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Inspection on 07/02/06 for Five Stacks Residential Home

Also see our care home review for Five Stacks Residential Home for more information

This inspection was carried out on 7th February 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The strong sense of family continues to permeate the culture of the home, in part due to the owner`s close links with the day to day running, but also from a small staff group. Service users spoken with enjoyed the family atmosphere and felt this was a quality statement of the owner and manager`s commitment to the home.

What has improved since the last inspection?

The manager reported that a recent recruitment drive had resulted in a number of strong applicants for posts and was interviewing candidates for the second time on the day of the inspection. This would be a boost to the home, which has in the past found it hard to attract sufficient suitable applicants. The training planned for care staff was an encouraging indicator of the manager`s aims to deliver a specialist provision in dementia care. The inspections over the coming year will monitor how successful this intiative becomes. The level of activity within the home has become greater with lots of small scale one to one initiatives being used throughout the day. Service users indicated that they enjoyed these opportunities and took part in those they chose to.

What the care home could do better:

Presently the staff do not hold sufficient depth of knowledge to fully meet the needs of service users with dementia and there is an ongoing need to develop their skills in this specialist area.

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 Unannounced Inspection 07 February 2006 10:00 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 Five Stacks Residential Home DS0000017941.V272172.R01.S.doc Version 5.0 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.V272172.R01.S.doc Version 5.0 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.V272172.R01.S.doc Version 5.0 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 6th July 2005 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.V272172.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 7th February 2006. Diane Howard the appointed manager was present throughout the inspection visit. Ms Howard had not proceeded with her application for registration at the time of the visit and discussions took place in relation to this. This inspection was used to focus on the key standards not assessed at the previous visit, which had concentrated mainly on the documentation required to meet the National Minimum Standards (NMS). During this visit as well as sampling some documents the inspector was able to spend time with service users and staff observing and discussing the operation of the home. What the service does well: What has improved since the last inspection? The manager reported that a recent recruitment drive had resulted in a number of strong applicants for posts and was interviewing candidates for the second time on the day of the inspection. This would be a boost to the home, which has in the past found it hard to attract sufficient suitable applicants. The training planned for care staff was an encouraging indicator of the manager’s aims to deliver a specialist provision in dementia care. The inspections over the coming year will monitor how successful this intiative becomes. The level of activity within the home has become greater with lots of small scale one to one initiatives being used throughout the day. Service users indicated that they enjoyed these opportunities and took part in those they chose to. Five Stacks Residential Home DS0000017941.V272172.R01.S.doc Version 5.0 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. Five Stacks Residential Home DS0000017941.V272172.R01.S.doc Version 5.0 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.V272172.R01.S.doc Version 5.0 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): These standards were not assessed at this visit. EVIDENCE: Five Stacks Residential Home DS0000017941.V272172.R01.S.doc Version 5.0 Page 9 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): 10. Service users felt that staff treated them with respect. EVIDENCE: Service users spoken with were asked about their view of staff conduct. They stated that they felt the staff acted kindly and were polite. They gave examples of knocking on doors, and always asking if they needed help. Observations of staff and service user interaction on the day of inspection supported these views. Five Stacks Residential Home DS0000017941.V272172.R01.S.doc Version 5.0 Page 10 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): 14 & 15. Service users are supported in decision making and choices. Meals were considered to be of a good standard. EVIDENCE: Service users felt that within the limitations of their abilities they were supported in making decisions. They stated that the home operates on promoting choices such as when to get up or go to bed, what to eat and whom they accepted as visitors. The meals were remarked on by service users, who were aware of the menu on offer and were confident that they could have alternative choices if they wished. Five Stacks Residential Home DS0000017941.V272172.R01.S.doc Version 5.0 Page 11 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): These standards were not assessed at this visit. EVIDENCE: Five Stacks Residential Home DS0000017941.V272172.R01.S.doc Version 5.0 Page 12 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): These standards were not assessed at this visit. EVIDENCE: Five Stacks Residential Home DS0000017941.V272172.R01.S.doc Version 5.0 Page 13 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): 28. The staff are undertaking training in areas that will support service users assessed needs. EVIDENCE: All staff working at the home were undertaking their NVQ 2 and expected to complete in April 2006. Other mandatory training such as medication, and health and safety were being undertaken by staff on distance learning courses with Chelmsford College. The manager had completed the Certificate in Dementia Care and she planned to enrol all the staff on to this course. This will provide staff with a greater insight into the needs of service users with dementia and build on their existing skills in aiming to deliver a quality specialist care service. Five Stacks Residential Home DS0000017941.V272172.R01.S.doc Version 5.0 Page 14 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 and 38. The appointed manager is applying for registration with the CSCI. The service users’ finances are managed appropriately by the home. The home maintains appropriate levels of health and safety checks and measures in the home. EVIDENCE: The appointed manager Diane Howard, was not registered at the time of the inspection, but was in the process of application. A number of initiatives such as development of the activities programme, care planning and staff training had been introduced by Ms Howard since her appointment and the service appears to be moving to a period of consolidating its position in respect of offering a specialist care service. There appeared to be a good relationship between the staff team and the manager. Five Stacks Residential Home DS0000017941.V272172.R01.S.doc Version 5.0 Page 15 A sample of the records for service users held by the home was examined and were appropriately managed. Documentation relating to the health and safety management and monitoring were examined during the inspection. There was a sufficient level of maintenance checks and certification to meet the standard. Five Stacks Residential Home DS0000017941.V272172.R01.S.doc Version 5.0 Page 16 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X x x x x x x x x STAFFING Standard No Score 27 x 28 2 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 3 x 3 x x 3 Five Stacks Residential Home DS0000017941.V272172.R01.S.doc Version 5.0 Page 17 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 OP7 Regulation 14 Requirement The registered person must develop further service users plans of care to ensure they encompass all aspects of the assessment and provide a basis for the care to be delivered. This standard was not assessed at this visit and is therefore carried forward to the next inspection. The registered person must ensure that the protection of vulnerable adults policy meets current guidance. This is a repeat requirement. The registered person must ensure that there is a staff training and development programme which meets National Training Organisation (NTO) workforce training targets and ensures staff fulfil the aims of the home and meet the changing needs of service users. This standard was not assessed at this visit and is therefore carried forward to the next inspection. DS0000017941.V272172.R01.S.doc Timescale for action 30/06/06 2. OP18 13(6) 30/06/06 3. OP30 19 30/06/06 Five Stacks Residential Home Version 5.0 Page 18 4. OP27 18 The registered person must ensure that there are sufficient numbers of care staff and that the residential forum calculation is carried out to determine the appropriate levels. This standard was not assessed at this visit and is therefore carried forward to the next inspection. The registered person must ensure that the manager is provided with adequate opportunities to fulfil the expectations of the role, including the development of practice and policies. This standard was not assessed at this visit and is therefore carried forward to the next inspection. The registered person must ensure that all aspects of service users wellbeing are monitored, including diet, weight and fluid intake. The outcome of this record must be included in the action in care plans. This standard was not assessed at this visit and is therefore carried forward to the next inspection. 30/06/06 5. OP32 18 30/06/06 6. OP8 14 30/06/06 Five Stacks Residential Home DS0000017941.V272172.R01.S.doc Version 5.0 Page 19 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 OP31 Good Practice Recommendations It is recommended that the manager obtain a National Vocational Qualification level 4 qualification or equivalent. This standard was not assessed at this visit and is therefore carried forward to the next inspection. 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 staff supervision is carried out six times a year. This standard was not assessed at this inspection, therefore is carried over to the next report. 2. 3. OP28 OP36 Five Stacks Residential Home DS0000017941.V272172.R01.S.doc Version 5.0 Page 20 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.V272172.R01.S.doc Version 5.0 Page 21 - 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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