Care and Social Services Inspectorate Wales

Transcription

1 Care and Social Services Inspectorate Wales Care Standards Act 2000 Inspection Report Mount Eveswell Younger Persons Unit 22 Eveswell Park Road Newport NP19 8GS Type of Inspection Focussed Dateof inspection 3 December 2013 Date of publication 3 January 2014 You may reproduce this report in its entirety. You may not reproduce it in part or in any abridged form and may only quote from it with the consent in writing of Welsh Ministers Please contact CSSIW National Office for further information Tel: cssiw@wales.gsi.gov.uk

2 Summary About the service Mount Eveswell Younger Persons Unit is situated in Newport and is registered to provide nursing care to16 younger persons aged years, (including 2 older persons aged 65 years and over). The home is operated by Helden Homes Limited and there was a responsible individual (RI) nominated on behalf of the company. The manager Mr Manoj George was registered with CSSIW and the Care Council for Wales (CCfW). What type of inspection was carried out? This was a focussed inspection carried out as part of the schedule of annual visits to care settings. The report is based on: Consideration of the self assessment of service and annual data provided prior to inspection Consideration of the home s statement of purpose An unannounced visit to the home Observations of interactions between staff and people using the service Discussions with people using the service Discussions with a relative of a person using the service Discussions with staff Examination of service plans, risk assessments and daily records for two people using the service Consideration of quality assurance records, including a monitoring visit carried out by the area manager, audits of accident and incidents, medication and a record of complaints. Minutes of meetings held with service users families Consideration of an annual quality assurance report for 2013/14 What does the service do well? People had access to the services of a neurological? rehabilitation consultant, neurological? psychologist, physiotherapist, occupational therapist and a reflexologist, who visited the home on a regular basis. What has improved since the last inspection? Records of dietary intake were completed for people identified as being nutritionally at risk. Staff were provided with regular 1:1 supervision and an annual appraisal. What needs to be done to improve the service? No non-compliance notifications were issued. However, the provider was advised of non compliance with Section 11, Care Standards Act This was because the care documentation and the sign at the entrance to the home indicated that the Priory Group were operating the home, when not legally registered with CSSIW to do so.

3 The provider was advised an appropriate pain assessment tool should be completed for a person experiencing poorly controlled pain symptoms. It is expected that the provider will take effective action to address the concerns raised and this will be tested at future inspections. 3

4 Quality of life The home s philosophy of person centred care meant that in general, people can be confident about the quality of their care provision. People receiving the service can be assured that staff will respect their rights, choices, dignity, privacy and confidentiality when providing support. This was because people said they were consulted about their plan of care and staff were familiar with their needs and wishes. People, spoken with said they were asked when they wished to get up and go to bed. One person said The food is very good, we get lots of choices and also told us staff are very busy, but they always answer the buzzers. We (CSSIW) were told by people that any assistance with personal hygiene was provided in their bedroom or bathroom. Staff said people were able to have a bath or shower every day if they wished and this was verified by a person using the service and evidenced in the daily records seen. On the whole people can be assured that their health care needs will be well managed and any changing needs will be identified. This is because people told us that the general practitioner (GP) visited when they were feeling unwell and there was evidence in the files seen of the involvement of the GP, dietician, speech and language therapist, optician and dentist. The home also provided specialist support, to promote the rehabilitation of people with a severe brain injury. People had regular input from a team of specialist health professionals, including a neurological rehabilitation consultant, an occupational therapist and a neuro psychologist. People also benefitted from regular physiotherapy sessions and were able to see a reflexologist if they wished. A separate room was available for physiotherapy and reflexology sessions. Peoples day to day healthcare was overseen by the registered nurses and care staff were provided with guidance in meeting people s health needs within the service delivery plans and risk assessments. The care documentation evidenced that staff were consistently monitoring people s wellbeing and health professionals were contacted as needed. Although a referral had been made to the pain clinic for a person experiencing poorly controlled pain symptoms, pain assessments were not completed for this person. The registered manager agreed to take advice from professionals involved regarding the most appropriate assessment to be used for this person. People can be confident that they will be provided with opportunities for socialisation and mental stimulation. This was because there was an individual activity plan in place for each person, which set out the support needed to enable them to follow their interests and hobbies. People were also able to engage in a range of community activities, as the home employed two activities coordinators. We saw the activities coordinator helping one person to access his favourite music on his laptop, whilst care staff chatted to another person about the TV programme he was watching. We also observed staff sitting with people in their rooms, engaging them in conversation and in one instance reading the newspaper to a person in bed. We were told that people particularly enjoyed the visits from a pets therapy service People, generally can be sure of experiencing warmth and belonging. This is because several people told us they enjoyed living at the home. People said that they knew and liked the staff on duty and we saw people with limited communication, smiling when staff talked to them. One person commented, staff are lovely and a visiting relative also spoke positively of the willingness demonstrated by the staff team. Observations of the 4

5 interactions between people using the service and staff showed requests for assistance were responded to quickly and staff took time to explain their actions and establish people s cooperation when providing help. 5

6 Quality of staffing This was a focussed inspection and the quality of staffing will be looked at in detail at a subsequent inspection. We were able to establish that staff were provided with regular 1:1 supervision and an annual appraisal. A newly appointed member of staff was positive about her induction and the support received from more established staff in helping her to understand people s care needs. 6

7 Quality of leadership and management People can be confident that their views will be considered in the planning and provision of care and action will be taken to improve the service. This is because the registered manager held regular meetings with people using the service and their relatives. The annual quality assurance report for 2013/14 provided evidence of action taken to address issues raised by people during the meetings. The annual survey of peoples views undertaken by the home had produced a positive response. This was echoed in the feedback from staff and people using the service recorded by the area manager during her monitoring visits. The registered manager was awaiting the results of the annual staff survey from the organisation s human resources department. The annual quality assurance report also provided an overview of the outcome of reviews carried out by nurse assessors from the Aneurin Bevan Health Board and indicated health professionals were satisfied with the care provided to individual service users. The report also highlighted the positive report received from the Environmental Health officer. Evidence was seen of audits of care provision carried out by the registered manager in a number of areas. These included an analysis of accident and incidents and an audit of the safe administration of medication. Examination of the record of complaints indicated appropriate action had been taken by the registered manage to resolve a minor concern. In addition a visit undertaken by the area manager on 25 November 2013, under regulation 27 of the Care Homes Regulations (Wales) 2002, had considered the quality of care provision and the management of the home in key areas. CSSIW were informed in July 2013, that although the Priory Group had purchased Helden Homes Limited, it was intended that Helden Homes Limited would remain as the registered provider. During the inspection, we noted that logo on the sign at the entrance to the home and the care documentation used by the home referred to the Priory Group, rather than to Helden Homes Limited, as the registered provider. We considered this could be confusing for both people using the service and commissioners of care provision. The RI and registered manager were advised that action must be taken to avoid the Priory Group being identified as operating a home, when not legally registered to do so. 7

8 Quality of environment This was a focussed inspection and the quality of the environment was not looked at during this inspection. The quality of the environment will be considered at a subsequent inspection. 8

9 How we inspect and report on services We conduct two types of inspection; baseline and focussed. Both consider the experience of people using services. Baseline inspections assess whether the registration of a service is justified and whether the conditions of registration are appropriate. For most services, we carry out these inspections every three years. Exceptions are registered child minders, out of school care, sessional care, crèches and open access provision, which are every four years. At these inspections we check whether the service has a clear, effective Statement of Purpose and whether the service delivers on the commitments set out in its Statement of Purpose. In assessing whether registration is justified inspectors check that the service can demonstrate a history of compliance with regulations. Focussed inspections consider the experience of people using services and we will look at compliance with regulations when poor outcomes for people using services are identified. We carry out these inspections in between baseline inspections. Focussed inspections will always consider the quality of life of people using services and may look at other areas. Baseline and focussed inspections may be scheduled or carried out in response to concerns. Inspectors use a variety of methods to gather information during inspections. These may include; Talking with people who use services and their representatives Talking to staff and the manager Looking at documentation Observation of staff interactions with people and of the environment Comments made within questionnaires returned from people who use services, staff and health and social care professionals We inspect and report our findings under Quality Themes. Those relevant to each type of service are referred to within our inspection reports. Further information about what we do can be found in our leaflet Improving Care and Social Services in Wales. You can download this from our website, Improving Care and Social Services in Wales or ask us to send you a copy by telephoning your local CSSIW regional office. 9