CARE HOMES FOR OLDER PEOPLE
Stable Court Residential care home Bishops Way Meltham Huddersfield West Yorkshire HD9 4AG Lead Inspector
Sally McSharry Key Unannounced Inspection 26th June 2007 10:30 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 Stable Court Residential care home DS0000069028.V331398.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. Stable Court Residential care home DS0000069028.V331398.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Stable Court Residential care home Address Bishops Way Meltham Huddersfield West Yorkshire HD9 4AG 01484 851270 01484 851270 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) Helme Hall Ltd Mrs Julie Smith Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Stable Court Residential care home DS0000069028.V331398.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection This is the first inspection since Helme Hall Ltd purchased the home. Brief Description of the Service: Stable Court is now owned by a small locally owned care company. The home is registered to provide accommodation and care for up to eighteen older people. The establishment is situated in a residential area on the outskirts of the village of Meltham, with easy access by public transport to the town centre of Huddersfield. The property, a converted coach house, which has been sympathetically extended, is well maintained throughout and furnished and fitted to a good standard. All bedrooms are for single occupancy and all are equipped with en-suite facilities. Communal areas, that include a conservatory, are spacious and comfortable. Although the building has two floors only staff and service areas are located on the first floor. The ground floor has all the communal facilities for people who live in the home. The garden and courtyard with hanging baskets is an attractive well kept area, where people may sit out and relax in the warmer months of the year. The provider informed the Commission for Social Care Inspection on 26/06/07 that fees range from £380 to £420. Additional charges include hairdressing, private chiropody and newspapers. Information about the home and the services provided are available from the home in the statement of purpose and service user guide. Stable Court Residential care home DS0000069028.V331398.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. Stable Court was bought by Helme Hall Ltd in February 2007. This unannounced visit was carried out to assess the quality of care provided to people living at the home. An inspector visited the home on the 26th June 2007 and spent approximately 6 hours in the home. During the visit the inspector spoke to some of the people living in the home, visiting relatives, some of the staff and the home’s management. The inspector read care records, audited a sample of medications, reviewed staff recruitment and training records, carried out a brief tour of the building and observed lunch being served. Before the visit seventeen surveys were sent to people living in the home and their relatives or friends to obtain peoples’ views about living at Stable Court and the services provided. Two completed surveys were returned from people living in the home and seven from relatives or friends. Some people living in the home are very frail and may have had difficulty completing the survey. There were eighteen people living in the home on the day of this visit. Other information used in the inspection process included notifications from the provider to the Commission for Social Care Inspection about illnesses, accidents and incidents at the home and a questionnaire about the home completed by the provider and manager. The inspector would like to take this opportunity to thank everyone who participated in the inspection process. What the service does well:
When talking to people who live or work in Stable Court it is clear the home is generally a happy, welcoming care home. Although the home has recently changed ownership people feel settled and safe. One person’s opinion of the home; “ They are pleasant, friendly and helpful staff. The home looks cheerful and is nicely furnished and comfortable in the main sitting rooms. Individual rooms are clean and pleasant and some
Stable Court Residential care home DS0000069028.V331398.R01.S.doc Version 5.2 Page 6 furniture, pictures and ornaments from home are encouraged, which makes it familiar and homely.” Other comments included; “Very pleased with the care she receives. A homely atmosphere. Good home cooking.” “The home and residents always looked well cared for.” “ Stable Court is a homely residential home where both the manager and staff make everyone feel very welcome and relaxed. A good quality care home.” Before someone is admitted to the home, they are given information about the home and are able to visit and spend time in the home, to help them make a decision whether or not to stay at Stable Court. As well as Stable Court offering a pleasant and comfortable environment to live in, staff support people to maintain their independence and allow people to make informed choices about their lives. They recognise sometimes there are risks involved when someone wants to go out independently but also appreciate that life is for living and with that also comes some level of risk. Staff care for people competently, getting the support of doctors, district nurses and other health care specialists when needed. Medications are managed well in the home and some people are able to manage their own medications. One person living in the home said they had always looked after their own tablets and wanted to continue to do so. People are cared for in a kind and caring way. People living in the home felt staff respected them. Everyone felt the home is welcoming and that visitors can call at any time. Most people felt meals were good and that a choice is available. People felt able to raise concerns should they have any and these would be taken seriously. Staff are generally skilled and experienced and the manager works well with the staff helping to provide consistently good level of care. Staff know individual peoples needs, likes and preferences and provide personalised care. The home is generally a safe place to live, visit and work. What has improved since the last inspection?
Although this is the first inspection of the home since the change of ownership some improvements have been made. Staff feel well supported by the new company.
Stable Court Residential care home DS0000069028.V331398.R01.S.doc Version 5.2 Page 7 The home’s services and facilities have been audited and a “Home development plan” produced that identifies areas for improvement in the building and with the services provided. People living in the home and their families have been asked in questionnaires what they think of the home and the services. Their comments have been taken seriously and plans such as those to introduction of an activities person two hours every afternoon are being put in place. A redecoration programme is being implemented and other changes such as offering people a glass of wine or beer before their lunch is making a positive difference to people living in the home. 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
Stable Court Residential care home DS0000069028.V331398.R01.S.doc Version 5.2 Page 8 be made available in other formats on request. Stable Court Residential care home DS0000069028.V331398.R01.S.doc Version 5.2 Page 9 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 Stable Court Residential care home DS0000069028.V331398.R01.S.doc Version 5.2 Page 10 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): 3. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Before people move into the home, a member of staff carries out a preadmission assessment to make sure Stable Court and the staff are able to meet their health and welfare needs. EVIDENCE: People living in the home told the inspector that, before they had been admitted to the home, someone from the home had met with them and assessed their needs. This was done before admission to the home to make sure the home and its staff were able to meet the health and welfare needs of the prospective resident. The inspector also saw copies of pre-admission assessments in individual people’s care records. Relatives’ surveys confirmed that they were able to visit the home prior to making the decision to place their relative. Two people living in the home said
Stable Court Residential care home DS0000069028.V331398.R01.S.doc Version 5.2 Page 11 that they had visited Stable Court and spent time at the home with the staff before they decided to move in. The home welcomes people with different care needs and from differing cultural backgrounds. Staff at the home are from different cultural backgrounds. The cultural background of the people living in the home at the present reflects that of the local village community. Stable Court Residential care home DS0000069028.V331398.R01.S.doc Version 5.2 Page 12 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,and 10. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People’s health and welfare needs are set out in a written care plan. Medications are managed well and people are treated with respect and their privacy and dignity maintained. EVIDENCE: The care plans of three people living at the home were examined. These were clear documents, which included risk assessments regarding tissue viability (an assessment used to assess a person’s risk of developing pressure ulcers), falls, mobility, nutritional status and continence. However some written plans lacked specific detail about the individual person, their likes and preferences. When the inspector spoke to people living in the home and the staff it was clear that the staff do know each person very well. Staff know people’s likes, wishes and preferences and these are being met by staff. Unfortunately written records do not reflect this knowledge and detail.
Stable Court Residential care home DS0000069028.V331398.R01.S.doc Version 5.2 Page 13 The inspector recommended written care plans and risk assessments be expanded to include the important detailed individualised care that is delivered in the home. The daily records examined had a fair amount of detail. The people living at the home on the day of this visit, looked well dressed, clean, comfortable and relaxed. People responded well to the staff and it was evident from observing staff interaction with people living in the home that they knew each individual’s likes, dislikes and needs. Feedback from relatives in returned surveys was positive. Staff have also built good relationships with relatives, who stated that they felt comfortable approaching staff. The lines of communication between staff and families are generally good. The healthcare needs of people are met, evidence was seen of involvement from local doctors, optician, dentist and other healthcare professionals where needed. One relative commented, “The staff and manager were easy to contact by phone and explained anything relevant to my relative’s care. They liaised well with the social worker”. The medication of three people was checked and generally were found to tally with the records held. Systems are in place to ensure safe administration of medication. A staff signatory list is in place, so that you can clearly identify who has administered medications. During this visit staff were observed to maintain the privacy and dignity of people. Staff approached and spoke to people in an appropriate manner. Feedback from relatives was extremely positive about the staff and the care delivered. Comments from relatives in surveys included; “ Very caring staff, always ready to listen to your concerns. Pleasant manner and good working relationships between staff.” “ They are pleasant, friendly and helpful staff”. Stable Court Residential care home DS0000069028.V331398.R01.S.doc Version 5.2 Page 14 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 and 15. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The lifestyle at the home appears to satisfy the needs of the people living there, and encourages the involvement of family and friends. EVIDENCE: Activities are available in the home, people living in the home living in the home confirmed this and during the visit staff were seen playing dominos with some people, other people were going out either independently or with relatives. Some relative surveys indicated more in the way of activities could be offered. This was discussed with the manager. Since Helme Hall Ltd purchased the home this has been discussed and the manager said there are plans to employ an activities person to work two hours each afternoon. This should help widen the variety and increase the frequency of activities offered. People living in the home and their relatives confirmed that visitors are welcomed and that links with the local community are maintained. Visitors were seen to come and go thought the day of the visit.
Stable Court Residential care home DS0000069028.V331398.R01.S.doc Version 5.2 Page 15 Ministers from various local churches visit the home and people who are able use local community facilities. One person said in their survey “My relative was help to use the phone to keep in contact.” They keep the family informed and welcome the many relatives and friends who visit.” People living in the home confirmed that they are able make decisions in the home. Where ever possible they are able to maintain their independence, going out independently, managing their own medications and finances. People can also make choices in the home, such as where they spend their time, to take part in activities, what to have at mealtimes, when they get up or go to bed at night. Generally comments about the quality and variety of meals served were very good. One relative said in their returned survey, “Very please with the care she receives. A homely atmosphere. Good home cooking.” The menu in place at the home shows that a nutritionally balanced and varied diet is offered. The lunchtime meal on the day of the visit was meat and potato pie, carrots, peas and gravy followed by Manchester tart. The chef is aware of peoples likes, dislikes and any special dietary needs, gluten free and sugar free diets are prepared. Before lunch people were offered a glass of wine or beer and people said they really enjoyed this. People living at the home appeared to enjoy the meal and were assisted in an appropriate manner. Where possible people are encouraged to maintain as much independence as they can. People spoken to during the visit said that the meals provision is very good at the home and that there is always a choice. Stable Court Residential care home DS0000069028.V331398.R01.S.doc Version 5.2 Page 16 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 and 18. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People can be confidant that their complaint will be dealt with effectively and that they are adequately protected from abuse. EVIDENCE: The homes complaints procedure has been updated to reflect that Helme Hall Ltd now own the home. People who spoke with the inspector said they would be confident to raise any concerns with the manager. One person said in their returned survey, that staff are always prepared to listen to concerns and sort them out. Members of staff have in the past had safeguarding training. This was discussed with the manager. The inspector recommended that all staff receive an update in safeguarding training to ensure staff are aware what to do if they suspect any abuse is occurring. Stable Court Residential care home DS0000069028.V331398.R01.S.doc Version 5.2 Page 17 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 and 26. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People live in a clean, pleasant well maintained home. EVIDENCE: On the day of the visit Stable Court was clean tidy and well maintained. There is a redecoration programme in place and since Helme Hall Ltd purchased the home they have reviewed the facilities and are replacing some fixtures and fittings. Overall the standard of accommodation is good, homely and pleasant. People living in the home and relatives confirmed this during the visit and in positive comments in returned surveys, such as, “The home looks cheerful and is nicely furnished and comfortable in the main sitting rooms. Individual rooms are clean and pleasant and some furniture, pictures and ornaments from home are encouraged, which makes it familiar and homely.”
Stable Court Residential care home DS0000069028.V331398.R01.S.doc Version 5.2 Page 18 All the accommodation for people living in the home is on the ground floor with level access. All bedrooms are single with en suite facilities. Rooms vary in size, layout and aspect, this gives people opportunity to select a room that meets their individual needs. Stable Court Residential care home DS0000069028.V331398.R01.S.doc Version 5.2 Page 19 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 and 30. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Suitable numbers of staff are employed. The staff receive induction and foundation training and are competent to work in the home. Staff recruitment policies and records protect people living at the home. EVIDENCE: Stable Court has a dedicated team of care staff, who are trained to meet the needs of the people living in the home. The home has seventy four percent of its care staff trained to NVQ (National Vocational Qualification) level 2 in care. Each member of staff has a detailed and well set out training file showing training undertaken since they started work at Sable Court. Staffing levels have recently been reviewed and an extra member of staff allocated at the weekend at teatime to help with the serving of the evening meal. Staffing levels meet the needs of the people currently living in the home, but must be kept under review as the needs of the people in the home change. Recruitment records are organised and contain the required information references and checks needed to help prevent unsuitable people working with vulnerable people.
Stable Court Residential care home DS0000069028.V331398.R01.S.doc Version 5.2 Page 20 People living in the home and relatives told the inspector at the visit and in returned surveys how good the staff were. Some people made special mention of specific members of staff. Comments made included, “They are pleasant, friendly and helpful staff”, “The manager and staff were kind, courteous and understanding” and “ There appears to be staff with skills and experience to care for the resident properly. They are supportive and help my relative live an active a life as possible”. Stable Court Residential care home DS0000069028.V331398.R01.S.doc Version 5.2 Page 21 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, 33, 35 and 38. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The home is managed well, people are generally kept safe by health and safety practices; they are involved in making improvements as part of the home’s quality assurance system. EVIDENCE: Mrs Smith the manager is an experienced care manager and has obtained the RMA (Registered Managers Award). The deputy at the home is also working toward the RMA. Once this is obtained the inspector recommended both the manager and her deputy obtain NVQ level 4 in care to develop their knowledge and skills.
Stable Court Residential care home DS0000069028.V331398.R01.S.doc Version 5.2 Page 22 Since Helme Hall Ltd has purchased the home they have sent out quality assurance questionnaires to people living in the home and their relatives. The results of these surveys were seen during this visit. Issues identified are being addressed and the management team have developed an action plan to address the issues. Audits of the homes services and systems have been carried out and a “home development plan” produced. This is good because it means the management team is looking carefully at the home and the services and facilities it provides, its strengths and weaknesses and making improvements where needed. They are doing this by asking the people who live there and their relatives what they think about the service. Mr Hennessey the responsible individual for Helme Hall Ltd was present during the visit. He said that he plans to start producing a monthly management view of the home as required by the Commission for Social Care Inspection. This help the Commission for Social Care Inspection see what is happening in the home on a monthly basis and how the home is being managed. The records of three people’s personal monies were examined. All tallied with the records held. Since Helme Hall Ltd purchased the home they are making sure all people living in the home have a lockable drawer available in their rooms in which they can keep personal items safely. There is a planned programme of routine maintenance in the home including fire safety checks to ensure people living and working in the home are safe. All senior carers and night carers in the home have had first aid training. Therefore there is always someone trained in first aid on duty in the home. Stable Court Residential care home DS0000069028.V331398.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 Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Stable Court Residential care home DS0000069028.V331398.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? New service 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. Refer to Standard OP7 Good Practice Recommendations People’s care plans should include detailed information about that person’s personal health and welfare needs, preferences, wishes and choices. So that staff have all the information to meet their individualised needs. All staff should have up to date safeguarding training, so that they understand what abuse is and how to report it using local policy and guidelines. It is recommended the manager and her deputy obtain the NVQ level 4 in care to develop their skills and knowledge. 2. 3. OP18 OP31 Stable Court Residential care home DS0000069028.V331398.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Brighouse Area Team First Floor St Pauls House 23 Park Square Leeds LS1 2ND 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
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