Inspection on 30/09/08 for The Stables

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

The Stables 01/11/05

The Stables 19/04/05

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 20/12/2008.

CARE HOMES FOR OLDER PEOPLE The Stables Castle Road Hartshill Warwickshire CV10 0SE Lead Inspector Patricia Flanaghan Key Unannounced Inspection 02:30 30 August & 22 September 2008 th nd 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 The Stables DS0000062042.V370809.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. The Stables DS0000062042.V370809.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Stables Address Castle Road Hartshill Warwickshire CV10 0SE 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) 02476 392352 02476 392535 Mrs Catherine L Arnold Manager post vacant Care Home 7 Category(ies) of Old age, not falling within any other category registration, with number (7) of places The Stables DS0000062042.V370809.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category (OP) 7 The maximum number of service users to be accommodated is 7. 2. Date of last inspection 31st August 2006 Brief Description of the Service: The Stables is purpose and provides care for seven people, six of which are elderly. All seven bedrooms have ensuite facilities. The rooms also have a telephone, television and radio. There is a communal bathroom which contains both an assisted shower and bath with hoist to assist the less mobile residents. There is a church close by to the home and other amenities can be accessed with the assistance of the manager and staff. Fees are reviewed annually and can be requiested from the home. Additional charges are made for chiropody, hairdressing and personal toiletries. The Stables DS0000062042.V370809.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 2 star. This means the people who use this service experience good quality outcomes. The focus of inspections undertaken by the Commission for Social care inspection (CSCI) is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision that needs further development. This was an unannounced inspection taking place over two days and lasting eight hours in total. We used a range of methods to gather evidence about how well the service meets the needs of people who use it. This included talking to people who use the service and observing their interaction with staff where appropriate. We also looked at the environment and facilities provided and checked records such as care plans, risk assessments, staffing rotas and staff files. 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. We spent time in the communal lounges and talked to four people about their experience of living at the home. General conversation was held with others, along with observation of working practices and staff interaction with the people living in the home. We also spoke with two visitors to the home. Both expressed satisfaction with the care their relative was receiving. Three people using the service were identified for case tracking. This is a way of inspecting that helps us to look at services from the point of view some of the people who use them. We track peoples care to see whether the service meets their individual needs. Our assessment of the quality of the service is based on all this information, plus our own observations during our visit. At the end of the visit we discussed our preliminary findings with the manager. The Stables DS0000062042.V370809.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? 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. The Stables DS0000062042.V370809.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 The Stables DS0000062042.V370809.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): 3 Quality in this outcome area is good. People who are considering moving into the home benefit from having their care needs assessed so that they can be sure the home can meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has updated the Statement of Purpose and Service User Guide and this has been reviewed by our Registration Team as being satisfactory. We looked at the records for a person who had recently moved into The Stables and saw that a pre-admission assessment had been undertaken. Records were seen to be personalised and addressed all activity of daily living skills, physical and mental health, social care and spiritual needs. We spoke with the person who told us that their family had visited the home and arranged for them to spend some time there. The person said they were The Stables DS0000062042.V370809.R01.S.doc Version 5.2 Page 9 very settled at The Stables and commented “I couldn’t have found a better home.” The Stables DS0000062042.V370809.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. Each person living in the home has a plan of care and access to health care services so that their health and personal care needs are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents observed during this inspection visit looked well cared for; it was evident that the service is meeting their personal care needs. People were well presented and groomed and they wore well laundered clothes that were suited to the time of year. Three people were identified for ‘case tracking’. Each care file contained a profile about the person’s life history and enduring interests and relationships. This good practice should help staff to understand the cultural and social background of individuals and assist them to give ‘person centred’ care. The Stables DS0000062042.V370809.R01.S.doc Version 5.2 Page 11 Each person had a plan of care with information about the actions staff need to take to meet most of their identified needs. Care plans are based on the initial assessment of peoples’ needs and there is evidence that they are reviewed and updated. The service uses risk assessment tools for identifying the risk of falls and developing pressure sores. A dietary assessment is completed for each person to identify potential risk of poor nutrition. This good practice should identify risks to the health and well being of people living in the home so that care plans can be developed to minimise identified risks. Records examined showed that people are supported access to GP services, hospital out patient appointments, community nurses and optician. A relative told us “The standard of care is exceptional.” The systems for the safe management of residents’ medication were examined. A monitored dosage (‘blister packed’) system is used. Medicine administration records (MAR) were completed correctly. Audits of the medication of the people involved in case tracking were undertaken and were found to be accurate indicating that people living in the home have their medicines administered accurately. People living in the home were observed to be treated with respect and their dignity maintained; for example, personal care was provided in private and residents were spoken to respectfully. During observation of working practice it was evident that staff are knowledgeable about the likes and dislikes of people living in the home and were kind, caring and attentive towards them. One relative commented in their survey “The residents feels individually cared for. My relative would say the owner is a friend. If the others feel the same then The Stables will feel like home to all of them.” The Stables DS0000062042.V370809.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 excellent. People living in the home are supported to maintain their independence and enduring interests which enhances their quality of life. People benefit from a varied and nutritious diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home provides individual and group activities for people who live at the home. The manager obtains information about an individuals past life and an insight into interests and abilities when planning routines of daily living and arranging activities. There is an activity board with a list of activities or outings planned for the coming month, although this is very flexible and individual requests aer taken into account. An example of what the home provides include newspapers, periodicals and large print library books, art sessions inside and outside of the home, music and movement session, one to one reminiscence sessions. Outside trips are very well attended, so of these being arranged on a The Stables DS0000062042.V370809.R01.S.doc Version 5.2 Page 13 one to one basis. For example, a resident was assisted to attend an evening church service at a church in the Cotswolds. Activities are displayed throughout the home of forthcoming events. Pictures of activities that have taken place are displayed around the home. People living at the home told us “There is always something to do here”, “ there is never a dull moment, there is always something to do.” A number of people attend a local club and also participate in their outings. For example, a visit to the Derbyshire Dales has been arranged by the club and the home are enabling a carer to accompany the people to offer any assistance required. Afternoon teas are arranged monthly at a local garden centre and there are regular meals out at a local pub for those people who wish to go. Visitors are made welcome at all times and they are involved in the residents’ care and planning. The home is friendly and welcoming and visitors and residents are able to communicate well with staff. People use their bedrooms as well as communal areas to receive their visitors. This good practice supports people to maintain their enduring relationships. People are supported to attend the place of worship of their choice. People are encouraged to take control of their daily lives. There was evidence that people are consulted about their care. People signed their care plans to indicate their agreement. People who use the service receive a healthy, varied diet according to their assessed requirement and choice. The lunchtime meal was observed and was relaxed, choices were offered along with second helpings. Care plans documented likes and dislikes of people in relation to diet. Special dietary needs are recorded in the care plan and reviewed. People spoken to told us the quality of food is good and choice is offered. One person said the food was “very good” and they had a choice each day. Another said the food was “very nice” and there was enough to choose from. The Stables DS0000062042.V370809.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): 16 and 18 Quality in this outcome area is good. Complaints are taken seriously by the home and there are appropriate policies and procedures to safeguard people living the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service has a complaints procedure. The complaints procedure is available within the home and is also available in the service user guide given to all prospective service users. People spoken to during the inspection said they had no complaints that would know who to speak to if they had any concerns. A visitor told us “I have never needed to raise any concerns, but I know if I did, it would be dealt with immediately.” A policy on adult protection is available in the home. The manager was aware of her responsibilities in relation to adult protection. Staff have attended training on how to recognise abuse and when questioned were able to state what they would do including reporting this to the manager. The Stables DS0000062042.V370809.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, 24 and 26 Quality in this outcome area is good. People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has recently been extended and now provides accommodation over two floors. There is a communal lounge and conservatory on the ground floor.. All areas in the home were attractively decorated to a good standard. Residents were observed making use of all the communal spaces, although people who prefer to remain in their own rooms are accommodated. All of the bedrooms were viewed. They were comfortable, well decorated and had good quality furniture and co-ordinating soft furnishings. All rooms have The Stables DS0000062042.V370809.R01.S.doc Version 5.2 Page 16 ensuite facilities. Rooms were personalised with people’s own belongings and looked as though it belonged to the person. Comments received include: • • • • “I love my room, it’s a pleasure to go in to it.” “ The home is always clean and tidy” “ My room is cleaned every day” “I have been allowed to bring in things from my own home, it makes my room feel my own” The laundry has been moved to a separate building in the grounds of the home. Systems are in place for the management of dirty laundry. Peoples clothing looked well cared for and clean. Protective clothing such as plastic gloves and aprons were available and arrangements are in place for the disposal of waste. The Stables DS0000062042.V370809.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. Staff in the home are trained, skilled and in sufficient numbers to support the people who use the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staffing levels were appropriate for the numbers and needs of the people living in the home at the time. Training is provided in food safety, infection control, fire safety, health and safety, control of substances hazardous to health, dementia care, first aid, safe handling of medication, person centred care and safeguarding of vulnerable adults. Evidence of certificates for completed training were seen on staff training files examined. The file of two recently appointed staff showed that an in-house induction had been completed along with the skills for Care Council common induction standards. Completed records of induction identified further learning needs for the individual. Much of this training has been organised and dates arranged for completion were seen in the daily diary. The personnel files of two recently recruited staff were examined. The Stables DS0000062042.V370809.R01.S.doc Version 5.2 Page 18 Files contained evidence that Criminal Record Bureau (CRB) checks and Protection of Vulnerable Adult (PoVA) were requested before the person started working in the home working in the home but had not yet been obtained. The manager told us that the staff members did not have unsupervised access to residents. Robust recruitment checks, including satisfactory a CRB and PoVA First, if applicable, must be obtained before staff start working in the home to safeguard the vulnerable people living there. The Stables DS0000062042.V370809.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 home is owned and managed by an experienced and competent person to ensure the service is run in the best interests of people living at The Stables. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The owner/manager has approximately 30 years experience working in a care setting and is suitably qualified to manage the home. She has attained the Registered Managers Award qualification and has kept herself updated on training with conditions and illnesses associated with old age. Discussions with residents and staff and observation, indicated that she is approachable and relates to the residents. The Stables DS0000062042.V370809.R01.S.doc Version 5.2 Page 20 The people living in the home are issued with satisfaction surveys every few months and there are informal residents and staff meetings. The manager also undertakes audits within home, for example, medication audits and health and safety audits. People are supported to manage their own money where possible. Where this is not possible the home will keep money in safekeeping. Records for these individuals are maintained at all times. The home has effective systems for maintaining equipment and services to the home to promote the safety of people in the home. The home confirmed in a pre-inspection questionnaire forwarded to the commission that health and safety checks had been completed. A sample of service and maintenance records were examined and found to be up to date. The Stables DS0000062042.V370809.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 X 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 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 The Stables DS0000062042.V370809.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. 1 Standard OP29 Regulation 19(1) Requirement All pre-employment checks must be carried out to ensure that people who use the service are protected at all times. Timescale for action 31/10/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Stables DS0000062042.V370809.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 The Stables DS0000062042.V370809.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. 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