Inspection on 30/08/07 for St Stephen`s Court

This inspection was carried out on 30th August 2007.

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 no outstanding requirements from the previous inspection report, but made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Blenheim House

Prince Bishop Court

Park View (15)

Craigmore House

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

CARE HOME ADULTS 18-65 St Stephen`s Court Brunel Terrace Newcastle upon Tyne Tyne and Wear NE4 7RL Lead Inspector Mary Blake Key Unannounced Inspection 30 August & 4 September 2007 11:00 th th St Stephen`s Court DS0000069987.V346285.R01.S.doc Version 5.2 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 St Stephen`s Court DS0000069987.V346285.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 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. St Stephen`s Court DS0000069987.V346285.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Stephen`s Court Address Brunel Terrace Newcastle upon Tyne Tyne and Wear NE4 7RL 0191 273 0303 0191 373 3659 nevillesx@aol.com 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) Durham Care Line Ltd t/a Careline Lifestyles Vacant Care Home 10 Category(ies) of Learning disability (10), Physical disability (10) registration, with number of places St Stephen`s Court DS0000069987.V346285.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories Physical Disability - Code PD, maximum number of places: 10 2. Learning Disability - Code LD, maximum number of place: 10 The maximum number of service users who can be accommodated is 10. First inspection Date of last inspection Brief Description of the Service: St Stephens Court is a home registered to provide personal and nursing care to ten young adults who are physically dependent, learning disabled or require rehabilitation following brain injury or neurological disorders. The home provides permanent and respite places. The home was purpose built and provides care over two floors accessed by a lift. Situated in the west of the city of Newcastle there are limited local facilities. Residents have their own bedrooms, which are well furnished and have ensuite toilet, some also have shower facilities. Bathrooms and lavatories are equipped with specialist equipment to assist physically dependent people. There is one large lounge, dining area, quiet room, sensory room, spa/hydrotherapy pool, domestic kitchen and laundry. There is an accessible garden. Computers, plasma screens and internet access are available in all rooms. A Statement of Purpose and service user guide are available at the home for residents who are interested in coming to stay at the home. The guides describe the services and facilities provided by the home and inspection reports would be made available at the home detailing the quality of care provided. Fees payable for living at the home vary according to the individual package and currently range from £800 to £1200 per week. St Stephen`s Court DS0000069987.V346285.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit was initially unannounced and took place over two days and involved one inspector. A full tour of the premises took place and a sample of records were inspected which included: the Home’s Statement of Purpose and service user guide, two care plans, two staff files and other statutory records. Case tracking was carried out where certain residents and staff were spoken to and their records were examined. A questionnaire was also completed by the home before the inspection to provide information. Questionnaires were also sent to residents and other people involved with the home that may be able to comment about the running of the home. One resident’s and one relative’s questionnaires were returned and these gave positive statements on the care provided. There were four residents staying during the inspection visits. Private discussions took place with four residents, one relative, two staff, the acting Manager and the Provider. What the service does well: The service gives good support in preventative health care and enables individuals to have a healthy lifestyle. The service gives good support to enable individuals to maintain and develop personal and family relationships and provides support to help deal with change. The service gives good support to enable individuals to make decisions and participate in the running of the home. The building is purpose built and provides a range of aids and supports to enable residents to lead an independent lifestyle during their stay. It was observed, and residents and relatives confirmed, that staff were kind, considerate and supportive. There is a complaints procedure and in addition resident views are actively sought. Residents felt their views were listened to and acted upon. St Stephen`s Court DS0000069987.V346285.R01.S.doc Version 5.2 Page 6 Staff were friendly and relaxed with the inspector and were keen to discuss their work and the residents care needs. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. St Stephen`s Court DS0000069987.V346285.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection St Stephen`s Court DS0000069987.V346285.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3 & 4 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Interesting and useful information is given to prospective residents about the home. The home collects enough information about the needs of prospective residents before they move in to help ensure staff are aware of the amount of care and support needs of the resident as they settle in. Residents and their relatives are very welcome to visit the home to assess its suitability. EVIDENCE: The Home’s Statement of Purpose and service user guide were examined and they contained the necessary information as required and accurately reflected the service provided. Records for two of the residents showed that when they were admitted to the service an assessment of their care needs had been carried out before their admission. The resident and relevant people who knew them were involved in the initial assessment. The organisation has its own multi disciplinary team, St Stephen`s Court DS0000069987.V346285.R01.S.doc Version 5.2 Page 9 which would undertake an assessment. This information and the care manager’s assessment of the resident’s care needs were used to ensure all the needs of the resident could be met by staff. The records contained a range of information but not in sufficient detail. Whilst residents and their families confirmed their involvement this was not recorded. Residents have the opportunity to visit the home as often as they need in order to decide if they want to stay there. A resident may come for meals, have overnight stays and be introduced to other residents at the home at a pace suitable to the individual. St Stephen`s Court DS0000069987.V346285.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7, 8 & 9 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. There are arrangements in place to ensure that residents’ health and social care needs are met. There is a system of reviewing the changing care needs of residents on each stay. Staff supports residents and care plans show the amount of care and support that staff are providing to residents. The operation of the home ensures that residents are consulted and involved in the running of their lives. Staff do support residents to take risks as part of independent living but this is not sufficiently documented. St Stephen`s Court DS0000069987.V346285.R01.S.doc Version 5.2 Page 11 EVIDENCE: There are detailed assessments in the residents’ care plans. Personal support needs are documented and give clear instructions to staff on how to support people in tasks such as washing, bathing, dressing, communicating and carrying out any assessed tasks to help promote the independence of the person. Moving and handling assessments were not in place. Technical aids and equipment is available for residents and it was evident that individual aids and beds had been provided as necessary and prior to admission. Residents were very positive about this individual provision and how this had given them independence during their stay. Relative commented “My son has settled well in this facility and has had very friendly warm attention at all times, He has also had encouragement to widen his abilities.” Residents care records showed that they have access to external health care services. GPs and Community Nurses were regularly consulted for advice and treatment. Records show the organisations own physiotherapist and occupational therapist visit the home as required and residents are helped to access other health care services as needed. Residents are asked individually and consulted about decisions involving themselves and the day-to-day running of the home. Staff at the home encourage residents to express their views and to communicate by whatever means so they may become more involved in running their lives and retain some control in decision making. The staff support residents to remain independent and take risks in order to live a more fulfilled lifestyle, however up to date risk assessments were not present in residents care records. St Stephen`s Court DS0000069987.V346285.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 & 17 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Residents are encouraged to take part in age, peer and culturally appropriate activities and use community facilities wherever possible, however this is restricted due to staff availability Residents are encouraged to have appropriate personal and family relationships. Residents’ rights and responsibilities are recognised in their daily lives. Residents’ are offered individual choices of diet but the quality is not always consistent. St Stephen`s Court DS0000069987.V346285.R01.S.doc Version 5.2 Page 13 EVIDENCE: The residents spoken to confirmed that they are involved in the running of the home and involved in making decisions about their lives. Residents and family were concerned about the limited opportunity for social or leisure activities particularly for the less independent residents and that either there were insufficient staff available or staff were busy with cooking and domestic duties and did not have time to meet this need. This was confirmed by discussions with staff and management of the home. Residents care plans and case records detail any family involvement. Conversation with residents, relatives and staff provided evidence that residents are encouraged to maintain contact with family and friends, staff providing the necessary levels of support for them to do so. Residents are asked individually daily what they wish to eat. Residents and families felt that the food was variable and that staff may not have suitable catering skills, management and staff confirmed this. St Stephen`s Court DS0000069987.V346285.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Residents receive personal support in the way they prefer but this is not always appropriately recorded. Residents physical and emotional health needs are met. Medication systems are being established but storage and security are not adeqaute. EVIDENCE: Two care plans and case records were inspected. The daily records detailed the care and support required for different needs. They reflected the changing needs of residents due to incapacity and ill health. The care plans recorded the needs and the care and support provided by staff but in a format that is not user friendly. St Stephen`s Court DS0000069987.V346285.R01.S.doc Version 5.2 Page 15 Residents do receive support in the way they prefer and require but this needs to be more detailed within individual plans. There are good arrangements in place to ensure that residents’ health care needs are met. Systems are in place for residents to retain and administer their own medication where appropriate this needs to be developed to safely manage the medication of residents having respite care. The medication trolley was not securely stored nor within a room where temperature was monitored. The storage and disposal of controlled drugs was not sufficient for residents who may be receiving nursing care. St Stephen`s Court DS0000069987.V346285.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The complaints procedure was available to remind people coming into the home of their right to complain. Residents are protected from abuse. EVIDENCE: There is a complaints procedure to inform people visiting the home of how they could complain if necessary. Residents have access to a complaints procedure that assists them and supports them to bring any matters to the attention of staff outside of the home in case they felt uncomfortable bringing any complaints or concerns to the attention of staff within their home. Residents and family spoke positively about being able to raise concerns with staff, acting manager and provider and that these would be addressed and action taken if necessary. Staff have received or about to undertake training about Protection of Vulnerable Adults and Prevention of Abuse. St Stephen`s Court DS0000069987.V346285.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29 & 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The building is comfortable and well maintained with good quality furnishings and décor. Bedrooms are personalised and comfortable and adapted to promote independence. The home is well equipped with specialist equipment as required by residents to meet their physical needs. There is a good standard of hygiene. St Stephen`s Court DS0000069987.V346285.R01.S.doc Version 5.2 Page 18 EVIDENCE: A tour of the premises was undertaken and all bedrooms viewed. The premises are well maintained. Residents have their own bedrooms that are well furnished, decorated and very well personalised according to the wishes and tastes of the individual. All have ensuite and some have individual shower facilities. Bathrooms and toilets are well equipped with specialised baths and/or overhead tracking systems. Appropriate call system is in place with the organisation intending to provide a pendant system as necessary. There was individual access to computer, Internet and plasma screen televisions. Residents’ bedrooms are equipped to ensure the comfort and safety of the individuals and at the same time specialist equipment is provided to promote the independence of individuals. Residents confirmed that individual specialist beds had been provided, other additional support equipment was provided based upon individual assessment and review by the organisations occupational therapist. This was done as part of the pre-admission assessment and prior to admission. One resident described how she was able to be independent and that she was able to move freely around the home using her electric wheelchair. There is a spa/hydrotherapy pool, which is awaiting suitable aids to support better access. There are currently no domestic/ancillary staff employed with support staff carrying out domestic, catering and laundry duties. They have maintained a good standard of hygiene in the home. St Stephen`s Court DS0000069987.V346285.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 & 35 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Residents’ needs are not fully met by the numbers and skill mix of staff. Systems are in place to ensure residents are in safe hands. There are recruitment policy and practices in place to protect residents. Staff are trained to meet the care needs of residents. EVIDENCE: Examination of staff rotas and discussion with the acting manager, staff team, residents and relatives provided evidence that the numbers of staff vary in according to the needs of the residents at any one time. Generally these have not been sufficient to provide support to all residents, whilst basic needs are met, staff numbers have meant that the opportunity for individual social and leisure activities has been very minimal. Additional ancillary tasks have also affected staff availability. St Stephen`s Court DS0000069987.V346285.R01.S.doc Version 5.2 Page 20 The necessary checks are being carried out prior to staff being appointed. Staff stated that they enjoyed working in the home and were observed to be kind, caring and respectful to residents. Residents and families gave positive comments about the staff “they are very kind” “nothing is too much trouble” “they are very busy but always helpful” “This is a new facility so there exits no history on which to base an opinion but as a lay person I consider that the 3 members of staff I have met engender in me a great confidence that they will produce a happy well run care home.” A very positive, happy rapport was noticeable between the staff on duty and residents. Staff stated that they receive induction training. New support workers will follow the Learning Disability Award Framework as part of their induction to make them aware of the rights of people with disabilities. Staff confirmed that they also receive advice and /or training in other areas, such as challenging behaviour, values and rights of people with learning disabilities. St Stephen`s Court DS0000069987.V346285.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39 & 42 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Residents’ benefit from the ethos, leadership and management approach at the home. Quality assurance systems are being established to take into the views of people using the service. The health, safety and welfare of residents are generally promoted and protected. St Stephen`s Court DS0000069987.V346285.R01.S.doc Version 5.2 Page 22 EVIDENCE: The acting Manager has recently taken up her position and is about to complete her application to become registered. Discussion and observation maintain that she puts the needs of the residents first and promotes an ethos amongst staff of involving staff and residents in decision making within the home. Residents and relatives were very positive about the changes she has already implemented in the quality and number of staff available and was ready to listen and action any concerns they had. Quality assurance systems including audits, surveys, residents and staff meetings and provider visits are being established. The home is well maintained with services and testing in place. St Stephen`s Court DS0000069987.V346285.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 2 3 3 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 3 26 3 27 4 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 2 33 2 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 X LIFESTYLES Standard No Score 11 X 12 2 13 2 14 X 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 3 3 X X 3 X St Stephen`s Court DS0000069987.V346285.R01.S.doc Version 5.2 Page 24 Not applicable 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. 1 Standard YA2 Regulation 15 5 4 Requirement Individual care plans must be completed on admission in the following areas a) Risk assessments b) Moving and handling c) Social activities and opportunities Individual care plans must be in a format that enable residents to be fully involved Sufficient individual activities and opportunities for social interaction must be provided for all residents The provider must undertake a review of the quality of food provided and all staff must have suitable catering skills A medication review must be undertaken to ensure that a) Medication trolley is secured when not in use b) Medication is stored at a appropriate room temperature c) Controlled drugs to be stored, administered and disposed of as necessary for a home providing St Stephen`s Court DS0000069987.V346285.R01.S.doc Version 5.2 Page 25 Timescale for action 01/11/07 2 3 YA6 YA13 15(2) 16(2)(m) 01/12/07 01/12/07 4 YA17 16(2)(i) 01/10/07 5 YA20 2 01/10/07 6 YA33 18(1)(a) 18(3) 7 YA37 8 nursing care d) Review staff procedures on receiving and administration of medication of residents receiving respite care The provider must undertake a review of the staffing levels to ensure that a) Suitably qualified nursing staff are available over all shifts if residents with nursing needs are admitted b) Sufficient support staff to be on duty at all times to meet the needs of residents on admission c) Ancillary catering/domestic staff to be employed to enable support staff to meet the care needs of all residents The provider must submit an application for registration of the manager to CSCI 01/10/07 01/10/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations St Stephen`s Court DS0000069987.V346285.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI St Stephen`s Court DS0000069987.V346285.R01.S.doc Version 5.2 Page 27 - 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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