This inspection was carried out on 21st January 2009.
CSCI found this care home to be providing an Good service.
The inspector found there to be outstanding requirements from the previous inspection
report. These are things the inspector asked to be changed, but found they had not done.
The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.
Inspecting for better lives Random inspection report
Care homes for older people
Name: Address: St Stephens Nursing And Residential Home St Stephens Nursing And Residential Home 4 St Stephens Avenue Bispham Blackpool Lancashire FY2 9RG The quality rating for this care home is: The rating was made on: two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Pauline Caulfield Date: 2 1 0 1 2 0 0 9 Information about the care home
Name of care home: Address: St Stephens Nursing And Residential Home St Stephens Nursing And Residential Home 4 St Stephens Avenue Bispham Blackpool Lancashire FY2 9RG 01253352625 Telephone number: Fax number: Email address: Provider web address: st_stephens@btconnect.com Name of registered provider(s): Type of registration: Number of places registered: Mrs Brenda Christine Bell,Mr Keith Bell care home 31 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia 31 Over 65 0 Conditions of registration: The registered person may provide the following category of service only: Care Home only - Code PC To Service Users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia - Code DE The maximum number of Service Users who can be accommodated is: 31 Date of last inspection Brief description of the care home St Stephens Nursing Home is registered to care for up to 31 people with dementia. The home is a detached 3-storey house with a purpose built 2-storey extension to the rear. The home is situated in the residential North shore area of Blackpool, close to the seafront, and approximately 10 minutes by car to the town centre. There is good access to local transport networks. There are a full range of appropriate aids and adaptations in place to meet the needs of residents who are frail and immobile. The Care Homes for Older People Page 2 of 11 home has 27 single rooms, 14 with on suite facilities, and 2 double rooms. Information provided by the home on 22nd January 2009 showed that fees for the home are from three hundred and eighty one pounds and six pence to six hundred and twenty pounds per week with some additional costs for one to one funding. There are added expenses for transport, magazines and other small items. Care Homes for Older People Page 3 of 11 What we found:
The reason for this inspection was to check that the good 2 star rating given at the last key inspection is still valid and that nothing has changed. We looked at all the key standards. The outcome is as follows and shows that although some areas of record keeping need attention the outcome for residents is still good. Prospective residents are assessed, before admission so that staff are aware of their specific care needs and know whether they can meet these. Both residents that we looked at had nursing assessments in place before they were admitted to the home. We case tracked two residents. This involved looking at their care records, the rooms they used in the home and talking to them or observing care staff supporting them and spending time with them. Care plans were in place for both residents covering most areas of care and there were detailed daily reports in place. However some areas of care records including life history and significant dates forms had not been completed for either resident. One residents weight had not been checked for several months and her history of falls form had not been updated since for nearly two years. Also there was no religion recorded for her. This information is important so that the residents spiritual needs, if any can be met. Some risks assessments were in place but had not been updated recently so risk management is less effective. Neither the dependency profile or the nutritional risk assessment had been completed. The residents care plan had not been reviewed for several months. Care plans must be updated at least monthly to ensure that information is up to date and accurate and staff are fully aware of current care needs and other information needs completing and reviewing regularly. The other resident case tracked had a care plan, dependency rating and risk assessments in place. The care plan had been reviewed monthly. However more information on the residents challenging behaviour would be beneficial, with a more detailed management strategy in place so staff are clear about how to support the resident effectively. There were records of transactions for all residents where the home deals with their money. Medication was appropriately managed and residents have access to appropriate health services. None of the residents case tracked had been involved in any accident, but senior staff are aware of the need to audit to see if any lessons could be learnt or accidents reduced if accidents/falls occurred. We were unable to ask many residents questions about the home because of their dementia but chatted with them and spent time in the lounge and dining area observing staff interaction. Staff chatted to residents as they went about their duties and spent time calming residents who were anxious or needing reassurance. One resident was spoken to and said that staff were alright and the food was quite nice. Another resident said the home was fine. Both were unwilling to have more detailed conversations. Care Homes for Older People Page 4 of 11 There are some activities available for residents. These include going for walks and bus trips. Staff spend time chatting to people on a one to one basis and are pleasant and friendly but the home would benefit from developing more indoor leisure activities to occupy and interest residents. We discussed developing activities using light sensory equipment and large games board games, skittles and soft ball games. Staff support residents to meet their spiritual needs and local ministers visit the home regularly. Staff were observed during the lunch time meal. Most residents need assistance to eat. Staff were supportive, kind and considerate with residents. The main communal area is a large noisy environment and the level of noise may cause distress to some people. The menu was seen. It has been recently changed as more exotic meals were not being eaten and more finger foods have been added to the menu as these are enjoyed by many residents. Residents are now eating more of their meals. A resident spoken to said she knew how to complain if she had any concerns. Senior staff said there have been no complaints since the last inspection. Senior staff said care staff have received some safeguarding adults training and have an understanding of the action to be taken if they are alerted to a safeguarding issue. We toured the home and found the environment, clean, tidy and well maintained. There is a member of staff for maintenance support and a painter/decorator in post between the organisations three homes. Most bedrooms were well personalised by residents and their relatives. New bedroom furniture including electric beds has been purchased. This makes the home more comfortable for residents. Aids and adaptations are in place to help residents get about more easily and to be as safe and as independent as they can be. A recommendation at the last key inspection was for the the home to consider including an additional ground floor toilet with wheelchair access for the benefit of residents with mobility problems. As the general manager was not aware of the outcome of this, it was agreed that it would remain a recommendation in this inspection. A lot of the staff have worked in the home for several years and there is only a small staff turnover. This ensures that staff are familiar with residents and their care needs and residents know the people caring for them. Staff rotas showed sufficient staff on duty to provide good care. The records of two members of staff were checked. Both applicants had an application form. One had a complete work history, the other did not. It only went back three years and had only the year of changes of employment, rather than the month and year. A complete working history from first to present job exploring any gaps is required. Both had written references in place and had completed health checks to show they were fit to undertake the work in the home. A recommendation at the last key inspection was for staff to have renewed fitness checks after three years in post for the protection of service users. As the general manager was not aware of the outcome of this, it was agreed that it would remain a recommendation in this inspection. We discussed staff recruitment and selection and staff retention and management of sickness and absence. The organisation is planning to introduce back to work Care Homes for Older People Page 5 of 11 interviews as part of the support for staff to assist them with any health or personal issues and monitor absences. Senior staff also need to record the decision making process when there are any potential issues with staff or prospective staff so that the reasons for decisions are clear. Staff training records were seen. Senior staff advised that staff have moving and handling training, and safeguarding and medication training. Many staff employed in the home have now commenced National Vocational Qualifications (NVQ) with over 50 per cent of staff having completed NVQ. There are regular staff meetings but records of these are not kept. It would be beneficial to keep these so that those staff unable to attend are clear about issues discussed. The registered manager has been on leave for a while and is due to return soon. The General Manager said that the registered manager would spend time updating on anything that has occurred while she has been off. Systems are in place for quality assurance. The home has met the standards for investors in people which is a national quality assurance award. Questionnaires are available in the home for residents, relatives and others to complete if they wish. Regulation 26 visits by the owner are not carried out and must be. This is where the owner makes an unannounced visit at least monthly and talks to residents and staff, checks paperwork and tours the home. The owner must then provide a report about the visit and send a copy to the home and make available a copy to CSCI if requested. The fire risk assessment is in place. The manager said that there are regular fire alarm and emergency light checks but these are not recorded. It is good practice to record regular visual fire safety checks. Health and safety checks are in place. What the care home does well: What they could do better:
Care Homes for Older People
Page 6 of 11 Some resident records were not completed or were not up to date. This included some care plans, risk assessments and other information about residents. This lack of written information means that staff may not be aware of important information. This reduces the effectiveness of residents care. Prospective staff need to have a full working history so that staff are aware of their past work experience and can identify any gaps in employment. This makes it less likely that people who should not work with vulnerable residents can gain employment in the home. Although the owners visit the home regularly they do not produce a report of their visit and must do. This is so all involved are aware of how the service is being managed and the views of residents and staff. The manager should record when visual fire alarm and emergency light checks are carried out so that it is clear that these have been checked and appear in good working order assisting with keeping residents safe. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 7 of 11 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set.
No. Standard Regulation Requirement Timescale for action 1 18 17(SCH 3) There must be evidence of 01/10/2007 records in place for the victim of any incident, which may affect their safety and welfare so that there is a clear audit trail of how the home managed such an event. There must be evidence monthly visits by the registered provider are recorded and a copy is available for inspection so that there is evidence of the providers knowledge about the general running of the care home for the benefit of all users of the service. 01/10/2007 2 33 26 Care Homes for Older People Page 8 of 11 Requirements and recommendations from this inspection
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 7 15 Residents care records must include all relevant health and personal care information and must be reviewed and updated regularly This is so that everyone involved has detailed information about each resident 23/02/2009 2 18 17 There must be evidence of 23/02/2009 records in place for the victim of any incident, which may affect their safety and welfare so that there is a clear audit trail of how the home managed such an event. There must be a complete 23/02/2009 work history including month and year of any changes of employment in place for all prospective staff This is so staff experience is clear and detailed and any gaps in employment can be explored. 3 29 19 Care Homes for Older People Page 9 of 11 4 33 26 There must be evidence that 23/02/2009 monthly visits by the registered provider are recorded and a copy is available for inspection This is so that there is evidence of the providers knowledge about the general running of the care home for the benefit of all users of the service. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No. Refer to Standard Good Practice Recommendations 1 2 12 21 More frequent and varied leisure activities should be made available to interest, occupy and stimulate to residents. The home should consider including an additional ground floor toilet with wheelchair access for the benefit of residents with mobility problems. Staff should have renewed fitness checks after three years in post for the protection of service users. Decision making processes when there are any potential staff issues should be recorded so that it is clear why decisions have been made in specific circumstances. Minutes should be kept of stff meetings so that everyone is aware of information discussed and agreements reached at the meeting. Fire safety checks should be recorded so it is clear that these have been checked and appear in good working order and assist with keeping residents safe. 3 4 29 29 5 33 6 38 Care Homes for Older People Page 10 of 11 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 11 of 11 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
