Inspection on 10/11/06 for Stacey Street Nursing Home

This inspection was carried out on 10th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Stacey Street Nursing Home 16/12/05

Stacey Street Nursing Home 12/07/05

Stacey Street Nursing Home 08/02/05

Stacey Street Nursing Home 05/10/04

Similar services:

Townley Road, 2-3

Foxley Lane (121a)

Tudor Lodge

Delrose House Ltd

Clovelly House Residential Home Ltd

Abbey Road [53]

Cherry Tree House

Ashwood House (Leyton)

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

CARE HOMES FOR OLDER PEOPLE Stacey Street Nursing Home 1 Stacey Street London N7 7JQ Lead Inspector Ms Edi O’Farrell Unannounced Inspection 10th November 2006 09:45 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 Stacey Street Nursing Home DS0000010327.V288049.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. Stacey Street Nursing Home DS0000010327.V288049.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stacey Street Nursing Home Address 1 Stacey Street London N7 7JQ 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) 020 7700 2400 020 7607 2842 margaret.ford@candi.nhs.uk Family Mosaic Housing Association Margaret Elizabeth Ford Care Home 30 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (0), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (0) Stacey Street Nursing Home DS0000010327.V288049.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. For the provision of Mental Nursing Care for up to 30 Adults mainly elderly, who are not required to be detained at the home under any section of the MHA. The Staffing Notice Date of last inspection 16/12/05 Brief Description of the Service: Stacey Street is a thirty-place care home with nursing for older people with mental health problems. This is generally people over the age of 65, but can also be those under 65 who meet the other admission criteria. The home was purpose built twelve years ago, as an alternative to long stay hospital provision. Camden and Islington Mental Health and Social Care Trust (the Trust) block purchase the service. Referrals are therefore only taken from the specialist multidisciplinary team for the mental health care of older people. The service is provided by a Housing Association, Family Mosaic, who contract the nursing, care, catering, and cleaning staff from the Trust. The home is situated in Finsbury Park on a small housing estate. Holloway Road shopping area is within ten minutes walk, and there are good bus, tube and train links. There are three floors, with access via a lift and stairs. There are three separate residential units, one on each floor with identical layouts. This is ten single bedrooms, dinning and lounge areas, quiet rooms, small kitchen, and staff office. In addition the ground floor houses the manager’s office and the main kitchen, and the first floor has the laundry and some communal staff facilities. There is a small garden located at the rear of the property. Nursing and personal care are provided on a 24-hour basis. Trained mental health nurses are on duty at all times, some of whom are also general nurse trained. The staff team meet complex health care needs with the support of visiting professionals such as Psychiatrists, Occupational Therapists and Psychologists. The cost of the service is from £415.65 to £440.62. This is funded by the Trust, with individual service users’ contributions being financially assessed. Stacey Street Nursing Home DS0000010327.V288049.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The site visit for this, unannounced, inspection took place on a weekday from mid morning to mid afternoon. A second visit was made later in the week to check some of the standards not assessed on the first visit. Over the two days a total of six and a quarter hours were spent in the home. All key standards were assessed, with many being scored as 4, ‘commendable’. Prior to the site visit all information held at our office was reviewed. This included reports about serious incidents, and pre-inspection forms that had been completed by the manager earlier in the year. Twenty six completed surveys were received from service users, which in many cases had been completed with the help of relatives or carers. Five further surveys were received from relatives and professionals who had contact with the home, such as social workers and GPs. All this information was used to devise an inspection plan for the site visit. During the visit records, such as assessments, care plans, and daily reports were examined. These were cross referenced with other records such as accident and incident reports. The information was then compared to the actual care being provided to service users. Two recently admitted service users’ files were examined in depth. Staff recruitment, training, and supervision, records were examined. Staff were observed, both directly and indirectly, carrying out their duties. Where possible service users were asked their views, but due to the level of disability many could give little information. Five relatives, who visited the home during the first visit, were asked for their views on the service. A comment card was left with the manager, so she could let us know how she felt the inspection was carried out. What the service does well: ‘First rate service from a highly responsible home’- comment received via postal survey from a professional. ‘Feel confident that every need is seen to’ and ‘staff always helpful’- comments received from relatives. Relatives also commented that staff talked to service users and ‘had a laugh with them’. They described the service overall as ‘excellent’, ‘near top notch’, and ‘good’. All relatives described staff as welcoming, and treating service users with respect and dignity. Our findings during this inspection supported the above views. We found a well-managed service, where the needs of service users were identified and Stacey Street Nursing Home DS0000010327.V288049.R01.S.doc Version 5.2 Page 6 met. There was a commitment to choice, respect, and dignity. Staff were well trained and supported to meet the needs of the service users. Cultural needs and diversity were taken seriously, and included in care plans, including communication needs. Staff were able to overcome communication barriers, such as a service user speaking no English, or having very limited vocabulary due to their level of disability. Nursing care standards were high, and based on up-to-date, best practice, guidance. Personal care was provided so as to maximise independence and encourage service users to retain skills. Service users enjoyed a pleasant and homely environment. It was exceptionally clean, well furnished and decorated. The separation into three ten-place units created manageable groups. Combined with good staffing levels this meant that service users received the attention that they needed. 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. Stacey Street Nursing Home DS0000010327.V288049.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 Stacey Street Nursing Home DS0000010327.V288049.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, Standard 6 is not applicable to this home. Quality in this outcome area is excellent. This judgement has been made using available evidence, including a visit to this service. Service users’ needs are comprehensively assessed prior to their moving in. They, and their relatives, can be confident that these needs will be met. EVIDENCE: The files of the two last admissions were checked. All referrals came from the Trust. This was a partnership arrangement between the NHS and the mental health services of the two local authorities. Assessments were carried out by professionals from the specialist teams for the mental health care of older people. These were multidisciplinary where required. Copies of these assessments, and reviews, were seen on both files. They were comprehensive, and included reports from the responsible consultant psychiatrists. Where service users had been in hospital immediately prior to admission discharge summaries were also in the case files. Currently dementia is specifically excluded in the registration category of this home. Yet during the site visit many service users seen had that diagnosis, though in some cases there was also a pre-existing diagnosis of a functional Stacey Street Nursing Home DS0000010327.V288049.R01.S.doc Version 5.2 Page 9 mental health problem, such as bipolar disorder. This was discussed with the manager, who stated that the primary reason for referral to the home was for mental health needs to be met. In many cases this was behaviour that other services had been unable to respond to appropriately. All evidence demonstrated that the home was clearly meeting the needs of the service users. Outcomes for service users were excellent in most areas. We will look at the most appropriate registration categories for the home, and if a change is needed will advise the provider what action they need to take. Stacey Street Nursing Home DS0000010327.V288049.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is excellent. This judgement has been made using available evidence, including a visit to this service. Service users’ personal and health care needs are identified and met to a very high standard. EVIDENCE: The case files of two service users were examined in detail. The identified health and personal care needs were compared to the care being provided. This included looking at daily reports, incident and accident records and indirect observation of staff. Care needs were also discussed with five relatives, who were visiting during the site visit. The handover between the morning and afternoon shift was observed on one of the floors. Health and personal care needs were clearly identified in the pre-admission assessments. The home had a very structured admission process, which included an assessment within the first six hours. This formed the basis of the initial care plan. This was excellent as it meant that needs were identified, and met, at a very early stage. The two care plans seen very clearly identified physical, psychological, and social needs. In one case the service user did not speak English. The initial assessment included reference to this, and the limitations that this placed on the service, Stacey Street Nursing Home DS0000010327.V288049.R01.S.doc Version 5.2 Page 11 and how staff needed to work to overcome this. An aid to communication was in the file, and attempts were being made to identify a volunteer who spoke the same language. This was discussed with the manager, as arguably the service user should not have been admitted until such arrangements were in place. The alternative would have been for the service user to remain in a placement where her needs would be less well met. Despite the language difficulty staff were meeting her needs, with the help of the family. The standard of basic nursing care was high. Where physical health needs, such as diabetes, mobility problems, and concern regarding nutrition, were identified, risk assessment and care plans were in place. Where changes in physical condition had been identified there had been prompt referral to the GP. Their advice had then been followed quickly and correctly. For example, for one service user, where staff had been concerned about deterioration in physical condition, blood tests had been arranged. As there was a risk of dehydration a fluid balance chart had been started. Where another service user was diabetic regular blood tests were recorded. In the handover staff were observed to be aware of the nutritional needs of each service user. They demonstrated competence in continuous assessment. For example, where service users had eaten little at breakfast being able to balance that with them having eaten well at lunchtime, or that the afternoon staff needed to encourage them at teatime. They also demonstrated adaptability of routines in order to meet health and personal care needs. This showed a commitment to providing an individualised service. There was an equally good level of psychological care. In the handover meeting staff demonstrated knowledge of psychiatric diagnosis. They were able to discuss how such conditions affected individual service users, and how best to work with them to reduce distress. This included service users with quite severe behavioural problems that other homes had been unable to manage. This understanding was reflected in the written records. Personal care giving was again to a high standard. Preferences, such as bath or shower, and time of day to have it, were included in the care plans. In the handover meeting staff described the care they had given. Both sources of evidence demonstrated a commitment to service users maintaining as much independence as possible. All relatives reported that staff always treated service users with respect and dignity. Warn, yet professional, relationships were observed during the first visit. Medication was stored in individual, locked, cabinets in each of the bedrooms, along with the medication administration charts (MAR). One cupboard was checked and the number of tablets did not correspond with the information on Stacey Street Nursing Home DS0000010327.V288049.R01.S.doc Version 5.2 Page 12 the chart. This was because unused stock was not being recorded when it was brought forward. This is Requirement 1. Medication risk assessments started from a position of the service user being able to self medicate. This was good practice in promoting independence. Stacey Street Nursing Home DS0000010327.V288049.R01.S.doc Version 5.2 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Service users enjoy a range of activities both within and outside of the home. EVIDENCE: From the service user and relative surveys, and discussion with five relatives during the site visit, the vast majority felt that the home provided suitable activities. Relatives spoke about the recent Halloween party and the forthcoming Christmas parties, and how they always felt welcome at all events. There had also been a trip to London Zoo in September, and trip to the Oxford Street lights was planned. The information provided by the manager prior to the inspection detailed speech and art therapies, social evenings and BBQs, Christmas pantomimes and parties, mobile library, resident/relative meetings, birthday parties, video, TV and crafts, manicure and massage, reminiscence and reality orientation, gym at the local leisure Centre, church services, and walks. Information in care plans, daily records, and from relatives verified this, and the mobile library arrived during the second visit. In the handover meeting staff spoke about the social and activity needs of service users, for example who liked to go out for walks, and were supported to do so. They were trying to get a day centre placement for one service user, Stacey Street Nursing Home DS0000010327.V288049.R01.S.doc Version 5.2 Page 14 and persevering when a first visit had not gone well. Staff were able to describe how each service user responded to different activities. For example, how different one person had been on the trip to London Zoo, and how they planned to build on this. The manager reported that they were currently looking at ways to increase activities external to the home. We look forward to seeing the results of this on our next inspection. A sample three week’s menu was sent to us prior to the site visit. The menu format promoted healthy eating. There was an emphasis on avoidance of health conditions common in older people, such as constipation. To counteract this there were creamed porridge oats with honey or prunes every morning for breakfast. Lunch and supper were very varied, and included identification of which dishes were a healthy eating option, and which could be pureed. The menu also included which choice was higher energy for people with poor or small appetites. There were always vegetarian options, and where sandwiches were on the menu it stated what the fillings were. Fresh fruit, yogurt, and fresh vegetables were the norm. In the service user survey 23 out of 26 replied that they liked the food. Relatives spoken to during the visit said that it was ‘OK’, ‘good’ and ‘like a hotel’. Preferences and allergies were included in the care plans, and the information passed to the catering staff. Breakfast and lunch were observed being served during the site visit. The surroundings were pleasant, and the service unhurried. Where assistance was needed it was given in an unobtrusive manner. Where service users chose to eat in their rooms this was facilitated. Stacey Street Nursing Home DS0000010327.V288049.R01.S.doc Version 5.2 Page 15 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 inspected at least once during a 12 month period. 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. Service users, and their relatives are listened to, and their views acted upon. Service users are protected from abuse, self-harm and neglect, but the policy and procedure needs to be amended. EVIDENCE: Twenty one of the returned surveys stated that service users, or their relatives, knew who to speak to if they were unhappy with their care. Where they had complained all were satisfied with the response. The complaint records were looked at, and demonstrated good follow through by the manager. The log showed how each complaint had been dealt with, and whether it had been resolved to the satisfaction of the complainant. There had been some recent changes in terminology on a national level in relation to adult protection. The new term was ‘Safeguarding Adults’, so we have used this in this report. The home’s policy and procedure needed to be revised, as it did not advise managers of correct procedure. Local authorities have lead responsibility for safeguarding adults and no action should be taken until agreed by the appropriate staff within that organisation. The home’s policy and procedure implied that an in-house investigation could be started prior to this happening. This is Requirement 2. In practice the home did follow correct procedure, and had many practices in place to safeguard service users. This included risk assessment for such things as safety outside the home, self-neglect, and self-harm. Observation of activity was recorded, with the regularity being dependent on the assessed Stacey Street Nursing Home DS0000010327.V288049.R01.S.doc Version 5.2 Page 16 risk. For example, where a service user was known to often try and leave the building to return home and it had been risk assessed as dangerous for the person to be outside alone. A further use of this type of information for care plan development was discussed with the manager and floor team leader. This was to monitor well-being and understand service users’ behaviour as a means of communication, and then to use the information in care planning. We are currently developing an inspection tool covering this, which will be used on future visits. The manager confirmed that some staff had already received training in these type of techniques. Stacey Street Nursing Home DS0000010327.V288049.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is excellent. This judgement has been made using available evidence, including a visit to this service. Service users live in a homely and comfortable environment, which meets their needs. Service users benefit from a commendable standard of cleanliness. EVIDENCE: The building was toured with the manager at the start of the inspection. Visits were then made to the three floors over the course of the day. This included seeing some service users in their bedrooms. During the initial tour not all areas had been cleaned that day, but they were still sparkling. Relatives said that all parts of the home were always this clean, and stressed how much they appreciated the hard work of the cleaners. The evidence we saw supported that view. This was a very clean home where cleaning staff obviously worked very hard, and took pride in their work as part of the team. All parts of the home were well decorated and furnished, homely and comfortable. In some cases service users had been in other homes and Stacey Street Nursing Home DS0000010327.V288049.R01.S.doc Version 5.2 Page 18 relatives said that they thought this was much more ‘personal’. The split into three units of 10 was excellent and met service users needs. Although bedrooms were not ensuite and did not meet the Standard room sizes, they were ample for service users’ needs. They were encouraged to personalise them including moving their furniture around if they wished. Each floor had the same layout of 10 single bedrooms, with sinks, small kitchen, dinning room, and main lounge. There were separate lounges for smoking on each floor. There was an assisted bath and shower on each floor, and toilets with raised seats where needed. Since the last inspection all communal areas, halls, and the external of the building had been painted. The plumbing had been upgraded. Air conditioning had been installed and there were plans for this in the kitchen and the office. This all demonstrated a commitment to continuous improvement of an already excellent environment. Stacey Street Nursing Home DS0000010327.V288049.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is excellent. This judgement has been made using available evidence, including a visit to this service. A competent and experienced staff team meets service users’ needs. Service users are in safe hands, and protected by the recruitment procedures. Staff training and development is given a high priority. EVIDENCE: The home had a staff team of 14 first level registered nurses, 20 care staff and 20 ancillary staff. They were deployed as dedicated teams across the three floors, allowing for continuity of care. Each floor had a registered mental nurse and two carers on duty during the daytime shifts. All care staff had achieved NVQ level 2 or above and six held first aid certificates. A philosophy of continuous professional and personal development underpinned the service. All staff were encouraged to attend the training courses that the Trust provided. They also had access to external courses. During the handover on the second floor staff discussed the backgrounds of the service users and how they had been during the shift. They demonstrated a sound knowledge of the physical, psychological, and social needs of each person. They conducted the discussion in a professional manner, which reflected the principles of respect, dignity, and choice. They were also aware of their responsibilities to safeguard service users from abuse, neglect and self-harm. Stacey Street Nursing Home DS0000010327.V288049.R01.S.doc Version 5.2 Page 20 During the site visit staff were observed carrying out their duties. They did so in an unhurried, and professional manner, whilst also displaying warmth and affection for the service users. During the handover meeting we commented on the very high standard of cleanliness, and how hard cleaning staff must have worked to achieve this. Staff present in that meeting stressed how important all staff were to each floor’s team. This demonstrated a commitment to team working for the benefit of the service users. Supervision and annual appraisal files were seen on the first visit. There was a standard format, which was skills and knowledge related. Three recruitment files were also looked at on this visit. All required checks had been carried out. A very positive point was that the person specification for carers included ‘willingness to undertake NVQ at level 2 or Certificate in Mental Health’ as essential. This set a clear expectation from the outset. Stacey Street Nursing Home DS0000010327.V288049.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is excellent. This judgement has been made using available evidence, including a visit to this service. Service users and staff benefit from an exceptionally well managed home. The home is run in the best interest of service users and their financial interests are safeguarded. The health, safety, and welfare of service users and staff are promoted. EVIDENCE: The manager demonstrated a high level of knowledge of the needs of the service users. She correctly identified the key strengths of the service, including the ability of the staff team to manage challenging behaviour. She, and the staff team, used their extensive psychiatric knowledge and experience within a social care context. She was very highly qualified, demonstrating a commitment to lifelong learning, which provided an excellent role model for other staff. She was extremely well organised, with good systems which were followed through on each of the three floors. Relatives and staff described her as approachable and responsive. Stacey Street Nursing Home DS0000010327.V288049.R01.S.doc Version 5.2 Page 22 Staff felt able to raise both work related and personal issues with the manager and team leaders. They felt that where criticism was necessary, it was given in a constructive manner, leading to skill development. They felt supported and enjoyed working in the home. The home is a good ambassador for social care, and partnership working. For example a student nurse had heard very positive feedback about the home at university, so asked for his placement. In another case a carer, who had worked at the home for approximately 2 years said that she did not initially see herself having a career in care work, but working at the home had made it seem a positive option. The combination of sound systems, positive environment, team working, and effective management resulted in a home run in the best interest of service users. An annual quality service review was carried out, with the resident survey having last been done at the end of September 2006. The results were being collated at the time of the site visit. The Trust carried out an annual staff survey, and the results of both were used to inform service development. On the second visit the service users’ personal money was checked with the administrator. Two lots of money was counted with a small discrepancy in one. This had already been picked up and was being dealt with by the administrator, demonstrating an approach that safeguards service users. Where staff shopped on behalf of service users, goods were checked in against receipts. The administrator’s line manager carried out periodic audit. Also on the second visit the health and safety records were looked at. There were two, very comprehensive, risk assessment systems in place. A contractor on behalf of the Trust carried out one, as they employed the staff working in the home. The other was carried out by the housing association, as they leased the building. The two systems were, as far as possible, carried out in tandem. The last risk assessment was dated 25/7/06 and was carried out by the manager and the contracted firm. The report clearly identified issues for action to a far greater level than we would be able to during a site visit. Required actions were clearly being followed up. The judgement of a commendable score was therefore based on the risk assessment system and practice, rather than our carrying out a sample audit. Stacey Street Nursing Home DS0000010327.V288049.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 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 4 STAFFING Standard No Score 27 4 28 4 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 4 X X 4 Stacey Street Nursing Home DS0000010327.V288049.R01.S.doc Version 5.2 Page 24 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 OP9 Regulation 13 (2) Requirement Where surplus medication is brought forward and used in the following cycle the amount must be recorded on the MAR chart. The safeguarding adults policy and procedure must be reviewed and amended. The procedure must reflect the local authority as the lead agency. It must also clearly state that in-house investigations can only be started once the local authority has agreed to this course of action. Timescale for action 31/12/06 2 OP18 13 (6) 28/02/07 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 Stacey Street Nursing Home DS0000010327.V288049.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Camden Local Office Centro 4 20-23 Mandela Street London NW1 0DU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Stacey Street Nursing Home DS0000010327.V288049.R01.S.doc Version 5.2 Page 26 - 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. 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