Inspection on 17/04/07 for St Stephens Care Home

This inspection was carried out on 17th April 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 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 Stephens Care Home 01/11/05

St Stephens Care Home 28/06/05

St Stephens Care Home 25/01/05

St Stephens Care Home 13/07/04

St Stephens Care Home 03/03/04

St Stephens Care Home 07/10/03

St Stephens Care Home 30/09/02

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

CARE HOMES FOR OLDER PEOPLE St Stephens Care Home London Road Elworth Sandbach Cheshire CW11 4TG Lead Inspector Denis Coffey Unannounced Inspection 17th April 2007 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address St Stephens Care Home DS0000018741.V336746.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. St Stephens Care Home DS0000018741.V336746.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Stephens Care Home Address London Road Elworth Sandbach Cheshire CW11 4TG 01270 759565 01270 753425 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) www.c-i-c.co.uk. Community Integrated Care Sharon Timms Care Home 40 Category(ies) of Dementia - over 65 years of age (19), Old age, registration, with number not falling within any other category (21) of places St Stephens Care Home DS0000018741.V336746.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 40 service users to include: * up to 21 service users in the category of OP (Old age not falling within any other category) * up to 19 service users in the category of DE(E) (dementia over the age of 65 years) 1st November 2005 Date of last inspection Brief Description of the Service: St Stephen’s is in the village of Elworth, close to Sandbach and 3 miles from Middlewich. It is a single storey purpose built home consisting of two wings where nursing care for older people is provided. Saxon Wing is registered for nineteen people with dementia, and Penda Wing for twenty-one people who are elderly and infirm. There are 40 single bedrooms. All bedrooms, lounges and dining rooms are close to bathrooms and toilets. There is enough shared space such as lounges and dining rooms for the number of people who live in the home. There are nurses on duty at all times. The fees range from £390.35 to £551 per week. Additional charges are made for hairdressing and aromatherapy. Further information can be obtained from the manager of the home. The home manager confirmed the level of the fees at the time of the inspection. St Stephens Care Home DS0000018741.V336746.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector, Denis Coffey, visited the home on 17 April 2007 as part of its key inspection. The visit was just one part of the inspection, which took other information into account. Before the visit, the manager was asked to complete a questionnaire to provide up to date information about the home. During the visit, the inspector toured the building, looked at both records, including care plans and spoke with people who live at the home as well as members of staff. People who live at the home were satisfied with the home in general and the care they receive. Staff said that they felt supported in their work. All the minimum standards that were checked during the inspection were met. What the service does well: People who are thinking of moving into the home and those living there are given information about the home. Staff from the home find out about people’s care needs before they move in so they all know that the person can be given all the care they need at the home. The care records show the individual needs of people and what staff have to do to make sure they get the right care. The records also include information about any visits made to people living at the home by healthcare people such as doctors and nurses. This means that there is a record of the care given to make sure that people keep well and healthy. There is a wide range of activities offered for the people who live in the home to take part in. People are helped to make choices about what they do each day so they keep active and stimulated. Food provided at the home is varied and nutritious and people spoken with said it was good quality and they enjoyed it. The home is well kept so that people live in clean, comfortable and homely surroundings. Thorough checks are done on new staff so the people who live at the home know the staff are suitable to work with them. Staff receive training so they can give good quality, skilled care to the people living at the home. Health and safety is taken seriously and is well managed so that the people who live at the home and the staff are safe. St Stephens Care Home DS0000018741.V336746.R01.S.doc Version 5.2 Page 6 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 Stephens Care Home DS0000018741.V336746.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 St Stephens Care Home DS0000018741.V336746.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 & 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are given information, and have their needs assessed before deciding to move into the home so they know that their needs can be met. EVIDENCE: The home has a statement of purpose and a service user guide, both of which contain information about the home and the services provided. People living at the home confirmed that they had enough information about the home to make a decision about moving in. One person stated that this was ‘by far the best home visited’. People whose care is funded by a local authority are given a copy of the contract by the authority and a ‘residential care agreement’ by the company that owns the home. The agreement identifies the weekly fee payable and the rights and responsibilities of the person. Those people funding their care privately are given the same information together with a statement outlining the weekly fee. St Stephens Care Home DS0000018741.V336746.R01.S.doc Version 5.2 Page 9 The care records of three people living at the home were checked during the visit. They contained an assessment that had been carried out by a trained nurse employed at the home, before the person moved in. The assessment was based on the person’s abilities/problems in coping with everyday living, and plans of care had been drawn up for any problems/needs identified at the assessment. St Stephen’s does not provide intermediate care so Standard 6 does not apply. St Stephens Care Home DS0000018741.V336746.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s needs are identified and their care plans include full information to make sure that they get all the care they need. Care is given in a way that makes sure the privacy of each person living at the home is respected. EVIDENCE: The care records of three people who live at the home were checked at this inspection. They all included a life story of the person. Care plans had been drawn up for each of the person’s identified needs/problems that described the care to be given, and why it should be given. The records showed the plans were reviewed regularly and each person’s daily records referred to their health and social needs. Assessments were in place for each person’s nutrition, how to move them safely and about whether they were at risk of developing pressure sores. The care records included the person’s own wishes and preferences about how they wanted to be cared for. Records were seen in the care records of people such as doctors and other healthcare workers giving care to the people living in the home. One of the St Stephens Care Home DS0000018741.V336746.R01.S.doc Version 5.2 Page 11 doctors who visits people living at the home sent a comment card to the Commission before the inspector went to the home. It said; ‘excellent nursing care was provided, and that the staff were very helpful and reliable’. The inspector watched how the medicines were given in one of the units of the home, Penda Unit. A student nurse, on placement at the home, gave out the medicines, supervised by one of the home’s qualified nurses. The medicines were kept properly and securely whilst this was happening. Each person was helped and encouraged to take their medicines. The medicine administration record (MAR) sheets on Saxon Unit were checked; they had been filled in correctly and the medicines were stored securely. Medicines that kept under stricter controls were checked and the stock levels of these matched the records of what had been given. Staff were seen to knock on bedroom and bathroom doors before they went in and making sure that personal care was given to people in a way that respected their dignity. The people who live in the home who were spoken with during the visit said the staff made sure that their privacy and dignity was respected. St Stephens Care Home DS0000018741.V336746.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are able to take part in a wide range of activities that suit their lifestyles and maintain their interests. EVIDENCE: There is an activities organiser working at the home who arranges social and leisure activities for the people who live there. A programme for the current week’s activities was on display and what was to be provided, such as quizzes, knitting and a sing-a-long. One person who lives at the home and is a keen gardener was tending to seeds they had sown. They said that when the seedlings were ready they would be planting them in the central garden area. A group of people were taking part in a flower arranging session, and a minister from a local church conducted a communion service in the morning. The home manager said that the activities organiser spends time with people at the home and their families to find out what interests they have, and adapts the activities programme to suit their needs. One person who lives in the St Stephens Care Home DS0000018741.V336746.R01.S.doc Version 5.2 Page 13 home said that activities are arranged most days and they are encouraged to join in. The home shares the use of a minibus that belongs to another home that is owned by the company. Two visitors at the home said that the more trips out could be arranged if the home had its own mini bus. Visitors can call at the home at any reasonable time and those spoken with said that they are made to feel welcome. They said the staff at the home let them know about their relative or friend and how they are. One visitor spoken with said that ‘the staff care and it shows’. The care records had a section in them that asks for the person’s preferences and interests to be identified. A guide to the major religions is available for the staff at the home, and the manager said that if someone from an ethnic minority was referred to the home she would liaise with this person and their family to make sure the home could provide everything they needed. Menus were on display in the dining rooms and showed that a choice is offered for all meals. The food provided appeared varied and nutritious and people spoken with said that they were happy with the standard of the food. One person said that the ‘meals were appetising, and that it was good wholesome cooking’. Pureed diets are provided for people who have problems swallowing. St Stephens Care Home DS0000018741.V336746.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live at the home and their relatives know how to make their concerns known. Staff at the home know about protecting adults from abuse so they can keep the people who live in the home safe from abuse and harm. EVIDENCE: There have been no complaints received at the home since the last inspection. A copy of the home’s complaints procedure was on display and the manager said that a copy of this is given to everyone, with the home’s service users guide, when they move into the home. A person from the company’s training centre was booked to visit the home in the week following this inspection visit to provide a full day’s training to the staff about the protection of vulnerable adults. Those staff who are unable to attend will be given this training by the home’s training co-ordinator. The home has a policy on protecting people from abuse along with a whistle blowing policy that tells staff how they can make known any concerns they may have about possible poor practice, harm or abuse to the people who live at the home. St Stephens Care Home DS0000018741.V336746.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 24 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained so the residents live in clean and comfortable surroundings. EVIDENCE: There is a part-time maintenance person employed to carry out general around the home. Redecoration of the corridors of both units has been completed since the last inspection and the décor of the home has been maintained to a good standard. There are private gardens for both units and the home is surrounded by grassed areas. At the time of inspection the lawns needed mowing and the home manager confirmed that this was to be done on the day after the inspection visit. St Stephens Care Home DS0000018741.V336746.R01.S.doc Version 5.2 Page 16 There is a choice of sitting areas in each unit and both of them have a large central lounge that can be used for social functions. Bedrooms were comfortably furnished and were personalised by the person occupying the room or by members of their family. There are bathrooms and toilets close to the bedrooms, lounges and dining rooms. Grab rails were installed by the toilets, and specialist baths provided for people who cannot get into and out of a domestic style bath easily. People who were at risk of developing a pressure sore had specialist mattresses on their beds. All areas of the home were visited at this inspection and found to be cleaned to a high standard. There were no unpleasant smells. St Stephens Care Home DS0000018741.V336746.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. JUDGEMENT – we looked at outcomes for the following standard(s): 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. Staff have had training to help them develop their skills and provide safe care. Recruitment procedures are thorough enough to ensure that residents are protected. EVIDENCE: The staffing rotas showed that there are enough staff on duty to care for all the people living at the home. Trained nurses are on duty at all times and carry out their duties helped by a team of support workers. The home also employs maintenance, domestic, laundry, catering and administrative staff. One of the trained nurses working at the home has recently taken on the role of training co-ordinator and has been given time away from nursing duties to provide training for other staff. Staff training records showed that training that has been given includes catheterisation, continence, reminiscence and recall, end of life care, and dementia. Future planned training includes wound care, diabetes, infection control, communication skills and nutritional support. Two of the qualified nurses were doing a course in palliative care and another nurse was attending a course about cognitive behaviour. Five of the staff employed at the home have received training so they can train other staff in safe moving and handling techniques. Records seen showed that all staff have received this training within the past twelve months. St Stephens Care Home DS0000018741.V336746.R01.S.doc Version 5.2 Page 18 Thirteen of the support workers at the home have achieved an NVQ level 2 in care. Another support worker has recently started this training and two others were waiting to start it. Five of the staff have a current first aid certificate. At the time of inspection a student nurse was on an eight week placement at the home. They said was this was their first placement and that they had been well supported whilst working at the home. They had been able to observe various procedures, and received guidance and training. A tutor responsible for the placements of student nurses sent a completed comment card to CSCI saying that she thought the home provided a good standard of care and support. The personnel files of two staff who had started working at the home since the last inspection were checked. Both contained all the necessary information about Criminal Record Bureau checks, employment history and satisfactory references. St Stephens Care Home DS0000018741.V336746.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32, 33, 35 & 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is run in the best interests of the people living there, and health and safety issues are managed well to ensure that people are safe. EVIDENCE: The manager is a qualified nurse who has worked at the home for a number of years before becoming manager. She is supported by the assistant manager who has an average of thirteen hours a week to undertake management duties, in addition to her nursing duties. Staff spoken with said that they are happy with the way the home is managed, adding that the manager is approachable and listens to their views. The relatives of one person said that ‘since the manager took over there has been an improvement’. St Stephens Care Home DS0000018741.V336746.R01.S.doc Version 5.2 Page 20 A manager from one of the other homes owned by the company carries out a monthly unannounced visit to the home to review the care and general records, speak with people living at the home and the staff, and tour the building. Relatives’ meetings are held on average once a month, and a written record of what is discussed is available. Relatives leave small amounts of money for people living at the home to pay for personal items. This money is kept securely at the home with a record of what it is spent on and receipts for all purchases. A random selection of two records was checked and the records matched the cash balances. A number of people were being cared for in beds that had bed rails fitted. The care records of some of these people were checked and found to contain a risk assessment for the use the rails. Risk assessments were also seen for such things as falls/trips, the use of electrical equipment, and infection control. A food hygiene/health and safety report from a local council in August 2006 stated that the home ‘had a high compliance with food hygiene registration’. Records were in place that showed that equipment was serviced and maintained, and that health and safety issues were well managed. St Stephens Care Home DS0000018741.V336746.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 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 X 3 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 4 3 3 X 3 X X 3 St Stephens Care Home DS0000018741.V336746.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. Refer to Standard Good Practice Recommendations St Stephens Care Home DS0000018741.V336746.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Stephens Care Home DS0000018741.V336746.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. 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