Inspection on 30/07/08 for Stanford House

This is the latest available inspection report for this service, carried out on 30th July 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Stanford House 08/01/07

Stanford House 01/03/06

Stanford House 27/10/05

Stanford House 17/02/05

Stanford House 20/11/04

Stanford House 03/02/03

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOMES FOR OLDER PEOPLE Stanford House 15 Dudley Road Sedgley Dudley West Midlands DY3 1ST Lead Inspector Chris Lancashire Unannounced Inspection 30th July 2008 09:30 X10015.doc Version 1.40 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 DS0000024973.V370254.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 Older People. 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. DS0000024973.V370254.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stanford House Address 15 Dudley Road Sedgley Dudley West Midlands DY3 1ST 01902 880532 01902 673518 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) Mr Stanley James Alan Blundell Mrs Wendy Jacqueline Blundell Mrs Wendy Jacqueline Blundell Care Home 10 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (2), Old age, not falling within any of places other category (8) DS0000024973.V370254.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection: 4th February 2008 Brief Description of the Service: Stanford House is located a short walk from the centre of the village of Sedgley, where there is a range of local facilities. A main bus route between Wolverhampton and Dudley is available nearby. The home provides care and accommodation for ten older people. There are four single bedrooms, and three double rooms. On the ground floor, people share a lounge at the front of the house and a lounge/dining room at the rear. There is a chair lift for people who require assistance accessing the first floor. There is a well-maintained and attractive rear garden and off-road parking space at the front of the premises. The fees are available on application to the home. DS0000024973.V370254.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. We visited the home without telling anyone that we would be arriving that day. The purpose of the visit was to find out about the quality of the care and to find out if the requirements in the last report had been met. We asked the manager to fill in a form called an Annual Quality Assurance Assessment before the visit. This tells us how the manager considers the home is running and gives us some information about the staff and the people in the home. During the visit we looked round the home and spoke to all the people who live there. We spoke to staff on duty and to the manager. We also looked at records which are kept on three of the people in the home, the staff, the medication and checks on the safety of the building. We used this information to make judgements about the home and the way it is run. The quality rating for this service is 2 stars. This means that the people who use this service experience good quality outcomes. What the service does well: What has improved since the last inspection? There are improved arrangements for the storage and administration of medication and for the storage of cleaning materials. There are also more detailed risk assessments. These improvements mean that people are better protected. DS0000024973.V370254.R01.S.doc Version 5.2 Page 6 The staff keep more detailed records of the food intake for people who may be at risk of becoming an unhealthy weight. Staff have received additional training in several relevant areas of care. The rotas are now more detailed so that it is easier to see who is on duty. 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. DS0000024973.V370254.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000024973.V370254.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3. Quality in this outcome area is good. Prospective residents are provided with the necessary information so that they can make an informed choice about moving into the home. Their needs are assessed and they are assured that these will be met by the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a Statement of Purpose and this contains relevant information about the home. We saw that this has recently been updated and includes current details of the staffing arrangements. However, the contact details for the CSCI have changed and the document needs to be amended to include the new address and contact number. We discussed this with the manager, who agreed to make the necessary changes. DS0000024973.V370254.R01.S.doc Version 5.2 Page 9 The manager informed us that she carries out pre-admission assessments on the needs of people who may want to be admitted to the home. She considers their needs and how these can be met by staff as well as how they may fit in with the people who already live there. We sampled three files and found the necessary paperwork to demonstrate that people had been assured that their needs could be met before they moved in. DS0000024973.V370254.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10. Quality in this outcome area is good. The health, personal and social care needs of the people who live in this home are set out in care plans so that staff can ensure that their needs are met. They are protected by the home’s procedures and practices for dealing with medicines. Staff treat the people who live in this home with dignity and respect their privacy. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager told us that she uses the information in the pre-admission assessment as well as any other information from the person concerned, their relatives or representatives and any professionals involved with them to form the basis of the care plan. This provides staff with details of how the person needs to be cared for and the ways in which they prefer the care to be given. The manager has developed new systems for these plans since the last inspection. DS0000024973.V370254.R01.S.doc Version 5.2 Page 11 We sampled three files and found that they contained care plans with clear information for staff. As well as details of the physical care to be given, they contained details of people’s past lives and important things which had happened to them. For example, in one file, the notes explained that one person had been bereaved in particular circumstances and warned staff that she may become upset if the conversation mentions certain people. There are details of people’s favourite performers, pets which they had in the past, thinks which they particularly like and important values. The plans also had details of each person’s preferences and any needs which arose from their beliefs and lifestyle choices. The health needs of each person were seen in the care plans and staff demonstrated awareness of these. There are suitable arrangements for the storage of medication in the home and the procedure for administering drugs has improved since the last inspection. On the day of the inspection, the home’s pharmacist also carried out a surprise inspection and found the storage and records to be in good order. We checked the storage facilities and the administration records and found them completed in the correct manner, with no unexplained gaps. This showed us that people are protected by the systems for storing and administering medicines. We saw that staff were polite and friendly to the people in their care. They spoke about them with affection and had a good level of knowledge of their particular needs. The care plans show the way people prefer to be addressed and staff respect these choices. We saw that toilet and bathroom doors were closed when in use and that staff knocked doors before entering. This showed us that the staff are aware of the need to treat people with respect and to make sure that their dignity is upheld. DS0000024973.V370254.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. Quality in this outcome area is good. The people who live in this home find that their lifestyle meets their needs and matches their expectations. They are enabled to maintain contact with family and to exercise choice and control over their lives. They receive a wholesome and appetising diet which meets their needs and takes account of their preferences This judgement has been made using available evidence including a visit to this service. EVIDENCE: We saw good, detailed records of what is important to each person in the home. Staff described the routines and activities which each person preferred and we saw that people were making choices throughout the day. For example, people were sitting in each room and some moved about and changed their seats after lunch. Some were sitting in the front lounge, chatting or reading, some were in the front part of the rear lounge, watching the television and others were in the back part of the rear lounge, knitting and DS0000024973.V370254.R01.S.doc Version 5.2 Page 13 chatting. The home has a supply of board and other games, which people like to play occasionally, but people who live in the home said that they prefer not to play every day. Some told us that they like to go out to the shops with the manager or out with relatives. The staff told us that there are occasional trips to shows or to see the Christmas lights. We spoke to people who live in the home and they said that they are satisfied with the amount of entertainment. One said, ‘I love to read’. Another said, ‘I am happy here, you can do what you want to’. One person likes to go out to a day centre to meet friends. All of the people except for one have regular visits from friends and relatives, sometimes several times a week. Staff chat to people as they move through the rooms and when they have finished their tasks. There is a relaxed atmosphere. In addition to finding out people’s choices at the time of admission, the preassessment to present, the staff and manager talk to people on a regular basis and ask them about how they are feeling. There are occasional residents’ meetings, but these have been difficult to organise and the manager and staff said that these have not been a good way of finding out each person’s opinions. We saw good records of what people like to eat, including their needs for medical reasons and they are given a choice at each meal. In addition, there are supplies of food so that, if people want a further choice, this is provided. The staff who put the meals out on the day of the inspection knew what each person liked and the size of their preferred portion. The tables were laid in an attractive way and one person helped by folding the napkins. We saw nutritional assessments on files and staff monitor the intake of people whose weight is changing. The manager explained that food is available at all times and said that if people want a cup of tea and snack in the middle of the night, this is possible. The people who live in the home said that they enjoy their meals. The menus reflect people’s culture and past. For example, the main lunch on the day of the inspection was faggots. DS0000024973.V370254.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. People who live in this home are protected by the staff, who follow the policies and procedures. There are good arrangements to make sure that people’s complaints will be listened to. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We saw that there are details of how people can make a complaint in the Statement of Purpose and service user guide to the home as well as on notice boards. The manager told us that the home has not received any complaints, but there is a book available for recording them if necessary. She said that she finds out the views of people in the home on a regular basis and makes small changes as comments are made. People who live in the home said that they are very happy with the care provided and they said that they would tell the manager if they needed to change anything. The manager explained the action she would take should she receive a complaint. The records show that staff receive training in recognising the signs of possible abuse and the action to take. The home’s own questionnaires which are used as part of the quality assurance process ask questions about possible abuse and there have been no reports of abuse in responses. People living in the home said that they are looked after well. One said, ‘They treat us too well’. DS0000024973.V370254.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. The home is well maintained so that people live in a comfortable, clean and safe environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We toured the building early in the day, before the staff had been able to check all the rooms, but we found all areas clean and tidy, with no unpleasant odours. The manager explained that the people in this home are not as dependent as in many homes and they like to keep their rooms in good order. The bedrooms were personalised with ornaments and pictures. People who live DS0000024973.V370254.R01.S.doc Version 5.2 Page 16 in the home told us that they like to keep their rooms tidy and their beds are comfortable. The fittings and furniture throughout the home are in good order and the home is decorated on a rolling basis. The first floor bathroom has a bath with access from both sides and the design of the room is not institutional. There is a shower room on the ground floor, which most of the people prefer to use. There are procedures which make sure that infections can be controlled. All staff are trained in food hygiene. Gloves and aprons are used by staff when there is a risk of infection. There is currently no need for specialist disposal systems or sluice facilities. The cleaning and other products which may pose a danger to people in the home are kept in a safe place. The gardens are well maintained and there is parking space at the front of the home. There are risk assessments to ensure that the building is kept safe. DS0000024973.V370254.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We saw that the people who live in the home are mobile and require a minimum of assistance with tasks. People were moving about without staff assistance and conversations showed that people are able to express their views or ask for assistance. Since the last inspection the manager has changed the rota so that there is increased cover at times when there are more tasks. We spoke to people who live in the home and they said that staff are available when needed, but people said that they get themselves up and tidy their own rooms. The manager told us in the AQAA that only two people need help with dressing and washing. No-one needs intimate physical care. We discussed, with the manager, the possibility that staffing levels may need to be increased in the future, if the people in the home become more frail and need more assistance. She said that she will continue to monitor people’s needs and respond appropriately. On the day of the inspection we saw that even the member of staff who was cooking lunch had time to chat to people in the home and to keep popping into the lounges to make sure that people had everything that they needed. DS0000024973.V370254.R01.S.doc Version 5.2 Page 18 The staff team is well established and most of the members have worked together for a long time. The home has a family atmosphere and staff said that they enjoy coming to work. Staff are recruited thorough a standard process. The manager told us that she takes up references and carries out checks through the Criminal Records Bureau on all staff. We sampled two staff files and they confirmed this. This home has always had a good record for staff training and all staff are trained to at least NVQ level 2. Four members of the team have level 3. In addition, they have received training in food hygiene, dementia care, adult protection, manual handling and infection control amongst other relevant areas. We saw a range of certificates displayed on the wall in the hallway and the manager also keeps a record of what each person has achieved. DS0000024973.V370254.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38. Quality in this outcome area is good. The people living in this home benefit from a competent manager and the home is run in their best interests. Their financial interests are safeguarded and their health, safety and welfare is promoted and protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager is also the joint registered owner of the service. She has managed and owned the service for many years. She spends time at the home each day, working on paperwork as well as supervising staff and working on the floor. She demonstrated a thorough knowledge of the needs of the DS0000024973.V370254.R01.S.doc Version 5.2 Page 20 people in the home and a commitment to improvement by meeting the requirements in the previous report. The manager told us, in the AQAA, that the policies and procedures have been reviewed in December 2007, with the exception of the medication policy, which has been reviewed more recently. We saw that the records examined were up to date and had been signed by the manager to show that she makes regular checks. As part of the quality assurance system, the manager sends out questionnaires to people who live in the home, their visitors and other professionals. She also finds out the views of staff and residents through staff and residents’ meetings. There are also monthly checklists which are completed in respect of safety in the home. The manager analyses the results of surveys and checks, together with information about events in the home, such as falls, to find out if there are any areas where improvements can be made. The manager looks after small amounts of money on behalf of some residents, so that they will have cash for personal spending such as hairdressing. This is kept in a secure place to which only the manager and senior staff have access. We checked the money against the records for two people and found that the records were correct and that all money had been signed for. The manager told us in the AQAA that all necessary safety checks have been carried out on the equipment in home and the gas and electrics. This includes the fire safety equipment. We sampled the records and found that they were up to date. We also saw risk assessments for the premises and activities. This means that the staff, people who live in the home and visitors are protected from environmental dangers. DS0000024973.V370254.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 DS0000024973.V370254.R01.S.doc Version 5.2 Page 22 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. 1 2 Refer to Standard OP1 OP27 Good Practice Recommendations Update that Statement of Purpose with the latest contact details for the CSCI in so that people have relevant information. Continue to monitor the dependency levels of people in the home so that the home can continue to provide appropriate staffing levels. DS0000024973.V370254.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 DS0000024973.V370254.R01.S.doc Version 5.2 Page 24 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!