Care and Social Services Inspectorate Wales Care Standards Act 2000 Inspection Report Stradey Park House 61 New Road Llanelli SA15 3DP Type of Inspection – Baseline Date(s) of inspection – 13 September 2013 Date of publication – 18 October 2013 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: 0300 062 8800 Email: [email protected] www.cssiw.org.uk Summary About the service Stradey Park House is registered as a care home to provide care for younger adults who have a learning disability and require assistance with personal care; it can accommodate no more than seven people. A variation to the registration is in place to allow one named older person with a mental health problem and one named younger adult with a mental health problem. There were five people living in the home at the time of the inspection visit. The home is situated in a quiet residential area within walking distance of Llanelli town centre with many shops and facilities, including public transport. The home is owned by Stradey Park Care Homes Limited. The responsible individual for the company is Mrs. Patricia Williams. The registered manager Rachel Edwards has day to day responsibility for the home. Of the five service users residing at Stradey Park House four have resided at home for some years. The most recent service user has been living at the home for the past two weeks. Residents were seen as happy and were engaging in the inspection process. What type of inspection was carried out? This was a scheduled baseline inspection, conducted on the 13 September 2013, and focussed on the quality of life for service users, together with the quality of staffing, leadership and management and the environment in which people live. Information was gathered for this inspection following scrutiny of the returned self assessment of service and annual data collection documents as well as information held by CSSIW. People living at Stradey Park House and the manager/staff were spoken with. Documentation maintained within the home was observed as was the environment in which people live. What does the service do well? The manager and staff know the people who use the service very well and are therefore able to offer individualised personal care. The service is responsive to the changing needs of the people who use the service. The service offers a homely and comfortable environment for people to live in. What has improved since the last inspection? The office space has been reorganised and there is a renewed filling system which providers a simpler, efficient way to access records. What needs to be done to improve the service? No compliance issues were identified. The following recommendations and notifications were made: We notified the registered manager that they were not compliant with the following Version 1.1 07/2012 regulations: Regulation 15 (1) there was no written plan as to how the recently admitted service user’s health and welfare needs were to be met. Regulation 19 (2) (d) fitness of workers. Staff files lacked appropriate proof of identification. Regulation 13 (2) suitable arrangements for the recording, handling, safe keeping, safe administration and disposal of medicines received into the care home. Regulation 12 (1) (a) to make proper provision for the health and welfare of service users. It was recommended that a policy is in place for staff to adhere should emergencies/issues occur during the night. The above issues have satisfactorily been address following inspection and prior to report writing. 3 Version 1.1 07/2012 Quality of life People who use the service feel listened to and believe that their views are valued. They indicated that they feel confident in raising any issues with the manager or staff at any time and they freely interacted and contributed to discussion. This was also evidenced in the records of the six monthly house meetings in which actions had been taken following service user suggestions such as new handrails on the stairs. People are clearly given choice and are able to influence all aspects of their lives, and described how they contributed to meal choices, shopping, activities undertaken both within and outside the home. Service users demonstrated throughout the inspection that they felt recognised and valued by the registered manager and the staff. People living at Stradey Park House are active, positively occupied and stimulated. The current service users are encouraged to access opportunities to learn and to follow individual interests which they might have, both within and outside of the care home. They access a variety of local drop in centres such as FAB, Breakthrough, and Gateway Clubs with staff support. People are given a choice about what activities they wish to engage in. In addition to the structured weekly time table of activities, people are supported to access the community with support whether this is to go out for lunch, play snooker, and watch a rugby match or other events. Two of the service users will be going to Cardiff overnight and are looking forward to seeing a Michael Jackson show in October 2013. Staff have developed a good understanding of the needs and preferences of the service users. A sample of care plans and risk assessments were examined. The ‘My Plan’ of service users who had been at the home for sometime were detailed, person centred and reviewed appropriately, files included numerous photographs of the individual engaging in different events and activities. The care plans had been developed over time and added to when necessary. The care file of the latest person admitted however, lacked a care plan and risk assessments devised by the home to support staff in delivering care to meet the individuals identified care needs. This has been address and care plans and risk assessments for the individual have been forwarded following inspection. Service users are encouraged to look after themselves and are supported to be fit and well. Close and regular contact is maintained with all relevant health and social care professionals, as documented in the files of each service user. Discussion with the manager and observation of service user records indicates that any change to the health of the service users receives prompt and appropriate response. Service users experience enhanced wellbeing because the service anticipates their needs and are proactive in addressing potential needs. This was evidenced through discussion with the manager who informed about research undertaken with regards to the effects of Huntington’s Disease, such as early trigger signs and training for Epilepsy which staff will be undertaking despite no residents currently experiencing. People who use the service cannot be confident that they are safe from potential medication errors. This was because suitable arrangements for the recording and safe administration of medication were not in place. It was observed that the Medication Administration Sheets needed brining in line to reflect the actual date of medication given. The home administers a new medication pack on a Monday however, the pharmacist sheet reflects a start date as a Friday. As such medication given today was recorded on the MAR’s sheet three days earlier which could potentially lead to 4 Version 1.1 07/2012 medication errors. Following the inspection this was addressed immediately and the manager provided assurances to CSSIW that the pharmacist has adjusted the MAR’s sheets to reflect the correct date. 5 Version 1.1 07/2012 Quality of staffing People living at Stradey Park House experience a strong sense of belonging and have forged close relationships with the staff working there. This was evidenced from the observations of staff and service user interaction. Service users are cared for by motivated and familiar staff, who actively engage with them and want to make a positive contribution to their lives. Their needs are anticipated and people benefit from good, timely decisions and responsive care. Staff spoken with were enthusiastic about their involvement with service users, and demonstrated a good knowledge of their individual needs and preferences. A key worker system is in place and every effort is made to match the service user with a staff member of similar interests. One staff member was obviously passionate and proud about his work, he informed that he support one service user to attend every home game the Scarlett’s play regardless if he is on shift or not. The service user was described as being ‘one of the boys’ and ‘knows more people than me’, it was evident that the service users had an enhanced wellbeing due to the commitment displayed by the staff members working at the home. The same service user plays for a rugby team and has previously been fortunate to go on tour with staff support. It was evidenced from staff meeting records that both staff and management are supportive of their service users with management approaching Asda for the possibility of sponsorship to enable a future rugby tour to New Zealand. Staff, demonstrated that they knew the service users very well, service users spoke very highly of the care they received and of the way in which they are treated at Stradey Park House. The atmosphere within the home is relaxed and informal and care is offered in a calm and unhurried manner. Service users have very good interactions with staff and the manager. People could not be assured that staff files contain the necessary documentation. A random selection of personnel files were examined and were found to be lacking proof of identification.