Inspection on 21/11/07 for Strode Park Nursing Home

This is the latest available inspection report for this service, carried out on 21st November 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Strode Park Nursing Home 20/02/06

Strode Park Nursing Home 11/08/05

Strode Park Nursing Home 01/11/04

Strode Park Nursing Home 15/06/04

Similar services:

Thorndene

Sutton Lodge Nursing Home

Wingham Court

Bethany Lodge

17 John Street

Red Oaks

Clare House Nursing Home

Broad Oak Manor Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Strode Park Nursing Home Strode Park House Herne Herne Bay Kent CT6 7NE Lead Inspector Mary Cochrane Key Unannounced Inspection 21st November 2007 10:30 Strode Park Nursing Home DS0000026122.V356193.R01.S.doc Version 5.2 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 Strode Park Nursing Home DS0000026122.V356193.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 Adults 18-65. 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. Strode Park Nursing Home DS0000026122.V356193.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Strode Park Nursing Home Address Strode Park House Herne Herne Bay Kent CT6 7NE 01227 373292 01227 369033 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) Strode Park Foundation for Disabled People Mrs Alexandra Juniper Care Home 56 Category(ies) of Physical disability (56) registration, with number of places Strode Park Nursing Home DS0000026122.V356193.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 42 of the 56 beds are registered for nursing clients and 24 are registered for residential clients. The total number of beds is 56, however, there is flexibility established between the use of nursing and residential beds. 1st August 2006 Date of last inspection Brief Description of the Service: Strode Park Nursing Home provides accommodation and support for permanent and respite residents. The majority are accommodated in single rooms. All facilities are situated on the ground floor. The home has recently opened a new wing. There is a shaft lift to access the first floor. The home has a call bell system and each bedroom has a television point. A small number of bedrooms have been provided with telephone points, which residents have requested. There is a day centre located next to the home, which provides people with access to physiotherapy and IT facilities. Residents are able to maximise their independence through the provision of environmental aids and adaptations. There are extensive grounds with mature gardens and an attractive fountain. Located within the grounds is the Theatre in the Park and cafe which is well utilised by both residents and visitors throughout the year. The home is situated in the village of Herne immediately adjacent to the main Sturry to Herne Bay Road. There is access to a bus service and other facilities such as local shops, which are within walking distance. There is ample car parking. The current fees for the service range from £640.18 to £1,076.20. A copy of the most recent CSCI report can be found in the reception area of the home. Strode Park Nursing Home DS0000026122.V356193.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the Service was an unannounced “Key Inspection”. The Inspector arrived at the Service at 10.30 a.m. and was in the home for seven hours. It was a thorough look at how well the Service is doing. Information received by the CSCI about Strode Park Nursing Home since the last inspection was used in the report. There was in depth discussion with the manager during the site visit. There was one-to-one discussion with people who use the service and staff. Staff interactions with clients, care interventions and activities were looked at. Individual support plans and risk assessments were discussed. Selected policies, medication charts and training programmes were seen. A partial tour of the building was undertaken. There is one required development and 5 good practice recommendations at the end of this report. What the service does well: The registered manager of Strode Park Nursing Home has the competency, experience and skills to manage the home to a good standard. She is able to demonstrate a clear sense of direction and leadership, which the staff and residents understand and relate to. The home is well managed. The Foundation’s senior management and trustees support the registered manager in her role. There is a Director of Care, Human Resources Manager, Chief Executive and Maintenance Manager on site as well as other corporate staff. Prospective residents and their families can visit the home and access the information to help them decide whether or not Strode Park will be the right place for them to live. Residents have comprehensive care/ support plans and staff employ sound risk assessment processes. This minimises identified hazards and protects people whether they are in the home or out in the community, while allowing people to do the things they want. People are able to make decisions and have choices on how they live their life’s. Privacy and dignity is maintained. Life at Strode Park Nursing Home is flexible and safe. All health and personal care needs of the residents are being well met by the staff team and specialist out-side support is accessed when required. Strode Park Nursing Home DS0000026122.V356193.R01.S.doc Version 5.2 Page 6 The home provides a relaxed, friendly and welcoming environment for residents to live in and for staff to work in. Residents are supported to be as independent as they can and to keep in touch with family and friends. Residents said “ the staff are always very helpful and would do anything for them”. The care staff on duty were seen to interact with the residents in a respectful and caring way. Staff are enthusiastic and take pride in the work they do. The people at the home reported that the food is always good, there is always enough and they always have a choice of menu. The registered manager and staff team keep the vast majority of documentation in good order. All health and safety records were up to date and plans and records were generally well maintained. The home seeks the views of the residents, their relatives and others involved with the home so they can continue to improve the service. What has improved since the last inspection? The home has now been split into 4 zones and there is a skill mix of staff working in each zone. Each of who have been delegated specific responsibilities. This has meant that support and care is now delivered in a more holistic and person centred way. Residents spoke positively about this. They said that staff have more time to spend with them and they don’t feel rushed. One lady said ‘The staff have more time to help me do things for myself’. The home has increased the number of staff on each shift to make sure that everyone gets the support and care that they need, in the way that they choose. The organisation and planning of activities for individuals is developing. The home now has a dedicated activities co-ordinator who is working towards improving the quality and quantity of activities. Medication is now administered safely. A record is kept of the meals eaten by the residents. This means that any dietary problems can be identified and addressed quickly and effectively. The Foundation now makes sure that all safety checks are completed before staff start to work at the home. This protects residents. Strode Park Nursing Home DS0000026122.V356193.R01.S.doc Version 5.2 Page 7 Any untoward incidences are now reported promptly to the necessary agencies. The environment in the main dining room is improving. More work could be done to make it more inviting and homely. 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. Strode Park Nursing Home DS0000026122.V356193.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Strode Park Nursing Home DS0000026122.V356193.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 and 5. People who use the service experience good outcomes in this area People who use this service have sufficient information about the home in order for them or their representatives to make an informed decision about whether the service is right for them. An individual needs assessment is carried out to make sure peoples diverse needs are identified and planned before they move to the home. Resident’s places at the home are protected and on the whole they know what they are paying for. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a comprehensive statement of purpose and service users guide which clearly sets out the aims and objectives of the service and details the facilities provided by the Strode Park Foundation. The information does need to be reviewed and updated to include the the new ways of working within the home and also about the opening and function of the new unit. The guide would also benefit from including the views of the people living at the home. The registered manager did explain that the Director of Care was in the process of updating both of these documents. Strode Park Nursing Home DS0000026122.V356193.R01.S.doc Version 5.2 Page 10 The home has had several new admissions since the last inspection. 3 of these were looked at. The service has all the necessary tools in place to undertake a good assessment. The assessments look at all the different levels of need and support. They contain all the necessary information for developing robust care plans. Only a member of staff with the necessary skills and knowledge will undertake the assessment. The registered manager is trying to ensure that who ever goes to do the assessment will be one of the key members of staff supporting the person if they decide to come and live at the home. This will give the prospective resident the opportunity to have key person to assist them in settling into their new environment. For the people who are already living at the home the plans are that they will be re-assessed to make sure that their goals and aspirations and support needs have been identified and acted on. All the residents have contracts and terms and conditions of residency on file. There is information about the fees charged what they cover when they must be paid and by whom. Some of the people living at the home did report that they had to pay for transport on some occasions. The contracts and service users guides need to give information about when the home pays for transport and when the residents have to pay. Strode Park Nursing Home DS0000026122.V356193.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8 and 9 People who use the service experience good outcomes in this area. Residents have individual care and support plans that ensure their needs are identified and met. They are supported to take assessed risks as part of an independent lifestyle and to make decisions in their lives. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection the registered manager has totally reorganised how the home functions. It has now been divided into 4 zones of between 12 –14 residents. Each zone has a skilled mixed staff team. Residents reported the this has improved the support and care they are receiving on a daily basis. They said that there is more continuity and they are able feel confident that the staff know them.. One person said ‘I know my key worker, There are more staff and I now get the all help that I need’. Strode Park Nursing Home DS0000026122.V356193.R01.S.doc Version 5.2 Page 12 Another said ‘We don’t have to wait for somone to come now, everyone knows what they doing’ Each person living at the home has a care plan. 5 care plans were looked at in detail. The majority are of a good standard and reflect the individual and changing needs of the residents. Some are more person centred than others and showed that consideration had been given to supporting resident’s holistic needs. These looked at what people could do instead of what they could not. They also looked at all different areas of peoples life’s and how goals and aspirations could be achieved. Some plans are still task orientated. The registered manager needs to make sure that all the plans are of a good standard. She did tell us that in January she plans to transfer the plans onto a format that is person centred. Each plan will be developed following consultation and input from the individuals living at the home. The homes advocate has already started discussing care plans with individual residents. A working party is going to be set up which will include residents from each zone within the home and also team leaders. There are also plans to ensure that staff have the necessary training and support to undertake this task effectively. The majority of plans do contain all the necessary information to ensure that needs are met. There are also plans on eating and drinking needs, personal hygiene, medical and specialist needs, and individual management. The home arranges 6 monthly reviews for all the residents. Residents are supported to take risks as part of maximising their independence and this is recorded. They are supported to take reasonable risks to allow them to participate in the activities they wish to. Risk assessments are individualised pending on the person’s specific need. There are risk assessment tools in place for individual physical needs e.g. manual handling, pressure area care, nutrition and self-medication. Residents are encouraged to make choices. They receive continuity of care by having individual key workers. There is evidence that attention is given to helping people to make decisions and choices about how to spend their time. It was observed that residents are encouraged and supported to live how they want to. Residents are involved as far as possible in decisions regarding the running of the home. Regular residents meetings are held and the home employs an advocate. Residents said they can talk to the advocate in private and can ask advice. They feel supported and feel that their views and concerns are listened to and acted on. One person said ‘Sometimes it takes a while to get things done, but we get there eventually’ Strode Park Nursing Home DS0000026122.V356193.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,1314,15,16 and 17. People who use the service experience good outcomes in this area Residents have improved access and involvement to meaningful and fulfilling activities inside and out side the home. Equality and diversity issues are recognised and individual rights are respected. The home offers a healthy, balanced diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection the home has taken positive steps towards improving the facilities and activities on offer. One of the large rooms is in being decorated and reorganised to accommodate an activities area. The home now also has a dedicated activities co-ordinator who has lots of good ideas on how to develop meaningful and diverse activities, which will help residents in achieving their goals. There is still a generic activities programme in place, Strode Park Nursing Home DS0000026122.V356193.R01.S.doc Version 5.2 Page 14 which people can join, or not as they please. The co-ordinator told us she is in the process of finding out about what individuals want to do and their likes and dislikes in this area. From this information individual programmes will be developed and will be incorporated into the new support plans. The service told us at the present time there is more 1:1 activities with residents who wish to stay in their rooms. People are now able to spend individual time with their key workers. The residents reported that this has made a difference. One person said ‘they know me better now’ another said ‘there is more to do, its getting better’. The registered manager recognises that they are developing this part of the service and there is more work to do. The co-ordinator and manager have direction and a vision on what they want to achieve to ensure that the residents enjoy a full and stimulating lifestyle with a variety of options to choose from. The home needs to make sure that it keeps an accurate record of the activities people do. There was a requirement made at the last inspection with regards activities. There will now be a recommendation that the work continue. The residents have a good range of leisure pursuits to choose from. Everyone was very complimentary about the activities co-ordinator who has organised trips to the London Eye, the London Christmas Lights and Dickens World. All of which were enjoyed. Residents said ‘there is more to choose from’. ‘We are doing different things’. In the better weather some activities are held in the grounds of the home. There is an amphitheatre and café in the grounds, which is accessible to all residents. There is now also a mobile bar in the home, which residents are reported to enjoy using. Residents are supported to go out into the community. The home has its own minibus and drivers. Each of the residents can take an annual holiday if they wish. The company will pay £500 pounds towards this. Visitors are welcome within the home at all reasonable times and no restrictions are imposed. Staff respect the wishes of the residents should they not wish to see someone. People are able to receive their visitors in the privacy of their own rooms or in the quiet communal area. They are supported to develop and maintain intimate personal relationships with people of their own choice and information and guidance is provided to help people make appropriate and informed decisions. The rules of the home respects resident’s rights to privacy and dignity and staff were seen to respect these. Staff were observed demonstrating good communication skills. They were seen speaking and interacting in a positive way. Residents were included in all conversations. Strode Park Nursing Home DS0000026122.V356193.R01.S.doc Version 5.2 Page 15 Bedroom doors are fitted with locking devises. Residents are encouraged to be involved in the day to day running of the home as far as they can be and they have access to all communal areas. Many of the residents said that since the home has been divided into 4 zones the care staff have more time to spend with them. One person said ‘they are not running around so much now. Its much better’. Another said ‘its not so rushed’ Care staff agreed with this. Residents said they can choose when they want to be in company or when they want to be in the privacy of their own room. The home now has a no smoking policy. There are plans in place to build a shelter with some lighting in one of the garden areas so those who wish to smoke can enjoy doing so with some shelter. Those residents who have an identified specific need have a care/support plan, which covers eating, drinking and meal times. These plans are adhered to. Residents said that they enjoy the food offered by the home. They are offered a choice of meals on a daily basis and were complimentary about the menu. One lady said ‘ You can’t fault it’. They said meals are served hot and portions are sufficient. Comments were ‘if you did not like what is on offer you could choose something else’. Staff were seen supporting people to eat in a respectful, caring and thoughtful way. Residents were not rushed and the atmosphere was relaxed and conducive. There is a choice of 2 main courses every day. The cook in a central kitchen usually prepares meals. Other catering staff are also employed. The cook said that residents can choose what they want to eat and where they eat it. Some people said they preferred to eat in their bedrooms. Special diets are also catered for. Drinks and snacks are available throughout the day. The home now keeps a record of meals eaten or not eaten by the residents. This means that any nutritional concerns can be quickly identified and addressed promptly. Strode Park Nursing Home DS0000026122.V356193.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20. People who use the service experience good outcomes in this area The home provides appropriate personal and healthcare support care for the people living at the home. Residents are safer due to improved practises when administering medication. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Personal care needs and how they are to be met are detailed in individual residents plans. Staff said that residents are encouraged and supported to do as much as possible for themselves. The home operates a key worker system to provide sensitive and individual support to residents. Personal care, life skills and dignity are promoted. Personal care is delivered in a way that is flexible reliable and person centred. The staff were seen to respect the privacy and dignity of the residents allowing them control over their own life. Strode Park Nursing Home DS0000026122.V356193.R01.S.doc Version 5.2 Page 17 The residents are encouraged to choose their own clothes and are supported to shop. There is a flexible approach to daily living activities e.g. getting up, bed, bath and mealtimes. The service makes sure that the residents have access to all healthcare facilities and routine checks and monitoring are carried out at the necessary intervals. Resident’s health care needs are closely monitored and they are promptly referred to professionals when necessary. Each resident is registered with a local G.P. and any area of concern related to health is referred to the G.P. A safe guarding adults alert had been raised in June ‘7 in regards to pressure areas. But following an investigation these alerts were closed .Any concerns about tissue viability are assessed so that appropriate treatment and intervention is commenced as soon as possible. Residents who have pressure areas are receiving the prescribed treatment and for those identified as at risk of developing pressure areas appropriate pressure relieving equipment is in place. A member of staff accompanies residents when they are attending appointments and visits from healthcare professionals are conducted in private. A medical report sheet is maintained by the home to evidence dental, chiropody, G.P. and other health care appointments. There was evidence to show that staff are pro-active in seeking specialist support when it is needed and do everything possible to make sure the needs of the residents are met. All the residents have seen a G.P in the past 12months and have been reviewed. The home uses a Monitored Dosage System (MDS) from Boots and all staff who administer medication have received appropriate training. 2 members of staff have now received more extensive training. A list of staff competent to administer medication is kept. Sample signatures are also available. The medication is stored in locked cupboards and the keys to these are kept on the person who is in charge of the shift. MDS were cross-referenced with drug dispensing sheets and at the time of the visit these tallied. A requirement was made at the last inspection with regards medication. Practises have improved. A drug round was observed and this was done safely. All drugs administered had a written prescription in place. The home now undertakes regular medication audits and this has identified some shortfalls, which the manager is addressing. The service told us that staff competencies are also being checked. As recommended at the previous inspection the home does still need to develop clear written protocols and guidance in relation to medication to be administered as and when required. This will give staff direction and guidelines on when administer ‘as required’ medication. This also needs to include topical creams. Strode Park Nursing Home DS0000026122.V356193.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. People who use the service experience good outcomes in this area The home has a satisfactory complaints procedure. The staff need to make sure that they adhere to it. The residents are protected from harm and abuse This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service has a clear complaints process meeting all relevant requirements. However at the time of the visit it was seen that the policies and procedure was not being adhered to when a complaint was received and investigated. The registered manager took immediate action to address this and was going to speak to all staff to ensure they are aware and follow the procedures. The registered manager told us that initially she aims to deal with any concerns or issues in the home on an informal basis in the first instance with recourse to the formal process if required. Residents said they feel comfortable raising any concerns either on a 1:1 level, through house meetings or informally with staff. There have been a few complaints made to since the last inspection these are mainly concerning the laundry facilities. The registered manager is pro-actively addressing these issues. Strode Park Nursing Home DS0000026122.V356193.R01.S.doc Version 5.2 Page 19 All new staff address safe guarding adult issues through the home’s induction programme and the company does provide additional training. However it was identified that some staff do still need the training. The companies human resources department is aware of this shortfall and are in the processes of organising the necessary training. Staff did demonstrate a good awareness of issues surrounding this topic. There has been one safe guarding adults alert since the last inspection this has now been investigated and closed. Strode Park Nursing Home DS0000026122.V356193.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 People who use the service experience good outcomes in this area. The home continues with its on-going maintenance and refurbishment plans to create an environment that is homely, comfortable and safe for those living there. The residents live in a home that is clean and hygienic. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The homes’ environment continues to improve and work has been done since the last visit. There are still areas that need attention. The home has an ongoing maintenance plan with timescales to ensure that the necessary work is identified and completed within a reasonable length of time. The premises are safe, comfortable, airy and clean and provide sufficient light heat and ventilation. The home employs a maintenance manager who is Strode Park Nursing Home DS0000026122.V356193.R01.S.doc Version 5.2 Page 21 responsible for ensuring the environment is safe for residents. Regular audits are carried out to ensure the home is safe and well maintained. The home has been adapted to meet residents’ needs with wide doorways, assisted bathrooms and some automatic doors have been fitted. Furnishings and fittings are of good quality and domestic in nature. There are several communal rooms, which are airy and light with views over the gardens from most rooms. The main dining area has improved since the last inspection and some pictures have been put on the walls to make it more homely. More work can still be done. The food trolleys are still stored against the walls and cutlery is left out on a trolley. Some of the residents now eat in the dining area of the new wing, this means the original dining room now has more room for people to manoeuvre and more choice about where to sit. Residents said that this was much better arrangement. One person said ‘meal times are now a quieter and more relaxed affair’. The people who choose to eat in the new wing said the same. There is an area where residents can help themselves to drinks and snacks throughout the day. The grounds are extensive and attractive. There are seating and patio areas. There is a bird aviary and an ornamental fountain. The communal areas and grounds are accessible to people in wheelchairs. All bedrooms are for single occupancy and have wash hand basins. Rooms are personalised with service users own possessions. Strode Park is a very large building with many entrances. The management are aware of the security issues this raises and are taking extra precautions with regards security while allowing the residents the freedom to come and go as they please. The home is kept hygienically clean and there are no unpleasant odours. The home employs a number of domestic staff. Hand washing facilities are sited appropriately and staff have access to gloves and aprons. There are procedures in place to protect residents from the risk of cross infection. Laundry is transported safely and washed at the required temperatures. The laundry facilities are in line with the standards. There are suitable washing machines and dryers. Laundry staff are employed by the home. Some laundry is sent out to a contractor. Some residents did say they were not very happy with the laundry service as items of clothing go missing. This has been discussed at the residents meetings and the registered manager is being proactive in addressing the issue. Any item of clothing lost are replaced by the home. Strode Park Nursing Home DS0000026122.V356193.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35 and 36. People who use the service experience good outcomes in this area. The staff have a good understanding of the people living at the home. Positive relationships have been formed. On-going training needs to be in place to make sure the staff have the competencies and skills to meet all the needs of the residents. Recruitment practises protect the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The residents and care staff reported that they have developed good relationships with each other. It was observed that the staff are able to anticipate and meet the individual needs of the client group. The residents responded positively to staff. It was seen that the staff are accessible and approachable. They are able to exhibit good listening and communication skills. It was evidenced that the staff on duty put the needs of the people living at the home first. At this visit the staff were more enthusiastic and positive about their roles in supporting and caring for the residents. They were able to give Strode Park Nursing Home DS0000026122.V356193.R01.S.doc Version 5.2 Page 23 good accounts of the needs of the people at the home and how those needs are met. It was evident that the staff took a pride in the work that they do. The staff did report the recent changes made at the home with regards working in splitting the home into zones and working in smaller teams has been beneficial and an improvement for everyone. Staff, pending on their roles and responsibilities spend varying periods of time within a team, they then move to another team. This enables staff to develop their key worker role and give continuity of care and support to the residents. Members of the staff team have responsibility for different areas e.g. Training new staff, auditing, medication, skin integrity. The development of the zones has also meant there has been an increase in the number of staff working each shift. There has been an increase from 8 carers in the morning to 11 and from 3 trained nurses to 4. There has also been an increase in numbers during the afternoon and night shifts. Extra staff are available if residents want to go out. The registered manager has been very creative in her use of staff numbers and hours to ensure that all the residents receive the support and care that they need when they need it. For example 2 carers are brought in from the company’s domiciliary care agency each morning to assist in meeting the personal of a resident who needs extra support with personal care. There is flexibility and access to staff according to the support needs of the residents. The home does have a thorough recruitment practises. The sample of staff files looked at contain all the necessary information to ensure that the residents are protected. The service now ensures that a full employment history is obtained from all prospective staff and that any gaps in employment are explored at interview. Shortfalls were identified in areas of staff training. From looking at the evidence it was seen that some staff have not received the required up dated mandatory training even though they have been at the home for a considerable period of time. There are also gaps in specialist training. Staff need to gain the knowledge and skills they require to undertake their role effectively, efficiently and safely. The home needs to ensure that this short fall is addressed and that training is planned and on –going. This was a requirement at the last visit and remains out-standing. The Human Resources department of the foundation are in the process of planning a training programme to address this shortfall. Human Resources informed us that 38 of care staff team have achieved NVQ level 2 or above. This is less than on the last visit because of the numbers of new staff that have been employed. Care staff are working towards the qualification and the 50 target should be reached again within the next few months. All staff receive regular supervision. Those spoken to said that they found it beneficial. Strode Park Nursing Home DS0000026122.V356193.R01.S.doc Version 5.2 Page 24 Strode Park Nursing Home DS0000026122.V356193.R01.S.doc Version 5.2 Page 25 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39 and 42. People who use the service experience good outcomes in this area. The home is well run and in the best interest of the people who live there. The health, safety and welfare of the residents is promoted and protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has the required qualification, experience and is competent to run the home effectively. She is person centred in her approach to care. Over the past year she put a great deal of effort and time into reorganising the way the home is structured and the way individual care and support is delivered. She has promoted and developed the staff teams so as to improve and provide a better standard of care for the people who use the Strode Park Nursing Home DS0000026122.V356193.R01.S.doc Version 5.2 Page 26 service. She has demonstrated vision and has been creative with the resources available. There is an ethos of being open and transparent in all areas of running the home. The registered manager is aware of the shortfalls within the service and with support from the management team is working towards addressing them. Both residents and staff praised and spoke very positively about the registered manager. They felt confident in her skills and abilities. The home has effective quality assurance and monitoring systems in place. Systems are in place to ensure financial planning and quality monitoring. Monthly-unannounced visits are made to the home usually by one of the trustees. The trustee will talk to staff and residents and have a look around. A report is produced about the visit. This is all required under Regulation 26 of the Care Homes Regulations. All incidents that are reportable under Regulation 37 of the Care Standards Act are now reported to the appropriate agencies. Feedback is sought from residents, families and others external agencies involved with the home. The information is then used to improve the service. The home employs a maintenance manager who is responsible for health and safety. Regular checks are made of equipment and the premises. There are systems in place for monitoring health and safety. A sample of records relating to building and equipment checks were looked at, all were in order and well recorded. Staff are trained in all areas relating to health and safety during their induction. As mentioned previously the registered manager needs to ensure that all mandatory training is on going and up-dated when necessary. Strode Park Nursing Home DS0000026122.V356193.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 2 33 3 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 2 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 3 3 X X 3 X Strode Park Nursing Home DS0000026122.V356193.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? YES 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. 1. Standard YA35 Regulation 18(1)(c) Requirement The home needs to ensure that mandatory is up-to date for all staff. The home also needs to ensure that all staff receive more specialist training (including safe guarding vulnerable adults) to ensure that they have an understanding and knowledge of residents conditions and how to best meet individual needs. Timescale for action 29/02/08 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. Refer to Standard YA5 Good Practice Recommendations The service needs to make sure that residents know when and how much they have to pay for transport. This information needs to be included in contracts and the service users guide. The home needs to continue the work in developing and organising activities to met the individual goals and aspirations of the people who use the service. The home does still need to develop clear written protocols DS0000026122.V356193.R01.S.doc Version 5.2 Page 29 2. 3. YA12 YA20 Strode Park Nursing Home 4 5. YA22 YA32 and guidance in relation to medication to be administered as and when required. The manager needs to ensure that all staff follow services procedures for logging and dealing with complaints. 50 of staff need to achieve their NVQ level 2 or above. Strode Park Nursing Home DS0000026122.V356193.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Strode Park Nursing Home DS0000026122.V356193.R01.S.doc Version 5.2 Page 31 - 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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