Inspection on 07/11/05 for St George`s Care Centre

This inspection was carried out on 7th November 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

St George`s Care Centre 18/03/09

St George`s Care Centre 06/12/06

St George`s Care Centre 04/07/05

St George`s Care Centre 23/09/04

St George`s Care Centre 22/04/04

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

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Stoneygate Ashlands Ratcliffe Road Leicester Leicestershire LE2 3TE Lead Inspector Fiona Stephenson Unannounced Inspection 7th November 2005 10:30 X10029.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 Stoneygate Ashlands DS0000006446.V264584.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 and Care Homes for Adults 18 – 65*. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Stoneygate Ashlands DS0000006446.V264584.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Stoneygate Ashlands Address Ratcliffe Road Leicester Leicestershire LE2 3TE 0116 244 8624 0116 270 2318 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) Prime Life Limited Mrs Diane Smith Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40), Physical disability (40), Physical disability of places over 65 years of age (40) Stoneygate Ashlands DS0000006446.V264584.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Minimum age for admission under category PD is 50 years. To be able to admit the person of category PD identified in correspondence with the previous registration authority dated 16 June 1994. To admit one named person with a physical disability, under 50 years of age, as identified in application number V24213, dated 31st August 2005, to commence from the 31st August 2005 until 30th November 2005. 4th July 2005 Date of last inspection Brief Description of the Service: Stoneygate Ashlands is a 40-bedded home for up to forty older people, some of whom have physical disabilities. The home is a two-storey, purpose-built building and is situated in the quiet residential area of Stoneygate, Leicester. It is set in extensive grounds, surrounded by lawns and trees. There are currently 27 residents living at the home. Stoneygate Ashlands DS0000006446.V264584.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on Monday 7th November from 10:30am to 2:00pm, and was conducted by one inspector. The focus of inspections undertaken by the Commission for Social Care Inspection is upon the outcomes of care and service provided to residents living at the home. The primary method of inspection used was ‘case tracking’ which involves selecting a number of residents and tracking the care they receive through looking at their records, talking with them and their relatives where possible, talking to care staff, and observing parts of the home they use. This is the second statutory inspection of the home, and the inspector focused on the ‘standards’ that were not looked at during the previous inspection. The recommendations arising from this inspection are a direct result of the evidence gathered from the case tracking process and observations of the inspector. What the service does well: What has improved since the last inspection? Although care and staff records were of a satisfactory standard at the last inspection, the manager has further improved the standard of record keeping. Stoneygate Ashlands DS0000006446.V264584.R01.S.doc Version 5.0 Page 6 There is now a system in place to ensure that the condition of resident’s wheelchairs is monitored and steps are taken if they need repair or replacement. Staff now spend more time with residents in the home engaging in social and recreational activities, however this is mainly due to there being fewer residents with high dependency needs living at the home since the last inspection, and this has freed up staff time accordingly. Residents are enjoying the puddings provided by central kitchen for their lunchtime menu. 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 Stoneygate Ashlands DS0000006446.V264584.R01.S.doc Version 5.0 Page 7 contacting your local CSCI office. Stoneygate Ashlands DS0000006446.V264584.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) Stoneygate Ashlands DS0000006446.V264584.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 Service users assessed and referred solely for intermediate care are provided with sufficient support to maximise their independence and return home. EVIDENCE: The inspector case tracked a resident who was being provided with intermediate care and found that all necessary equipment was being used to support her care, and that staff had received sufficient training to support her in providing the care required. Stoneygate Ashlands DS0000006446.V264584.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are 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 The manager and staff, in general, promote and maintain the health and well being of resident’s living at the home. EVIDENCE: The files of service users who were being case tracked were checked and the inspector noted that they had received regular chiropody appointments, eye tests, nutritional screening and were registered with the GP of their choice. The notes made clear when a resident was self-caring and when a resident required assistance. Monitoring of a resident’s psychological health was not always as detailed as it could be. Stoneygate Ashlands DS0000006446.V264584.R01.S.doc Version 5.0 Page 11 Staff were competent in reviewing the resident’s plans of care each month, and records gave a reasonable understanding of the person’s health and well being. They were not as detailed as they could be, and didn’t always pick up on issues that could be addressed. For example, one resident was recently bereaved, however the psychological impact of this wasn’t linked into a plan of care. Also, resident’s medication requirements are separately documented, however it would be helpful for staff when reviewing a resident’s emotional and psychological needs to see whether any changes in medication have had an impact e.g. changes to anti-depressants, or refusal of a resident to take antidepressants. The inspector also, although satisfied in general with daily notes, noted a couple of occasions where the recorder was detailing their views by using exclamation marks, and using expressions such as ‘(resident) was very demanding today’. The manager said she was sure the remarks were not meant as they sounded, but acknowledged how they could be received may be different to the intention. The inspector noted that all creams are now kept in the resident’s bedroom and are not shared with other residents. Stoneygate Ashlands DS0000006446.V264584.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,14,15 Residents are generally well supported in their daily life and in the provision of social activities. EVIDENCE: Since the last inspection there has been a decrease in the number of highdependency residents living at the home. The manager informed the inspector that this had the effect of providing staff with more time to engage with residents on a recreational and emotional basis. The inspector did not ask residents about the social activities, but did note whilst walking around the Stoneygate Ashlands DS0000006446.V264584.R01.S.doc Version 5.0 Page 13 home that there was a more relaxed atmosphere, and staff were sitting talking to residents in the living areas. The inspector spoke with eight residents about the food. There were no complaints about food provided on the premises, and there were positive comments about the puddings that residents have with their lunchtime menu from central kitchen. However, residents did ask for a variety of vegetables, as they were getting fed-up with carrots. The inspector checked the menu and did note that carrots were frequently on the menu, either as part of ‘mixed vegetables’ or on their own. There were also concerns raised about the temperature of food, with some residents complaining that it is ‘cold’ when you get to eat it. Stoneygate Ashlands DS0000006446.V264584.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) 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 The homes manager responds appropriately to complaints about the service. There are good systems in place to protect service users from abuse. EVIDENCE: The inspector checked the complaints log and found it to contain relevant information. She also arrived at the home whilst the manager was in a meeting with two residents who had a complaint about the service. This was dealt with in an effective and sensitive way. The inspector checked the staff records of new staff at the home and found that the company had followed the appropriate procedures in relation to references, and Criminal Records Bureau and Protection of Vulnerable Adults checks. The company’s policy is to allow staff to commence work before the results of the checks have been returned to the organisation, however the inspector was assured that staff without clearance are always supervised, until clearance is gained. She was also assured that staff are not confirmed in post until after all checks are returned. Stoneygate Ashlands DS0000006446.V264584.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,26 Residents have the specialist equipment required to maximise their independence. The home is clean, pleasant and hygienic. EVIDENCE: The inspector observed the communal dining rooms and living rooms, as well as looking at some of the bedrooms. The inspector observed all areas to be of a good level of hygiene, to have a pleasant décor, and be tidy. Stoneygate Ashlands DS0000006446.V264584.R01.S.doc Version 5.0 Page 16 One resident who was case tracked required specialist equipment, and the notes indicated that the equipment was provided quickly once it was identified as being required. Stoneygate Ashlands DS0000006446.V264584.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 30 Staff are well trained and competent to do their jobs. EVIDENCE: The inspector checked the training records of staff and found staff to have been provided with very good levels of training to support the health, safety and welfare of residents. All staff have induction training and records demonstrate that staff receive up-dated training to support them with their work. Stoneygate Ashlands DS0000006446.V264584.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33,35,38 The manager works hard to run the home in the best interest of the residents living there. EVIDENCE: Stoneygate Ashlands DS0000006446.V264584.R01.S.doc Version 5.0 Page 19 The manager has residents meetings to discuss ideas or concerns residents may have. The manager informed me that the new quality assurance survey is being conducted via a ‘quality assurance’ comments book located by the entrance of the home; where-as previously it was via a questionnaire, which went out to all residents. The inspector checked the quality assurance book and found entries by visitors to the home, but none from people living at the home. It also, unlike the questionnaire, did not detail the different aspects of life at the home which could be commented upon e.g. menus, social activities etc. It looked in effect like a ‘visitors book, with the comments one would normally expect from visitors to the home. The inspector checked financial procedures and found them to be in order. The manager has recently introduced a system of recording the amount of money ‘respite care’ users have on entry to the home, to tighten up on security measures relating to money held by residents in the home. There are good training systems in place and the inspector commends the manager of the home for ensuring that her workforce are well trained in ‘moving and handling’, ‘hoist use’, ‘COSHH’, First Aid, and Food Hygiene. Stoneygate Ashlands DS0000006446.V264584.R01.S.doc Version 5.0 Page 20 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 X 2 X 3 X 4 X 5 X 6 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 ENVIRONMENT Standard No Score 19 X 20 X 21 X 22 3 23 X 24 X 25 X 26 3 STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No Score 31 X 32 X 33 3 34 X 35 3 36 X 37 X 38 4 Stoneygate Ashlands DS0000006446.V264584.R01.S.doc Version 5.0 Page 21 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 OP37 OP7 Good Practice Recommendations Improve staff recording to ensure it objectively states care given. Consider improving care plans to give more emphasis to the psychological and emotional needs of residents, as well as including their medication and any changes relating to medication. Look at ways in which the satisfaction levels of residents regarding the lunchtime menu, and delivery of food, can be further improved and tailored to meet their specific needs and desires. Consider whether the current quality assurance system is an effective vehicle in gaining the views of residents living at Stoneygate Ashlands. Continue to monitor the levels and deployment of staff, particularly when there is an increase in the number of residents who are high dependency. 3 OP15 4 5 OP33 OP27 Stoneygate Ashlands DS0000006446.V264584.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX 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. 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