Inspection on 20/09/06 for Five Stacks Residential Home

This inspection was carried out on 20th September 2006.

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

Five Stacks Residential Home 15/08/07

Five Stacks Residential Home 07/02/06

Five Stacks Residential Home 06/07/05

Five Stacks Residential Home 21/03/05

Five Stacks Residential Home 25/06/04

Similar services:

Claremont House

Firstlings

Fen Road

Dial House Nursing Home

Croxley House

Eversley Nursing Home

Cresta Lodge

Chilton Meadows Residential & Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Five Stacks Residential Home 209 Point Clear Road St Osyth Clacton on Sea Essex CO16 8JD Lead Inspector Sara Naylor-Wild Key Unannounced Inspection 10:10 20 September 2006 th 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 Five Stacks Residential Home DS0000017941.V302496.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. Five Stacks Residential Home DS0000017941.V302496.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Five Stacks Residential Home Address 209 Point Clear Road St Osyth Clacton on Sea Essex CO16 8JD 01255 820417 01255 820417 fivestacks@tinyworld.co.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr John Sidney Donhou Manager post vacant Care Home 14 Category(ies) of Dementia - over 65 years of age (14) registration, with number of places Five Stacks Residential Home DS0000017941.V302496.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Persons of either sex, aged 65 years and over, who require care by reason of dementia (not to exceed 14 persons) The registered person shall ensure that a continuing programme of development is provided for managers and staff in relation to dementia care and good Practice, equivalent to the recommendations of the Alzheimer’s Society The registered person shall keep under review the provision of additional communal living space to meet the assessed needs of service users The registered person shall ensure that staff provision is increased to meet the needs of planned admissions of service users 7th February 2006 3. 4. Date of last inspection Brief Description of the Service: Five Stacks Rest Home is a former family dwelling house that has been extended and improved to form the present accommodation. The detached house is located within a residential area. The accommodation is within both single and twin occupied bedrooms on the ground and first floor. There is a passenger lift available. The communal space is ample, there being a main lounge area and a kitchen/dining room. The decoration, furniture and fittings were of a high standard and the whole house represents a comfortable living environment. The front of the property has been laid to hard standing but is enclosed by attractive trees and shrubs. The rear garden is large and features an enclosed swimming pool and sun terrace with extensive lawns. The garden is also enclosed with attractive trees and shrubs The home changed registered category of care to Older People Dementia Care in 2004. There were conditions attached to the registration that required the home to continue to review and develop the accommodation and staff training in dementia care. Five Stacks Residential Home DS0000017941.V302496.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection was carried out on Wednesday 20th September 2006. The newly registered manager Diane Howard was present throughout the inspection visit. This visit to the home forms part of the overall assessment of the services compliance with the Care Homes Regulations 2003 and the National Care Standards. A variety of information was used to inform the inspectors judgement and these included questionnaires sent to relatives, service users and health professionals, reading of documents and records and discussions with service users, staff and the manager. During the inspection visit the inspector carried out an assessment of a new extension to the building that provides for three additional bedrooms with ensuite, a bathroom and communal space. The accommodation had been built to a high standard to match the existing building and met the NMS for individual and communal accommodation. The provider is planning to develop the building further at a later stage, providing both additional bedrooms and communal facilities. What the service does well: What has improved since the last inspection? What they could do better: The records that underpin good practice require greater attention. In particular the completion of care planning to ensure they reflect the daily care practice and knowledge held by staff. The records relating to staff supervision did not demonstrate a consistent programme of 1:1 discussion of the homes ethos and the individual’s development and practice. Five Stacks Residential Home DS0000017941.V302496.R01.S.doc Version 5.2 Page 6 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. Five Stacks Residential Home DS0000017941.V302496.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 Five Stacks Residential Home DS0000017941.V302496.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 5 & 6 Prospective Service users know what to expect from the service and they are provided with information about the service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Statement of Purpose and service users guide were available and referred to the items listed in the standard. Service users spoken with said they had received information about the home prior to moving in, and had found this useful in making a decision. One service user said, “ it helped having something to look at after you’ve visited, especially when you’re seeing a few places” The files of three service users were sampled as part of the case tracking exercise. These contained assessments of need carried out prior to the service users admission to the home. In some cases a social workers assessment had been supported by the homes own assessment to provide a more detailed picture of how the service would need to support the individual. These documents were complete and provide a good basis from which to make Five Stacks Residential Home DS0000017941.V302496.R01.S.doc Version 5.2 Page 9 decisions about the suitability of the proposed admission and to commence care planning. Service users were all aware of a meeting where there abilities were discussed. The home offers prospective service users opportunity to visit prior to their admission. In one case the service user and their family had visited frequently and spent a number of hours at the home on each occasion. Both the service user and the manager felt that this had helped the admission and the homes understanding of how they would assist them. Five Stacks Residential Home DS0000017941.V302496.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 The service identifies the support need to meet individuals needs, sets out how it will meet these and keeps them under review. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service user files sampled each contained care plans. The completion of these document was generally good, although the plan for the most recently admitted service user was still at a basic level. Although the care plan that had been completed at their admission did refer to the support they would need in areas of daily activity, the discussions with staff and daily records indicated that a greater depth of knowledge was now known and the care plan should have been updated to include this. In general, the care plan format fulfilled the objectives of the NMS and provided a breadth of detail in all areas of daily living. They were regularly reviewed and updated accordingly. Care plans contained reference to service user health care including monitoring of pressure areas, diet and fluid intake and health professionals’ visits. Service uses spoken with stated that they were able to access their GP and other Five Stacks Residential Home DS0000017941.V302496.R01.S.doc Version 5.2 Page 11 health providers whenever they wished, and one service user said he attended the surgery. . The manager was able to outline how independent consultation with the GP was supported considered. The care plans also contained a variety of risk assessments including moving and handling and skin integrity. These were individual and the outcomes were incorporated in the care planning. There were some additional assessments that appeared to be individualised but the action detail was general. Medication is provided from a monitored dosage system and there are staff specifically trained in the administration from this system. The inspector had opportunity to speak with service users during the visit and specifically asked them how they felt that the staff demonstrated respect for their rights. They spoke about the way they were addressed and that staff always knocked before entering. Service users families were invited by the Commission to complete a survey prior to the inspection visit. This asked them to give details of their experience of the home. All of those returned commented positively about the service and the care provided to their family member. Comments such as “….of the homes I inspected ..in my opinion it is definitely the best” “I would recommend it to anyone” and ”Nothing is too much trouble ..they are very caring at all times…I have nothing but praise for the staff at this home” “The care my mother in law receives is excellent” Five Stacks Residential Home DS0000017941.V302496.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Service users are provided with stimulation and activity to meet their preferences. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users social care is a large focus of the daily life of the home and effort had been made to include service users wishes and preferences in respect of their social interests on care plans, so staff were clear about how they should support this. The staff spend significant portions of the day engaging service users in activities such as crosswords, hand massage, quizzes etc. These are offered at the service users cognitive level and staff assist sympathetically where required. The inspector witnessed a typical mornings activity, and noted that staff’s tone and approach was respectful and considerate in their collaboration with service users in the chosen activity. Service users were genuinely enjoying the distractions provided and those spoken with later in the day were pleased with the support staff provided in this area, although for some the opportunity to go out of the home more was an issue. Although the home owns a mini bus and the proprietor often takes service users out for social and shopping activities, for more active service users the loss of independence in this area was keenly felt. The issue was discussed with the manager at the visit. Five Stacks Residential Home DS0000017941.V302496.R01.S.doc Version 5.2 Page 13 Friends and family continue to enjoy a free and welcoming visiting arrangement in the home, and service users spoken with were particularly keen to tell the inspector of how friendly the home was to their family members. Comments in surveys returned from relatives included “I and my dog are always made welcome “ and “I visit frequently and am always made to feel at home” Meals are provided against a planned menu that is posted in the dining room. The menu did not advertise a choice although on the day of inspection a number of variations to the meal were served to service users, and service users asked for alternatives when they did not like the meal offered to them. The inspector discussed with the manager how the menu was advertised to service users with cognitive impairments and suggested this was further developed in recognition of the services registered category of care. Meals were appetising and well presented; although the meals are plated and some service users commented that the quantity was too much for them. Discussions with the cook, manager and administrative staff indicated that the serving of meals was under review and that they intended to introduce a system where meals were served according to service users preferences at the table. This would provide an additional quality to the meal and enable service users to exercise choice to a greater degree. Service users spoke highly of the quality of the food cooked at the home and particularly liked the fact that the majority of the ingredients are locally delivered and as well as the main meals, cakes and biscuits were homemade. Five Stacks Residential Home DS0000017941.V302496.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Systems operated by the home support Stakeholders in making their concerns known, including allegations of abuse. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints policy that meets the expectations of the standard. The staff and those service users spoken with were clear that they had a right of complaint and that they would raise their concerns with the manager or proprietor. The way in which service users who have cognitive impairments express their views should be considered by the service. The policy in respect of abuse had been updated and staff had undertaken training in whistle blowing and protection of vulnerable adults. Five Stacks Residential Home DS0000017941.V302496.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 The building and grounds support service users needs. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The environment is maintained to a high standard, with updating of décor and furnishings as required. The manager was aware of the ongoing maintenance plan although this had not been committed in writing. The new wing of three bedrooms and communal space compliments the existing premises well and the provision in these rooms is to a high standard. Service users spoken with had already visited the area and one service user had been able to pick out one of the rooms to move into. The décor in the home is low key and pale, and the inspector discussed with the manager the good practice evidence in respect of the use of colour for service users with dementia. The home makes use of signage on doors and in corridors to assist service users in navigating their way about the home. Five Stacks Residential Home DS0000017941.V302496.R01.S.doc Version 5.2 Page 16 The home continues to benefit from a large garden and service users were using the facility on the day of inspection. Five Stacks Residential Home DS0000017941.V302496.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 The service users benefit from the numbers skills and knowledge of the staff group. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staffing levels are maintained a three care staff on duty including the person in charge, a cook, office staff and cleaner. The staff did not appear hurried on the day of inspection and staff spoken with said that the organisation of their day allowed them to spend time with service users as a priority. The organisation of the manager’s time continues to need consideration to ensure those tasks requiring her individual attention are completed. These include updating care plans and staff supervision. There is a staff training programme, with ongoing training in the mandatory subjects such as fire training, first aid, infection control and medication etc. All the staff had recently undertaken an 8 week dementia training programme, which ends with a competency based exam. The manager advised that additional training was planned in house using the training tools purchased from the Sterling University Dementia Services Development Trust. Additionally the manager had identified a communication training pack called CLIPPER from the Journal of Dementia Care that she planned to introduce to staff. Five Stacks Residential Home DS0000017941.V302496.R01.S.doc Version 5.2 Page 18 The manager and a member of the administration team had recently completed their NVQ 4 Managers Award, and a further administration team member had undertaken a Certificate in Positive Dementia Care with Chelmsford College. A sample of Staff files was examined during the course of the inspection visit and these contained appropriate levels of documents to demonstrate the service operates a robust recruitment procedure. The cross referencing of the documents and information provided by candidates would assist the home in protecting service users from unsuitable candidates to work in a care setting. Five Stacks Residential Home DS0000017941.V302496.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 The service is led by a capable manager who has instilled a strong ethos of person centred care in the service. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager Diane Howard, had recently completed the registration process with the CSCI. She had introduced a number of initiatives in the home and the joint working with the proprietor and staff at the home was successful in delivering an improving service in the home. The overall ethos of the home is reflected in the managers and staffs focus on service users. The staff spoken with were clear that tasks that did not directly affect service users should be secondary in importance. They felt confident in the manager and the expectations of their role. Five Stacks Residential Home DS0000017941.V302496.R01.S.doc Version 5.2 Page 20 Staff supervision had not been regularly undertaken. Although the manager works along side staff on a daily basis, and frequent communication takes place between them, there is a need to ensure that there is formal feedback to individuals. This supports the services ethos as well as staff development and training needs. The inspector examined documentation in relation to the maintenance of safety equipment and procedures operated in the home. These were all up to date and provided evidence of the services compliance with their legislative duties to protect service users, staff and the public. Five Stacks Residential Home DS0000017941.V302496.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Five Stacks Residential Home DS0000017941.V302496.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP28 Good Practice Recommendations The registered person is recommended to ensure that a ratio of 50 care staff members are trained to National Vocational Qualification level 2 or equivalent. The registered person should ensure that the manager is provided with adequate opportunities to fulfil the expectations of the role, including the development of practice and policies The registered person should ensure that staff supervision is carried out six times a year. 2 OP32 3. OP36 Five Stacks Residential Home DS0000017941.V302496.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Five Stacks Residential Home DS0000017941.V302496.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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