet conversant with the implications of this and the relevant consideration had not been applied to peoples care plans. Standards of hygiene and odour control in some areas did not always ensure the home was a clean or pleasant place for residents to live in. Random inspection report Care homes for older people Name: Address: Smalley Hall Residential Home Main Road Smalley Derbyshire DE7 6DS two star good 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: Bridgette Hill Date: 2 0 0 5 2 0 1 0 Information about the care home Name of care home: Address: Smalley Hall Residential Home Main Road Smalley Derbyshire DE7 6DS 01332882848 01332882848 Telephone number: Fax number: Email address: Provider web address: www.ashmere.co.uk Name of registered provider(s): Name of registered manager (if applicable) Rosamund Morley Type of registration: Number of places registered: Conditions of registration: Category(ies) : Ashmere Care Group care home 27 Number of places (if applicable): Under 65 Over 65 27 old age, not falling within any other category Conditions of registration: Date of last inspection Brief description of the care home 0 Smalley Hall is registered to provide personal care and accommodation for up to 27 older people, male and female. It located in attractive surroundings on the outskirts of the village of Smalley, which lies within close proximity to the market town of Ilkeston accessible by public transport. Accommodation is over two floors and with a passenger lift provided. There are 23 single bedrooms and 2 double. A choice of communal bathrooms and toilets, a large lounge area and connecting dining dining room, together with a smaller sitting room and spacious conservatory. The latter opens onto a patio area and car parking space is also provided. People are provided with care and support from a team of care and hotel services staff led by the registered Care Homes for Older People Page 2 of 9 Brief description of the care home manager and with external management support. Fees charged per week are in accordance with peoples assessed needs determined either by way of via individually agreed private contract arrangements or for those who may be eligible, via local authority arrangements for funding. Up to date information about fees charged, what they cover and arrangements for their payment may be obtained directly from the registered manager at the home or the registered provider. Care Homes for Older People Page 3 of 9 What we found: At our last inspection of the home on 5th June 2007 the home was considered to offer good outcomes for the residents who lived there. The purpose of this Random Unannounced Inspection was to check compliance with the Care Homes Regulations 2001 in a narrow focus of inspection activity and in preparation for the registration transfer arrangements under the Health and Social Care Act 2008. Our focus was primarily on the homes systems that were in place and as part of the inspection we reviewed a range of records and spoke with the Area Manager, Manager, residents and staff. The Annual Quality Assurance Assessment and discussion with the Manager informed us that pre admission visits to residents were always undertaken and a file we examined confirmed that a written assessment of the resident had been completed but this was not signed or dated. Care plans were in place for each resident and gave a basic task oriented overview of the residents assessed needs but lacked a level of personalisation and detail that would make them individual to the resident and their preferences and needs. Other documents were available which recorded the resident life histories and personal histories. Dietary preferences were recorded with the cook having a copy of these. Systems to ensure monthly reviews were in place. We discussed changes in legislation and practices which required consideration by care homes when providing care such as the Mental Capacity Act and Deprivation of Liberty safeguards with the Manager. Care plans did not record consideration of these or include assessments of residents ability to consent to treatment. Some of the staff were completing training on the Mental Capacity Act on the day of our visit. The care plans had suitable risk assessments in them which were updated. Where risks were identified for example tissue viability referrals to healthcare professionals had been made and equipment had been obtained to lower the risk level. Where there had been visits by healthcare professionals these were documented. Residents we spoke with said that a Doctor visited the home on a regular basis each Tuesday and that staff requested them at other times if they were needed. Medicines management appeared to be well organised with regular audits in place and suitable recording procedures. Residents gave us examples where medicines had been prescribed and the home had obtained these very quickly to enable the treatment to commence as soon as possible. All residents appeared to be clean and well dressed often with matching accessories. One resident told us the clothing was always quickly laundered and well pressed and even pleated skirts which were returned with all the pleats ironed in. Generally there was good feedback regarding the food and choices available. Menus were available on table although these contained information on 2 weeks meals and were not the ones currently being followed as there had been a review and new menus were being Care Homes for Older People Page 4 of 9 introduced. Residents were asked about their choice of meal each day. Some residents we spoke to chose to eat their meal in a room away from the dining room and this choice was respected. All staff were responsible for delivering activities. Some outings were arranged for the Summer and entertainers visited the home. On the day of our visit a movement to music session had been held. A craft room was planned and had been discussed at the residents meetings. Some residents told us they would like more activities. A range of books including large print was available and one resident told us they accessed talking books. Some people had their own newspapers and quiz books and were occupying themselves with those. Residents told us they generally liked living together and got on well. Residents told they had choices relating to routines such as getting up and going to bed times. We found the home to be clean on the ground floor with a range of lounges and quiet areas that enabled residents to have a choice of places to sit. Most residents had their own particular seats which they preferred with their own possessions on tables at the side. Some bedrooms we viewed and the sluice and upstairs corridors had unpleasant odours and one commode was viewed with stains and marks on it where it had not been sufficiently cleaned. Bedrooms we viewed were personalised with individual with personal possessions some having tea making facilities. We viewed the fire safety log which recorded that suitable checks of the system were completed regularly. We spoke with staff about the training and support they received. They said they received regular training and were conversant with what to do should the fire alarm go off. Staff told us that staffing levels were sufficient to enable residents needs to be met. The staff training records indicated that a range of mandatory and specialist training such as dementia care had been delivered to staff over the past year. As identified previously some training had not yet been completed but was in process to ensure staff were kept up to date with changes in legislation. Residents generally told us that staff were kind to them although one resident said they sometimes felt a little rushed by staff but were able to tell them this and they slowed down. The Annual Quality Assurance Assessment informed us robust recruitment procedures were in place and a check on a staff file confirmed that all required checks had been completed and only a photograph of the staff member was now needed. A skill based induction pack was available for new staff and supernumerary days were organised when new staff commenced in post to enable them to be inducted to the home. We discussed with the Manager what quality assurance processes were in place. We were shown minutes from residents meetings which were held typically 3 monthly. These sought feedback from residents. Some questionnaires had been completed in February 2010 which indicated that residents generally agreed or strongly agreed that the service provided was of good quality. The Area Manager completed monthly quality assurance reports when they visited the home to monitor the service provided to residents. What the care home does well: Care Homes for Older People Page 5 of 9 There are suitable arrangements in place to ensure prospective residents are assessed prior to the admission being agreed. Suitable arrangement to meet residents healthcare needs were in place and where referral for specialist advice and intervention had been identified this had been swiftly completed. Residents were given a choice of food at each meal and they told us food was of a good standard. Their decision where they ate their meals was respected. One survey told us residents always look well cared for and the care staff are always pleasant to residents and visitors. General feedback from some of the surveys indicated resident were happy with everything. The home has established quality assurance systems in place which actively ask residents through meetings and surveys what they think about the service being offered. 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 6 of 9 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 27 18.1.a Ensure that staff are deployed in sufficient numbers to meet the needs of all the people. 12/06/2007 Care Homes for Older People Page 7 of 9 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 7 15 Care plans must include an assessment of the residents mental capacity to make decisions and consent to treatment and this must be considered when the plan of care is drawn up This will ensure that all decisions are made in consulation residents and decisions taken are in residents best interests 30/07/2010 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 2 3 7 26 29 Care plans should be reviewed in consulation witht hte resident to improve the level of personalisation in them Systems should be reviewed to ensure there is ongoing monitoring of standards of cleanliness in the home There should be photographs of staff contained within staff files Care Homes for Older People Page 8 of 9 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. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 9 of 9 - 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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