Inspection on 19/12/05 for Stuart House

This inspection was carried out on 19th December 2005.

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 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

Stuart House 15/11/06

Stuart House 10/02/05

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

CARE HOMES FOR OLDER PEOPLE Stuart House 21 - 23 Clevedon Road Weston Super Mare North Somerset BS23 1DA Lead Inspector Juanita Glass Announced Inspection 19th December 2005 09:00 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 Stuart House DS0000061793.V262132.R01.S.doc Version 5.1 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. Stuart House DS0000061793.V262132.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Stuart House Address 21 - 23 Clevedon Road Weston Super Mare North Somerset BS23 1DA 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) 01934 620195 01934 622670 Mr Nunzio Notaro Mrs Rachel Louise Clapham Care Home 21 Category(ies) of Dementia (21), Dementia - over 65 years of age registration, with number (21) of places Stuart House DS0000061793.V262132.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Staffing levels detailed in the letter to Nunzio Notaro dated 22nd November 2004 apply. May accommodate up to 21 Service users aged 50 years and over who have dementia 31st May 2005 Date of last inspection Brief Description of the Service: Stuart House provides care for older people with Dementia. The accommodation provided is on two floors served by a lift. It has 17 single rooms and two double rooms, which are on the ground floor. Stuart House is located close to the seafront in Weston-super-Mare, with a short level walk to local shops and surgeries; it is three-quarter miles to the town centre. There are parks close by. Stuart House DS0000061793.V262132.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the announced inspection for this year and took place in the presence of the acting manager Leila Sharkey. Residents were observed to be relaxed happy and well groomed, those who could express an opinion said that they were happy and that staff were kind. Staff were observed to have an easy and relaxed rapport with the residents whilst maintaining privacy and dignity. The home was found to be clean and tidy, and well maintained. The furnishings were homely in manner and residents have personalised their rooms. During the day residents were observed to exercise personal choice. This was a positive inspection and two recommendations were made. Staff had assisted all the residents top complete a comment card and four comment cards were received from relatives, all comments were positive and praised the care provided by staff. One residents said she was very happy and singled out the manager as a’ special friend’, another said that things were ‘very settled and the girls cared.’ What the service does well: What has improved since the last inspection? Following the last inspection, staff have received training in first aid so that there is a qualified first aider on each shift. All rooms now have their own lock and key and residents assessed as capable off holding their own room key do so. The manager has addressed the storage of and administration of medication which is now within current guidelines. The registered provider has addressed the hot water temperature in an identified bathroom. Stuart House DS0000061793.V262132.R01.S.doc Version 5.1 Page 6 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. Stuart House DS0000061793.V262132.R01.S.doc Version 5.1 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 Stuart House DS0000061793.V262132.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, and 6 does not apply The needs of residents are assessed before admission to the home, and relatives are provided with clear information and a chance to visit the home to assist them in making an informed choice. The manger shows a clear awareness of the needs of the current resident group. EVIDENCE: The home has a clear statement of purpose and residents guide which sets out the facilities and services provided. The statement of terms and conditions is included in the residents guide and is given to potential residents before admission. A copy of the residents guide is made available in each room, it is very clear and includes a list of items that are not covered by fees. The contract does state that keys are provided for rooms, at the last inspection some of the doors in the home did not have locks, however this has been addressed and all residents can have a key to their room if this is supported by a clear assessment. The care records reviewed contained preadmission assessments which were very clear and comprehensive, records also showed Stuart House DS0000061793.V262132.R01.S.doc Version 5.1 Page 9 that people were encouraged to visit the home before moving in, residents spoken to were not able to express an opinion. During discussions with the manager and observation through the day it was evident that Mrs Sharkey had a clear awareness of the needs of the current residents group, and how the home can meet those needs. Stuart House DS0000061793.V262132.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 The health and personal care needs of the residents are well met supported by a clear and consistent care planning system, which adequately provides staff with the information they require to satisfactorily meet residents needs. The rapport between staff and residents is informal and friendly whilst maintaining dignity and respect. Residents are protected by the policies and procedures followed for the administration of medication. EVIDENCE: Care plans continue to be clear and concise, they give adequate information to staff with clear guidelines for person centred approach to care. Allc are plans showed evidence of a monthly review and re-evaluation, all documentation was clearly signed and dated. Staff spoken to were aware of the contents of care plans and the importance of following the guidance for each resident as an individual. Identified risk assessments were in place these showed that individual rather than core needs were identified. Care records reviewed Stuart House DS0000061793.V262132.R01.S.doc Version 5.1 Page 11 showed that residents are encouraged to access health care services such as a chiropodist, optician and dentist. Residents were assisted with attending hospital outpatient appointments such as the diabetic clinic. The home continues to develop links with the local mental health service. During the inspection staff were observed to have a positive and respectful approach to the residents, residents spoken to said they were happy, one gentleman said he was happy and was later observed refusing to have a shave this was dealt with in such a way that he agreed to a shave and he felt he had made the decision to go for a shave, rather than being persuaded by a member of staff. This was good practice and showed that staff are aware of individual l triggers, and the needs to maintain dignity. Another lady was observed to be chatting cheerfully to staff who were always ready to reply to her and give her time she said she was ‘happy,happy.’ One visitor stated that the staff were always friendly and caring and his relative was ‘settled and content,’ however he did feel that a member of staff needed to be in the lounge at all times. The manager has involved keyworkers in contacting relatives to create a person profile of residents so they are more aware of personal likes and dislikes and hobbies or interests. The acting manager has identified problems with the recording of medication so has taken a full supervisory role over staff this has had the desired effect and staff are more aware of the correct procedures to follow. The acting manager carries out a weekly audit of medication in the home and the procedures followed by staff, she then discusses any shortfalls with staff. The medication cupboard was not over stocked and the returns book had been completed. A random audit was carried out and no errors found. Stuart House DS0000061793.V262132.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 The home provides a range of meaningful activities, organised by the care staff in the afternoons. There are no restrictions to maintaining contact with family and friends. Residents are encouraged to exercise personal choice where possible. Residents are provided with a nutritious and well balanced diet. EVIDENCE: The most notable improvement in Stuart House is the approach to meaningful activities; the manager shows a committed enthusiasm to providing activities that are more consistent with everyday life. The residents still have, organised sessions in the home, which include 1-1 games, which are very popular, music and dance, bingo, hoopla, seasonal parties, and the visiting pet a collie was at the home during the inspection. Residents enjoyed his company and talked about him and their pets. The acting manager has also worked hard finding venues that the residents can visit on a weekly basis. Residents have been taken to the Sea Life Centre the garden centres and out for a pub meal, staff take residents for regular walks along the sea front, those who are less capable Stuart House DS0000061793.V262132.R01.S.doc Version 5.1 Page 13 of walking go on a mystery tour in the countryside. This demonstrates good practice and those residents who could express an opinion had enjoyed the trip to the sea life centre. Through the day staff were observed to be encouraging residents to make their own choices and daily records showed that residents decided whether they wished to get up in the morning or have a lie in. There are no restrictions on visiting and one relative said he came daily and had never been made to feel unwelcome. The record of food provided showed a balanced and nutritious menu was offered, residents spoken with said that they liked the lunch they’d had that day, the mealtime was unhurried and staff were available to insist when necessary. Stuart House DS0000061793.V262132.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 The complaints procedure in the home is satisfactory and staff demonstrated a good awareness of adult protection issues. EVIDENCE: The home has a very clear and robust complaints policy and procedure the complaints folder was available to review and no further entries had been made. Residents spoken to who could express an opinion said they could talk to the manager. The home has its own adult protection policy and procedure and the North Somerset interagency policy and procedure was available for staff to consult, all staff attend regular In-House Adult Protection training, staff spoken to said they were aware of the issues and the companies Whistle Blowing policy. Stuart House DS0000061793.V262132.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 22, 23, 24, 25 and 26 Residents live in a safe and well maintained home which is comfortable and domestic in décor. Residents rooms suit their needs and are safe and comfortable, and contain personal furniture and fittings. Stuart House is clean, pleasant and hygienic. EVIDENCE: The home is well maintained and decorated in a homely manner the lighting is sufficient for residents to read by or take part in activities, communal space is provided in a lounge, dining area and conservatory, the garden area although small is paved and level. Residents who could express an opinion said that they liked their rooms and that the home was always clean. Private rooms were seen to be appropriately furnished and personalised by residents, shared rooms had screens to provide privacy. Toilets had appropriate signage to enable people with dementia to recognise the rooms. Stuart House DS0000061793.V262132.R01.S.doc Version 5.1 Page 16 The home was clean and tidy and staff have attended training in Infection Control, however it was recommended that ancillary staff also attend training in infection control. Stuart House DS0000061793.V262132.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 and 30 The numbers of staff on duty are sufficient to meet the needs of the current residents. All staff receive training in Dementia Care, and are being encouraged to pursue further training, including the NVQ 2 In Care. EVIDENCE: Staffing levels in the home are adequate to meet the needs of the current resident group and can be increased to meet extra needs identified, or for an activity planned. A visitor stated that he felt there were not enough staff on duty however duty rotas for the last month showed that this was not a problem, during the inspection staff were observed to make time to be with residents and one member of staff was involved in helping residents go to the hairdresser, the visitors main concern was that there were times that no staff were in the lounge with residents, this was discussed with the manager however it was not felt that extra staff were needed at the time. Staff and residents on the other hand that there are always plenty of staff on duty. All staff have received training in Dementia Care through Dementia Voce, and a training programme has been developed, records showed that staff have received training in administration of medication, food hygiene and fire procedures, since the last inspection staff have also received first aid training other courses attended included challenging behaviours, report writing and risk assessments. Stuart House DS0000061793.V262132.R01.S.doc Version 5.1 Page 18 The home exceeds the minimum ratio of 50 of staff with NVQ2 In Care. Stuart House DS0000061793.V262132.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 36, 37 and 38 The manager demonstrates that she is competent and experienced to run the home, and adopts an open and approachable management ethos. The home has carried out a Quality Assurance audit. All new staff carry out an induction process and formal supervision is carried out. Residents are safeguarded by the homes record keeping and policies and procedures. Health and safety within the home are satisfactory. EVIDENCE: Stuart House DS0000061793.V262132.R01.S.doc Version 5.1 Page 20 The registered manager has 16 years experience in care settings, the last five as a home manager; she holds a city and guilds qualification in Advanced Management in Care and has achieved the Registered Managers Award. The manager was observed to have a very open and relaxed rapport with both staff and residents they all confirmed that she is open and approachable at all times. A questionnaire has been developed and sent to relatives to obtain their views for a quality Assurance Audit however the manager was still awaiting replies to carry out a full assessment. There was evidence that staff have attended inductions and that formal supervision is carried out, staff confirmed that they receive supervision and training has been arranged for two members of staff in supervisory development. A review of the homes risk assessments and the fire log showed that health and safety in the home is satisfactory, and follows current guidelines. As previously discussed a qualified first aider is now present on each shift. During this inspection the need for ancillary staff to receive training in Infection Control and Manual Handling was discussed with the manager Stuart House DS0000061793.V262132.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 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 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 3 3 3 Stuart House DS0000061793.V262132.R01.S.doc Version 5.1 Page 22 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP18 OP30 Good Practice Recommendations The manager needs to attend POVA Investigators training provided by North Somerset Social Services Ancillary staff need to receive training in Infection control and manual handling Stuart House DS0000061793.V262132.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL National Enquiry Line: 0845 015 0120 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 Stuart House DS0000061793.V262132.R01.S.doc Version 5.1 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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