Inspection on 01/07/08 for Stone House

This is the latest available inspection report for this service, carried out on 1st July 2008.

CSCI found this care home to be providing an Excellent 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

Stone House 24/08/06

Stone House 05/01/06

Stone House 15/06/05

Stone House 04/10/04

Stone House 15/04/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Stone House Union Street Bishops Castle Shropshire SY9 5AJ Lead Inspector Karen Powell Key Unannounced Inspection 1st July 2008 10:30 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 Stone House DS0000020656.V367089.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. Stone House DS0000020656.V367089.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stone House Address Union Street Bishops Castle Shropshire SY9 5AJ 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) 01588 638487 01588 638582 www.coveragecareservices.co.uk Coverage Care Services Ltd Edna May Jones Care Home 40 Category(ies) of Dementia (9), Learning disability over 65 years registration, with number of age (3), Old age, not falling within any other of places category (28) Stone House DS0000020656.V367089.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The number of persons for whom personal care is provided shall not exceed 40. The number of adults with a learning disability over 65 years of age may not exceed 3. The number of older persons accommodated in the home shall not exceed 40 of whom up to 9 may have dementia. 21st June 2007 Date of last inspection Brief Description of the Service: Stone House care home is managed as a non-profit making venture by Coverage Care Limited, and registered to provide personal care and accommodation for up-to 40 older people with a range of needs. Situated near the centre of Bishops Castle, the home is adjacent to the Community Hospital. Accommodation is arranged over five separate units each comprising single bedrooms, toilet and bathing facilities, lounge/dining area, and a small kitchen facility for provision of beverages. There is a main kitchen, supplying meals to all five units, within the home, and a laundry facility, both of which service the requirements of the adjacent Community Hospital. Well decorated with comfortable furnishings, Stone House presents a homely atmosphere. There is also an active day centre, which adds to the air of community involvement. Weekly fees are published in the service user guide and are reviewed annually on 1st April each year. Fees currently range from £425.00 for ‘Residential’ clients to £450.00 for ‘EMI’ clients and £469.00 for private respite. Additional charges are made for toiletries, hairdressing, newspapers, and escort to hospital for routine appointments. People who use the agency and their representatives are able to gain information about this service from the Statement of Purpose and Service User Guide. Inspection reports produced by CSCI can be obtained direct from the provider or are available on our website at www.csci.org.uk Stone House DS0000020656.V367089.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 stars. This means that people who use this service experience excellent quality outcomes. The inspection was unannounced and took place on 1st July 2008 by one inspector over four hours. A range of evidence was used to make judgments about this service to include discussions with people who use the service, the registered manager, staff on duty, a tour of the home, and observation of care experienced by people using the service. We also looked at a number of records to include care records held on behalf of four people, complaints and protection, staff training, recruitment and health and safety records. Prior to this inspection an Annual Quality Assurance Assessment (AQAA) document was posted to the manager for completion. The AQAA is a selfassessment and a dataset that is filled in once a year by all providers. It informs us about how providers are meeting outcomes for people using their service and is an opportunity for them to share with us areas that they believe they are doing well. By law they must complete this and return it to us within a given timescale. Some of the manager’s comments have been included within this inspection report. The purpose of the inspection was to assess all ‘Key’ National Minimum Standards for older people and any additional Standards considered necessary. A quality rating is provided throughout the report based on each outcome area for the people who use the service. These ratings are described as excellent/good/adequate or poor based on findings of the inspection. What the service does well: The home ensures that good assessments are carried out to ensure that they are able to meet the needs of people prior to their admission. People told us they are “well looked after” and “everyone is so kind here.” Care plans are generated from the initial assessment. They are comprehensive and detail how an individual wishes their needs to be met. Medication administration, storage and disposal are in accordance with accepted good practice. All staff are trained in the safe handling of medication. Stone House DS0000020656.V367089.R01.S.doc Version 5.2 Page 6 People are encouraged to make choices about their daily lives, this was reiterated by people telling us about their positive personal experiences of living at the home. There is an accessible complaints procedure in place, which people are made aware of through good information provided to them before moving into the home. The environment that people live in is comfortable and well maintained. It is kept clean by a committed housekeeping team. People told us they are pleased with their rooms and the standard of hygiene maintained. One person said “ I like my room, it’s very nice, I have my things around me.” The home has a robust recruitment procedure to safeguard people who live at the home. Staff are properly inducted and trained to ensure they have the knowledge and skills to deliver good quality care. Staff are supervised and their practice monitored to ensure that this standard of care is maintained. The home has a qualified manager with strong leadership skills who ensures the ethos of the home is clearly understood by her staff team. People who use the service are listened to and their views are gained through surveys and informal discussions and meetings. What has improved since the last inspection? What they could do better: No shortfalls were identified at this inspection. Stone House DS0000020656.V367089.R01.S.doc Version 5.2 Page 7 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. Stone House DS0000020656.V367089.R01.S.doc Version 5.2 Page 8 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 Stone House DS0000020656.V367089.R01.S.doc Version 5.2 Page 9 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): 3 Quality in this outcome area is good. Prospective service users and their representatives have the information needed to choose a home, which will meet their needs. There is a clear assessment process in place, which involves the individual/representative. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We looked at a file of the most recent person admitted to the home. This person was staying on a short respite stay and knew the home well prior to admission. We found that a comprehensive assessment of the individuals needs had been carried out by the home prior to the admission. An assessment had also been carried out by the local authority that were supporting the individual through the care management process. Through discussion with the Stone House DS0000020656.V367089.R01.S.doc Version 5.2 Page 10 registered manager and examination of the assessment documentation it is clear that time and effort is put into planning the admission to make the experience personal to the individual. The individual concerned told us they were happy with the arrangements made to arrange the stay and the quality of the care and support they were receiving. Stone House DS0000020656.V367089.R01.S.doc Version 5.2 Page 11 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 & 10 Quality in this outcome area is excellent. The health and personal care, which individuals receive is based on their individual needs. The principles of respect, dignity and privacy are maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: It was stated on the AQAA that the home compiles care plans that cover individuals health, personal and social needs. They recognise the importance of documenting an individuals needs to ensure that they are able to plan the care to enhance the overall health and well being of people using the service. We looked at four care plans in detail. We found them to be clear and detailed, giving instructions to staff that provide care and support to individuals. Care plans also contain a useful personal profile document. This details a persons past history, important details that help care staff to view the person as an Stone House DS0000020656.V367089.R01.S.doc Version 5.2 Page 12 individual, and recognise their individuality. The home have trained staff in the topic of dementia and have introduced life storybooks into the care planning process. This means that staff obtain information about an individuals past life and an insight into interests and abilities when planning routines of daily living and arranging activities. All care plans have been reviewed on a regular basis and updated where changes had occurred to the individual. Records of specialist health care visits were seen. The home monitors the health care needs of individuals and appropriate action had been taken when individuals required support from a health care professional. It is worthy of note that people who use the service are enabled to visit their general practitioner at the local surgery. Those who are frail or too poorly are visited at the home by their general practitioner. Aids and equipment were seen to be in place on the tour of the home to encourage maximum independence for people. One individual has purchased her own special bed, which was seen to be in her bedroom. This demonstrates the homes desire to promote individual choice and personal preferences when people move into the home. The AQAA told us that the home has a comprehensive and efficient medication policy and procedure in place, and that all staff have undertaken training in safe handling of medication. We looked at the storage of medication and administration records along with observation of the lunchtime medication round. We found these to be satisfactory. We also talked to the staff member carrying out the medication round who confirmed that he had undertaken the medication training. We also saw confirmation of training when we looked at certificates held on individuals training files. Controlled drugs records now contain a photograph of the individual receiving the controlled drug, this is as a result of training attended by staff and the home wishing to further develop good practice within their medication procedures. Observations during the day confirmed that people’s privacy and dignity is maintained. We observed care staff respectfully interacting with individuals. People consulted as part of the inspection process told us that staff are kind and caring. They assured us that their privacy and dignity is maintained at all times. Stone House DS0000020656.V367089.R01.S.doc Version 5.2 Page 13 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 & 15 Quality in this outcome area is excellent. People are able to choose their lifestyle, social activity and keep in contact with family and friends. Social, cultural and recreational activities meet people’s expectations. People who use the service receive a healthy, varied diet according to their assessed requirement and choice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home told us in the AQAA that they provide individual and group activities to meet the needs and preferences of people who use the service. The ‘extend’ exercise group was taking place on the day of the inspection. The hairdresser was also attending individuals during the inspection. There are a variety of activities that take place, these are displayed around the home to let people know the forthcoming programme of entertainment. We saw lots of evidence of events that had taken place, pictures of entertainers and people who use the service enjoying a variety of activities. The home has worked hard to work Stone House DS0000020656.V367089.R01.S.doc Version 5.2 Page 14 with individuals to produce some very interesting local history facts displayed around the home. Many of the pictures contain people known from the local community, who may have been friends or significant individuals to people living at the home. The home has a ‘Friends of Stone House’ group who support the home in activities. The home are involved with Age Concern and came runner up in the Christmas card competition. The manager fully involves the home in local community events, such as watching Morris dancers and the local carnival. Local church ministers provide services at the home which individuals have a choice of participating in. People who use the service were complimentary about the quality of the food provided. The catering staff achieved the Shropshire healthy eating gold award this year. The menu offers healthy options and meals suitable for specialist diets, including diabetic, gluten-free and low-fat diets. Healthy options are indicated on the menu by a heart symbol. Stone House DS0000020656.V367089.R01.S.doc Version 5.2 Page 15 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): 16 & 18 Quality in this outcome area is good. People who use the service are able to express their concerns and have access to a robust, and effective complaints procedure, are protected from abuse, and have their rights protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: It was stated on the AQAA that the home has received one complaint since the last inspection. CSCI were made aware of this and the issues raised. The incident was referred to the safeguarding of adults process. The process was completed and the case was closed. The home has demonstrated that the action point made as a result of the referral has been acted upon. A recent incident, involving medication, which was beyond the home’s control was appropriately referred into the safeguarding of adults process and once again satisfactorily dealt with. All staff receive training in the protection of vulnerable adults. This ensures that people who use the service are protected at all times. Training undertaken was confirmed through discussion with staff and examination of training certificates seen on individual’s personal files. Stone House DS0000020656.V367089.R01.S.doc Version 5.2 Page 16 People living at the home and consulted on the day of the inspection had no complaints about the service. Information on how to make a complaint is readily available in the homes reception area. People were clear on who to speak to if they did have a concern or complaint about the service. The home is able to arrange an advocacy service through Age Concern for any individual who requires it. Stone House DS0000020656.V367089.R01.S.doc Version 5.2 Page 17 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 & 26 Quality in this outcome area is excellent. The physical design and layout of the home enables people to live in a safe, well maintained and comfortable environment which encourages independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A full time handyman is in post, which ensures the home is maintained to a good standard. There are five individual units each comprising of single bedrooms, toilet and bathing facilities, lounge/dining area, and a small kitchen facility for people to make drinks in. The home is well decorated, comfortably furnished and provides a homely atmosphere. The kitchen provides meals for all five units. Stone House DS0000020656.V367089.R01.S.doc Version 5.2 Page 18 In the past 12 months the home have had new windows fitted, replaced carpets in corridors and had new bedroom furniture. The home incorporates a day centre, which local people can access. People living at the home can also use these facilities, which we observed on the day of our visit. A tour of the home demonstrated that the housekeeping team work hard to maintain the standards of cleanliness. Those bedrooms seen were personalised with residents’ possessions. The gardens at the home are planted with colourful flower borders and mature shrubs. There is comfortable seating around a paved walkway and lawn area. There is an enclosed ‘safe’ garden for people who may have reason to be supervised. Stone House DS0000020656.V367089.R01.S.doc Version 5.2 Page 19 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 & 30 Quality in this outcome area is excellent. Staff in the home are trained, skilled and in sufficient numbers to support the people who use the service, in line with their terms and conditions, and to support the smooth running of the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Discussion with staff and people who use the service supported the home’s statement in the completed AQAA that told us “we meet the needs of our service users on a daily basis by making sure we have the skill mix and numbers of staff on duty that are suitable.” Induction training is provided to all new staff in line with the skills for care induction standards. We saw evidence of completed induction training and staff confirmed they had completed training when we spoke to them. Training leading to National vocational awards (NVQ) is provided. The AQAA stated that over 50 of care staff are trained to NVQ level two or above. A further 10 of staff are working towards their NVQ level two or above. This exceeds national minimum standards. The manager prioritises Stone House DS0000020656.V367089.R01.S.doc Version 5.2 Page 20 training and all mandatory training was seen to be up-to-date along with specialist training such as dementia care being provided to care staff. We saw evidence of completed training on individual personal files examined as part of the inspection process. The recruitment of good quality carers is seen by the manager as an important aspect of staff recruitment. This is to ensure that service delivery is of the highest standard. The home demonstrates this belief by operating a robust recruitment procedure. We looked at the file of the two most recent recruits employed at the home. All checks required by regulation were in place. Coverage Care were recently recognised by Shropshire Partners in Care (the local provider association) as ‘organisation of the year’ and have also achieved the investors in people award. Stone House DS0000020656.V367089.R01.S.doc Version 5.2 Page 21 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 & 38 Quality in this outcome area is excellent. The management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a qualified, competent manager. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager is a suitability qualified individual. She has good leadership skills and is well respected by people living at the home and staff alike. The manager has clear vision about the development of the service. It Stone House DS0000020656.V367089.R01.S.doc Version 5.2 Page 22 was clear through discussion with her and the staff group that ‘team work’ is important to ensure a high quality service is provided to people living at the home. During the home tour people living at the home complimented the manager on the good job she does. It was clearly evident that people have confidence in her ability to run the service. As noted earlier in the report the home has gained recognition by the independent accrediting body ‘Investors in People’. Quality assurance is evident throughout the home both formally and informally. The home carry out surveys, supervision of staff both formally and informally through observation of their practice. In addition to the homes internal quality assurance systems the home is supported through monthly ‘ regulation 26’ visits carried out by the operations manager. An internal audit was being undertaken on the day of the inspection. Useful contribution by the operations manager took place during the inspection. A number of compliments were seen in thank you cards from people who have had experience of their relative being cared for at the home. Some comments include “ thank you for looking after Mum for several years, for your care and patience” “ thank you for all the attention and care you gave mother while she was in your care.” People who use the service are safeguarded by strict financial procedures operated within the home. This was discussed with a senior member of staff and the administrator of the home who demonstrated their knowledge and understanding of policy and procedure to be followed. The home is regularly audited by a qualified accountant to ensure they comply with their policies and procedures. Health, safety and welfare of people using the service, staff and people visiting the home are safeguarded by safe systems of work being in place. We examined health and safety records and found that regular checks required by health and safety law are maintained. Staff are trained in the topic of health and safety and were observed to adhere to safe working practices during the inspection. The completed AQAA sent to us contains good information fully supported by appropriate evidence. The home recognises the areas that it wishes to further improve, and has clearly detailed some excellent ways in which they are planning to do so. Stone House DS0000020656.V367089.R01.S.doc Version 5.2 Page 23 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 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 4 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 4 x x x x x x 4 STAFFING Standard No Score 27 4 28 4 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 x 4 x 4 x x 4 Stone House DS0000020656.V367089.R01.S.doc Version 5.2 Page 24 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. Refer to Standard Good Practice Recommendations Stone House DS0000020656.V367089.R01.S.doc Version 5.2 Page 25 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 Stone House DS0000020656.V367089.R01.S.doc Version 5.2 Page 26 - 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!