Inspection on 16/03/09 for Stadium Court Nursing Home

This inspection was carried out on 16th March 2009.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Stadium Court Nursing Home 22/02/10

Stadium Court Nursing Home 14/01/10

Stadium Court Nursing Home 16/04/08

Stadium Court Nursing Home 18/07/06

Stadium Court Nursing Home 06/02/06

Stadium Court Nursing Home 20/09/05

Stadium Court Nursing Home 01/12/04

Stadium Court Nursing Home 28/06/04

Stadium Court Nursing Home 17/12/03

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Extracts from inspection reports are licensed from CQC, this page was updated on 10/07/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Stadium Court Nursing Home Stadium Court Nursing Home Greyhound Way Cobridge, Hanley Staffordshire ST6 3LL     The quality rating for this care home is:   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. Lead inspector: Yvonne Allen     Date: 1 6 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 35 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) 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. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 35 Information about the care home Name of care home: Address: Stadium Court Nursing Home Stadium Court Nursing Home Greyhound Way Cobridge, Hanley Staffordshire ST6 3LL 01782207979 01782266027 bradbury@bupa.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : BUPA Care Homes (CFHCare) Ltd care home 168 Number of places (if applicable): Under 65 Over 65 0 71 dementia old age, not falling within any other category Additional conditions: 97 0 The maximum number of service users to be accommodated is 168. The registered person may provide the following categories of service only: Care Home with Nursing - Code N To service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category - OP 71 Dementia - DE 97 Date of last inspection Brief description of the care home Stadium Court Care Home is owned by BUPA Care Homes. The Registered Manager is Sandy Bradbury and she is supported by a Deputy Manager and unit managers. The home offers twenty-four hour nursing care. Wedgwood unit has a number of beds contracted for Assessment and Rehabilitation Care Homes for Older People Page 4 of 35 Brief description of the care home needs, taking individuals directly from the hospital and assessing their needs for future placements. There are two units offering care to older people including nursing care and physical needs. These units have aids and adaptations to help individuals with physical limitations. All areas of the home and gardens are accessible to individuals who use wheelchairs. The other three units are adapted to meet the needs of older persons with varying degrees of mental health needs including dementia care. A senior sister/manager is responsible for managing each unit. Stadium Court is situated close to Hanley town centre, and it is on the main road, close to public transport. The home has ample parking facilities. All bedrooms are single occupancy and have en-suite facilities. Each one of the units has two lounge areas along with a dining area and a separate conservatory. Each of the units also has its own secure garden, which is accessible to individuals using wheelchairs. The amount of fees charged by the home ranges from 413.00 to 745.00 pounds per person per week. The fee includes the free nursing care allowance. The home accepts individuals who are funded by Social Services and other purchasers of care as well as those who are self-funding. Care Homes for Older People Page 5 of 35 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The overall quality rating for this service is 2 STARS. This means that the people using this service experience GOOD quality outcomes. We, the commission, carried out this unannounced Key Inspection visit on 16th March 2009. This inspection took place over two days and was undertaken by four inspectors. The inspection process was commenced several weeks prior to the visit and included surveys completed by people who live in the home, relatives and staff. All of the Key minimum standards were assessed and for each outcome a judgment has been made, based on the evidence gathered. These judgments tell us what it is like for the people who live in the home. Care Homes for Older People Page 6 of 35 Prior to the inspection visit the Providers had completed a self-assessment tool, which is known as the Annual Quality Assurance Assessment (AQAA). Completion of the AQAA is a legal requirement and it enables the service to under-take a self assessment, which focuses on how well outcomes are met for people using the service. It was completed to a very good standard and gave detailed information about the services offered. Information from the AQAA was used to plan the inspection visit and references to it have been included in this report. The ways in which we gathered evidence to make our judgments were as follows - We looked at any information we had received about the service since the last Key Inspection. We spoke with people who live in the home. We spoke with the staff who work at the home. Discussions were held with the Deputy Manager and the Manager from another home as the Registered Manager was on annual leave at the time of the inspection visit. We examined relevant records and documentation in the home. We walked around the home and visited all the units. We observed staff interaction with people they care for. At the end of the inspection visit we discussed our findings with the Deputy Manager and the Registered Manager from the other BUPA home. What the care home does well: The service provides a good standard of personal and nursing care to older people. This includes people with physical needs and also people with mental health related needs such as dementia. Care of people with Dementia is good. People are treated as individuals, their rights are promoted and they are safeguarded from harm or abuse. Care is planned and delivered in a person centered way. Staff are carefully selected to work in the home and are specifically trained to meet the needs of people who live there. There is a good staff team and staff feel valued and supported at the home. Peoples social and therapeutic needs are assessed and staff who are dedicated to activities help people to meet these needs. The service has access to, and works closely with other Social and Health Care professionals and their advice is sought when required. The home environment is very good. The home is modern, purpose built, spacious and well presented. These are some of the comments we have received from people who live at the home and staff who work there. The food is delicious, The variety is good and we can have snacks if we want them. Staff always tell us what is happening and keep in touch. Care is excellent. Mum is always clean and well presented and everything is done at her own pace. We have reports on all people from the nurse in charge at the start of each shift as we have many people on my unit with individual needs. References were obtained from my previous employer. I had all relevant information given to me on my induction. We are always having updates on our training and we always try and cater for everybodys needs. I am always willing to enhance my knowledge to better the care of peoples needs. Our manager meets with us to discuss how we are working and to give us support. This is ongoing through staff meetings. If any staff ring in sick for their shift, the staff co-ordinator contacts other staff - bank staff or agency or co workers on nights off. Yes I feel that the training I receive gives me the experience and knowledge that I Care Homes for Older People Page 8 of 35 need to fulfill my job. The care plans are up to date and very informative. I have just completed a course on Dementia Care. This was a fantastic course. There is a regular monthly staff supervision carried out by unit managers and some supervision carried out as necessary. We have staff meetings, personal advice and support, supervision sessions with the nurse in charge. I feel that communications are excellent at Stadium Court. Staff co-ordination will cover all sickness and absence. I have been in care work for 26 years and have never worked anywhere where there is so much training and support. The staff in here are second to none. Nothing is too much trouble for them. I can go home knowing that my husband is in safe hands and is well looked after. Wonderful - they are all angels! They are brilliant staff and very respectful. What has improved since the last inspection? What they could do better: 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 4. Care Homes for Older People Page 9 of 35 The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 10 of 35 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 11 of 35 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People coming to live at this home can be assured that their assessed needs will be met. It cannot always be guaranteed, however, that staff at the home will have all the information at hand to be able to meet the individual intermediate care needs of people. Evidence: In the AQAA the Providers tell us that - Comprehensive information is provided to people about the home. People who are unsure whether to come into the home are offered a trial run to see whether they like the home and whether it is suitable for them. The Providers say that provision of information is regularly audited and checked. Nobody is admitted to the home until they have undergone a pre-admission assessment carried out by an experienced registered nurse. This is to ensure that the Care Homes for Older People Page 12 of 35 Evidence: home can meet identified needs and that the placement is suitable. The service carries out an assessment of peoples needs before they offer them a place. These assessments were seen to be comprehensive and are undertaken by a person from the home who is suitably trained to do so. Assessments are usually carried out in conjunction with other professionals from health care or Social Services. The home also offers intermediate care and people are assessed by professionals from the hospital as well as from the home. A full assessment of their needs is contained in their care plan. People living in the home told us that they were given sufficient information about the home before they moved in. They said The home did give us information about what to expect but to be honest i think they have sold themselves short because it is lovely here. I can sleep at night knowing my mother is safe. I came and visited with my daughter. I came for an informal visit, received brochures and was shown around the home. Hospital gave us information and the nurse gave it on the pre-admission assessment. Nice brochure is provided. The home admit people for intermediate care direct from hospital. We looked at this admission process in one of the units and in one persons admission notes it was documented, Admitted but no information sent from the hospital. The hospital was contacted but only a list of medication was given. A further entry dated 14th March 2009 stated, Still waiting for discharge information. The information was faxed to the site office but home staff cannot access it. The hospital eventually sent the information by taxi at 00:15hrs. The concerns we have about this are that the home should not be accepting people unless they have all the information they need in order to meet that persons needs. The home needs to ensure access to the site office for out of hours admissions. The home and the Primary Care Trust should work together in preventing out of hours admissions to the home. Care Homes for Older People Page 13 of 35 Care Homes for Older People Page 14 of 35 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individual care is planned and delivered with dignity and respect. People have their care planned and delivered in a person centred way and specific health care needs of people are assessed, monitored and met. There is a need to tighten up the medication administration process in order to ensure that people have their medication on time. Evidence: In their AQAA the Providers tell us that All people have personal comprehensive plans produced with the help pf the QUEST assessment tool. They say that Plans are reviewed and updated monthly or more often. They also tell us that Regional and National specialists are available for consultation and staff can refer to the Royal Marsden Manual. The Providers say that they Record and report on the treatment of pressure ulcers as well as assess and document action taken to reduce the risks of developing these. Also All nutritional needs are assessed using a recognised Care Homes for Older People Page 15 of 35 Evidence: nutritional assessment tool. They say that People are registered with their choice of GPs andCare is person centered. Monthly audits are conducted by the Regional Manager assessing many aspects of care to allow continual quality assessment and improvement. Also regular audits are done at home level. They tell us that The Key Operating Guides have been developed to ensure best practice in selected aspects of care. Also that Staff have access to relevant up to date clinical guidance including the Liverpool Care Pathway to meet the needs of people at the end stages of life. This is well developed within the home preventing the need to transfer people to hospital or hospice. We visited each one of the units throughout the home. This is what people told us about their care or the care of their relative Its my home and I have a lovely family who are always made welcome. The staff are very good and kind. I can have a choice. I am very happy here, the girls are very good. Everyone who lives in the home has a plan of care in place which is developed from a comprehensive assessment of their needs. This plan of care takes into account both personal and nursing needs. Risk assessments are in place across all the activities of daily living and include specific needs of people. These assessments identify specific physical and mental health needs and care plans are developed to ensure that these needs are met. People and their representatives are involved in developing and reviewing their plan of care with their named nurse or key worker. People and their representatives tell us that they feel that their needs are being met well at the home and that they are kept informed of any changes to the care plan. Relatives also tell us that they are contacted should there be any sudden changes to their loved ones.,Staff always tell us what is happening and keep in touch. Care is excellent. Mum is always clean and well presented and everything is done at her own pace. Advice and treatment are sought from health care professionals as and when required. This includes seeking expertise for physical as well as mental health care needs. We saw evidence of this contained in care plans. This ensures that people receive the best up to date treatment for their problems. The staff also receive on going training and support from health care professionals and this helps to ensure that staff have the knowledge and skills to be able to meet the Care Homes for Older People Page 16 of 35 Evidence: needs of people who live in the home. People we spoke to told us that staff look after them well. They said, Carers are good and treat people with respect. We observed people being treated with dignity and respect and there is a good rapport between staff and people who live in the home. The care of people with dementia care needs is good and staff looking after people are trained to understand these needs. Specific mental health needs are identified and plans are put into place in order to help meet these needs. Expertise professional help and advice is obtained in order to help people get the best possible care. Care is person centered and delivered with dignity and respect. There is some confusion around the care of people with intermediate care needs on units and staff are not always clear about the specific needs of people coming in from hospital. This was evident when a person was admitted without staff being informed or aware of a persons special dietary requirements. Also another person receiving intermediate care told us, I feel somewhat isolated and do not fit in with the other people on the unit so I stay in my room. We looked at the process for receipt, storage, administration and disposal of medication in the home. People are able to self medicate if they wish to following a satisfactory risk assessment. Medication is administered safely and as prescribed. However, we noted that daily notes for a person showed that on at least three occasions Temazepam was not administered until very late. Entry in notes dated 19/02/09 stated, Temazepam not given because there was not a second nurse on duty to check its administration. The drug was eventually dispensed at 23:30hrs but the person who lives in the home said that, it was too late. The person wanted to complain but was calmed down so she took her tablet. Another entry dated 05/03/09 stated complained that she didnt get the Temazepam until 23:15 because staff were busy. There were no other concerns about this persons care. We did speak to the person and her family said that things were fine and that they had no concerns. The same person was unhappy because her medication had run out. This was discussed with the unit manager who said that for some reason some of the medications for people were running out of sequence. The doctor responsible for the people with intermediate care needs was on site and did write the prescription so that the medication would be available for tea time. This is concerning as our previous inspection report highlighted a need for improvement in the time that people receive their medication. However we looked at a number of other medication records and there were no other concerns highlighted. It is recommended that people receive their medication on time in order to meet the health care needs of people who live in the home. Care Homes for Older People Page 17 of 35 Care Homes for Older People Page 18 of 35 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to meet their social and therapeutic needs and life in the home is made flexible and varied. People rights are protected and autonomy is promoted. Evidence: In their AQAA the Providers tell us that they Ensure that all personal plans are individual and based on peoples choices and preferences. If people choose to do so they can handle their own finances. They tell us that they Encourage the personalization of personal space so that people really feel at home and that they Have developed menus to allow for peoples choices. They say that There is an open visiting policy at the home. The Menu Master and Nite Bite menus are in place to ensure that meals and mealtimes are flexible, nutritious and allow for personal preferences. They also tell us that they Provide picture menus to help with choice, and encourage the involvement of people in the development of menus. They also say that they Have a structured activities programme which includes weekend activity. We walked around the home and spoke with people who live there and their Care Homes for Older People Page 19 of 35 Evidence: representatives who were visiting at the time. These are some of the comments we received about what life is like in this home The food is delicious, The variety is good and we can have snacks if we want them. One person not so happy with the food said The soft diet and pureed food is awful, I have to try and pretend its something else. We did observe the staff serving soft and pureed diet and this appeared to be well presented on all the units, with each food variety being served as separate portions. We also observed the main meals at lunchtime and these appeared nutritions and well presented and some people were having alternative choices to the main menu. On Wedgwood unit, however, only one choice was being offered. When we spoke to the Cook he outlined the various choices available. There is an extensive menu available containing many choices to the alternative menu. On Ainsley unit we were not convinced that people were offered alternatives to the main menu. Neither was the dining experience considered an, occasion with few people sat around the table and table cloths removed whilst lunch was being eaten. People told us that, Meals are generally good. and, Food is always warm. Discussions with the Cook and documentation in care plans identifies that nutritional needs are assessed and met, with special dietary requirements being catered for. We looked at the how the service meets the social and therapeutic needs of people living in the home. Overall we found this to be good and needs are well met. People are encouraged to be socially active as much as possible and there is an organized programme of activities and entertainment for each unit in the home. This includes organized trips out. The home does not have its own minibus but arranges a minibus or wheelchair taxi to enable people to make visits outside the home. There are dedicated staff responsible for delivering this programme and discussions with them identified that they are enthusiastic and committed to improving the quality of life for people living in the home. People who do not wish to join in activities or prefer their own private company are offered one to one therapy sessions or are supported to maintain their privacy. Some of the records and documentation of activities is a bit scanty and does not always portray what people have done. These could be improved upon so that the service can evidence that needs are being met. We saw that people have their Rights promoted and protected in the home. We saw the use of advocates for people who have no other representatives. This includes the use of an Independent Mental Capacity Advocate (IMCA). We also noted that when people are placed in a position for their own safety, which could be viewed as restraint, such as the use of a reclining (Kirton) chair, then there Care Homes for Older People Page 20 of 35 Evidence: are definite reasons for its use and this is a multidisciplinary team decision and signed by a representative where the individual person lacks capacity. Care Homes for Older People Page 21 of 35 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The systems in place at this home help to keep people safe from harm. People can raise concerns knowing that they will be listened to and taken seriously. Evidence: in their AQAA the Providers gave us the following information The Company are currently reviewing its complaints policy. The current policy has agreed timescales for managing complaints. The procedure is prominently displayed in the home. The policy includes a three tier framework including the home, the regional management team and the national Quality and Compliance department. BUPA care homes have robust allegation of abuse and neglect policies allowing staff to raise concerns within the home or to senior staff outside the home. The POVA procedures are well documented. The Whistle blowing Policy - BUPA has a national team of Quality and Compliance experts available to provide advice and help. Staff training is available regarding all aspects of safeguarding. We spoke to people who live in the home and their representatives about if they feel able to raise concerns. They told us - I cant recall being given the complaints procedure but I would go straight to the sister in charge. I am happy to speak to the manager if there are any issues and know that it will be Care Homes for Older People Page 22 of 35 Evidence: sorted out. The service has a Complaints procedure and copies of this are displayed on the various units throughout. This procedure highlights how the service addresses concerns and complaints raised and there is a timescale to which the service must keep with regards to their written response. If the complainant is not satisfied with the response then they can take this a stage further to the Regional Manager as per BUPA policy. There is also a stage after this where an independent review is held. The Complaints procedure also contains the local Care Quality Commission details. We, the commission, have not received any complaints or safeguarding referrals about this home since we carried out the last Key Inspection. This has been a significant improvement and demonstrates how the service has improved in its management of complaints. There is a Safeguarding Policy in place at the home and staff receive instructions and training in this area. Also staff are carefully selected to work for the service and undergo Criminal Records Bureau (CRB) checks and checks to ensure that their name is not included on the Protection Of Vulnerable Adults (POVA) list. This helps to ensure that the people living in the home are kept safe from harm or abuse. Care Homes for Older People Page 23 of 35 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a pleasant environment which is purpose built and adapted to meet the needs of the people living there. Evidence: In their AQAA the Providers tell us that they Use a specialist cleaning system keeping the home clean. Also There are comprehensive policies and procedures including infection control and Services and facilities comply with the Water Regulations. They say that they Have a central team of experts who support the maintenance of the home and There is a specialist property and estates and hotel services department. Also This area is regularly audited during Reg 26 visits by the Regional Manager. We walked around the units and talked to people about their environment. The home is purpose built, modern and each room offers single en suite accommodation. There are many aids and adaptations throughout the home to help people with mobility problems to maintain their Independence. In Wedgwood unit we noted that one of the suction machines was not in good working order and it is required that this is made good in order for the machine to be effective. There are specially adapted toilets and bathing facilities and equipment available to help staff to move and handle people safely. Staff have received training in the use of the specialist equipment. Care Homes for Older People Page 24 of 35 Evidence: There are enclosed patio and garden areas on each unit offering pleasant outdoor space for people to sit out and enjoy the warmer days. At the time of the visit people were observed sitting out and enjoying the sunshine. Corridors are wide and spacious and allow for people to move up and own freely. This includes people who use wheelchairs, to whom all the areas of the home are accessible. The home is clean and well presented throughout with attractive fixtures and fittings. Bedrooms are personalized and adapted to meet the individual needs of the person living there. People have brought in personal effects from home and made their bedroom their own personal space. People who live in the home have an active role in the development of their environment and are able to choose colors and materials for their bedrooms. Also we saw evidence of people helping to cultivate plants and vegetables in the gardens with the help of the staff. There is an ongoing rolling programme of redecoration and refurbishment in place at the home. Care Homes for Older People Page 25 of 35 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be assured that the staff provided in this home are competent, trained and possess the necessary skills to meet their assessed needs. Evidence: In their AQAA the Providers tell us that they have Comprehensive human resource policies and procedures to aid staff management and recruitment and Endeavor to agreed staffing levels at all times. They also Perform appropriate checks on staff prior to employment and the training matrix is specific to the home and identifies the training requirements of staff. They also tell us that there is a Good level of staff retention and improved skill mix of staff and that Staff training is up to date. They have also received Investors In People accreditation - which has been reviewed since 2003. We looked at the provision and skills of staff throughout the home. The staff provided on each unit have a good knowledge base and are able to recognize and meet the individual needs of the people who live in the home. The Providers build on this knowledge base and ensure that staff are trained and equipped with the required skills to offer good care to the people who live in the home. Staff also receive regular supervision sessions in order to ensure that they continue to Care Homes for Older People Page 26 of 35 Evidence: develop and utilize their skills. This means that the people who live in the home can be assured that staff will be able to recognize and meet their needs. Staff are trained to meet the needs of people with dementia and other mental health related illnesses. These are some of the comments we received from staff about the home. We have reports on all people from the nurse in charge at the start of each shift as we have many people on my unit with individual needs. References were obtained from my previous employer. I had all relevant information given to me on my induction. We are always having updates on our training and we always try and cater for everybodys needs. I am always willing to enhance my knowledge to better the care of peoples needs. Our manager meets with us to discuss how we are working and to give us support. This is ongoing through staff meetings. If any staff ring in sick for their shift, the staff co-ordinator contacts other staff - bank staff or agency or co workers on nights off. Yes I feel that the training I receive gives me the experience and knowledge that I need to fulfill my job. The care plans are up to date and very informative. I have just completed a course on Dementia Care. This was a fantastic course. There is up to date information through the Companys distance learning and training on different issues from the North Staffs University teaching hospital. I did a six months adaptation in this home so I had enough time to know what I needed to do. There is a regular monthly staff supervision carried out by unit managers and some supervision carried out as necessary. Care Homes for Older People Page 27 of 35 Evidence: My induction covered fire training, manual handling training, use of bed rails, infection control training, hand washing, whistle blowing and abuse and Health and Safety. We have staff meetings, personal advice and support, supervision sessions with the nurse in charge. I feel that communications are excellent at Stadium Court. Staff co-ordination will cover all sickness and absence. I have been in care work for 26 years and have never worked anywhere where there is so much training and support. We looked at records and documentation relating to recruitment and training of staff and these confirmed what staff had told us. People who live in the home also told us - The staff in here are second to none. Nothing is too much trouble for them. I can go home knowing that my husband is in safe hands and is well looked after. Wonderful - they are all angels! They are brilliant staff and very respectful. Staff are carefully selected to work at the home and the recruitment procedure is robust. Care Homes for Older People Page 28 of 35 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is very well run and is managed in the best interests of the people who live there. Evidence: In their AQAA the Providers tell us that There are regular Health and Safety meetings where staff are given the opportunity to comment. They also tell us that There are regional and national experts available within the company for advice and guidance. They say that The home is supported by a national team of Quality and Compliance officers who offer support and guidance in this area and there are dedicated Health and Safety staff within the regions, this includes Health and Safety and fire management leadership. They tell us that the Company has a comprehensive collection of policies and procedures which are regularly reviewed and updated and there is an annual internal and external customer satisfaction survey- the BUPA SOP (Surveying Our People) is conducted annually. They tell us The Personal Best programme encourages a person centered approach to all tasks. Also Monthly staff Care Homes for Older People Page 29 of 35 Evidence: meetings are held. At the time of our inspection visit the Registered Manager Sandra Bradbury was on annual leave. A newly appointed Deputy Manager was in charge of the home. She was supported by a Registered Manager from another home within the Company. Also each unit has its own manager and senior nurses. She told us that she is enjoying her induction and feels well supported. Both the Deputy and the manager from the other home were helpful in assisting us with the inspection visit. Positive comments were received on staff surveys about the management of the home. They told us There is a supportive manager who is always there to help staff. Also there is a good deputy home manager who arranges all the training. The support is right across the site. Each unit manager is helpful and supportive. Staff also told us of regular staff meetings held at the home. Management of complaints has certainly improved since last Key Inspection. We found each unit effectively managed by a unit manager. This helps to ensure that each individual unit is managed in the best interests of the people who live there including meeting their differing needs. A unit manager confirmed that monthly managers meetings are held, chaired by the Registered Manager Sandra Bradbury. Also each monthly period is analyzed. He confirmed that regular audits are carried out on all areas and that an EWAT (Early Warning Audit Tool) is carried out by a person from another home in the Company or another region. We saw that, Quality and Compliance auditing tools are used. These audits cover finance, Health and Safety, reportable incidents, complaints, recruitment, staff training, medication, personal plans, wound management, infection control and safeguarding. We saw a recent Medication audit assessed as good, scoring 93 per cent. We also saw that action plans are in place to address areas needing improvement. We saw an internal Health and Safety audit which had been completed. Health and Safety quarterly meetings are held and every unit has a Health and Safety representative. BUPA comment cards are sent out to people who live in the home and their representatives on a regular basis. We looked at the maintenance of personal allowances. People are encouraged to Care Homes for Older People Page 30 of 35 Evidence: manage their own finances wherever possible and for as long as possible. When people are no longer able to do this then the administration staff can provide a secure facility for people to keep a small amount of monies. This money is then available to them as and when they wish. We looked at the way this is recorded and maintained and found this to be translucent and easily audited (which happens regularly). Receipts and invoices are kept for each person. People are employed to help ensure that the home is safe for people to live in and staff to work in. We saw the Health and Safety Policy Statement in place and all areas are regularly audited as highlighted above. Risk assessments are developed for each person who lives in the home. These are specific to their individual needs and are included in their plan of care. Also generic risk assessments are in place which include all work related risk assessments for staff. Specific risk assessments are in place in relation to fire safety and the home is inspected by the local fire safety officer. The kitchen is regularly inspected by the local Environmental Health Officer. Quality Assurance systems in place - usual BUPA audits carried out monthly and some weekly. These look at all services and areas and I saw where action plans are put into place to make improvements if needed. Care Homes for Older People Page 31 of 35 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 32 of 35 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 22 23 23(c). The registered person 10/06/2009 shall having regard to the number and needs of the people who live in the home ensure that - equipment provided at the care home is maintained in good working order. The suction machine provided on Wedgwood Unit must be made good in order to ensure that the machine is effective. 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 3 When admitting people for intermediate care, staff should have all the required information about the person before adnission to the home in order to be able to meet their needs safely. It is recommended that people with Rehabilitation or Intermediate Care needs are accommodated together so as to avoid feeling isolated. Page 33 of 35 2 8 Care Homes for Older People 3 9 It is recommended that people receive their medication on time in order to meet the health care needs of people who live in the home. Records of individual social activities should be improved upon so that the service is able to better evidence how peoples social needs are being met. It is recommended that everyone who lives in the home is offered the alternative choices to the main menu at mealtimes. This is so people are made aware of what is on offer at mealtimes, can make an informed decision on what they would like to eat, and that preferences are catered for. 4 12 5 15 Care Homes for Older People Page 34 of 35 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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. 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