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Inspection on 18/07/06 for Stadium Court Nursing Home

Also see our care home review for Stadium Court Nursing Home for more information

This inspection was carried out on 18th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The admission procedure is closely followed to ensure that the individuals` needs are identified and can be met at the home. The involvement of the families in this process is encouraged and was evidenced at the inspection. Health care needs are well addressed with the involvement of Clinical Nurse Specialists and other multi-disciplinary agents. Daily activities and social activities are monitored for each individual and the inspector looking at this outcome was extremely impressed with the activity organisers` enthusiasm and commitment. The Manager had handled the few complaints that had been received, satisfactorily and no complaints had been received by the CSCI. One vulnerable adults case had been reported and handled very professionally.

What has improved since the last inspection?

Social activities had improved since the last inspection and social records were also improved. All but one requirement had been completed.

What the care home could do better:

Formal staff supervision needs to be reassessed and further developed.

CARE HOMES FOR OLDER PEOPLE Stadium Court Nursing Home Greyhound Way Cobridge, Hanley Staffordshire ST6 3LL Lead Inspector Mrs Joanna Wooller Key Unannounced Inspection 18 July 2006 09:15 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 Stadium Court Nursing Home DS0000026967.V303591.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. Stadium Court Nursing Home DS0000026967.V303591.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stadium Court Nursing Home Address Greyhound Way Cobridge, Hanley Staffordshire ST6 3LL 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) 01782 207979 F/P 01782 266027 bradbury@bupa.com www.bupa.com BUPA Care Homes (CFHCare) Limited BUPA Care Homes Limited Miss Sandra Bradbury Care Home 150 Category(ies) of Dementia (60), Dementia - over 65 years of age registration, with number (60), Mental disorder, excluding learning of places disability or dementia (15), Mental Disorder, excluding learning disability or dementia - over 65 years of age (15), Old age, not falling within any other category (90), Physical disability over 65 years of age (90) Stadium Court Nursing Home DS0000026967.V303591.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. DE 60 beds minimum age 60 years MD 15 beds minimum age 60 years One PD resident minimum age 58 years Date of last inspection 6th February 2006 Brief Description of the Service: Stadium Court Care Home is owned by BUPA Care Homes. The Registered Manager is Sandy Bradbury she is supported by her Deputy, Mrs Judith Pearson. The home offers twenty-four hour nursing care. Five purpose built bungalows each have the facilities for thirty service users. There are three general elderly care units, which facilitate ninety service users, and two elderly mentally ill units, which facilitate sixty service users. 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. A Senior Sister in charge manages each unit. All bedrooms are single occupancy and have en-suite wc facilities. Each unit has two lounge areas along with a dining area and a separate conservatory. Service users on each unit also benefit from their own secure garden, which have ample seating areas. Staff training is continual which ensures safe working practises for staff and service users. Strict policies and procedures continue to safeguard service users wellbeing. Essential equipment was evidenced on all units, including hoists, assisted baths, and pressure relieving equipment, grab rails and a nurse call system. Stadium Court Nursing Home DS0000026967.V303591.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Key Inspection took place unannounced and five inspectors were present. The Manager, Sandra Bradbury and the Deputy Manager were in the home and a Senior Sister or Staff Nurse managed each of the five units. The National Minimum Standards were used as a guideline for the inspection with each inspector evidencing sections of the outcome groups. Each Service User is individually assessed prior to admission to ensure that their individual needs are identified and can be met whilst in the home. The requirements identified at the last visit were discussed and all but the staff supervision were completely rectified. All Managers and staff, to ensure robust working practices, closely follow BUPA policies and procedures. Many feedback cards and ‘Have Your Say’ forms were returned to the Inspector prior to the inspection. Most were completely filled in with no comments. Those with comments were positive and complimentary about the service as were the comments. One relative had made comment about their relatives’ care and this was investigated and rectified on the day of the inspection. Some requirements were made on the day, which were fully discussed with the Manager. Relatives and visitors spoken to on the day of the visit were complimentary about the service offered at Stadium Court. What the service does well: What has improved since the last inspection? Stadium Court Nursing Home DS0000026967.V303591.R01.S.doc Version 5.2 Page 6 Social activities had improved since the last inspection and social records were also improved. All but one requirement had been completed. 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. Stadium Court Nursing Home DS0000026967.V303591.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 Stadium Court Nursing Home DS0000026967.V303591.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): 1, 3 and 4 The unit maintained the necessary records relating to care practices and resident safety. Records relating to visitors were being kept, a record was being kept of accidents and records were being maintained over the staff on duty. Individual records were kept over medication, health and nursing interventions. Sampling of care plans did note that one file did not contain a photograph of the resident. Although the Health and safety of the unit was not fully assessed it was noted that the fire door next to the kitchen was not operating correctly. EVIDENCE: Evidence that these standards were being met was obtained at this visit. Through direct observation, discussions with Service Users and visitors and examination of documentation, it was identified that the staff in the home on a continuous basis were meeting the needs of the Service Users. Two residents who had been exhibiting extreme behaviour and appeared to need specific dementia care had undergone reassessment since the last visit and they were being cared for on another unit. Further reassessments had taken place for other Service Users also. Stadium Court Nursing Home DS0000026967.V303591.R01.S.doc Version 5.2 Page 9 Many ‘Have your Say’ forms and Service Users feedback cards were received with all but one having generally commented that the care was good at the home and they were content. One issue raised on the day was investigated by the inspector and was now rectified. Stadium Court Nursing Home DS0000026967.V303591.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 and 11 This quality outcome is good. This judgement has been made using available evidence including a visit to this service. Health care needs are identified and are well met although some discrepancies were noted. Medication issues were inspected. Gold Standard Award Training in Palliative Care is being given to the staff. EVIDENCE: Three of the five Units were inspected during this visit in relation to obtaining evidence for the above Standards. Wedgwood House accommodates up to 30 residents who are elderly frail. In Wedgwood House two residents were spoken to and their care plans examined. One of the residents was nursed in bed in her room. She commented that she preferred to stay in bed as she had everything she needed within reach and that she was comfortable. She stated that if she had to sit out in a chair then this would cause her discomfort and increase the pain in her legs. It was observed that this lady’s room had been adapted to meet her needs and that she had aids to help her reach items and the call bell was within easy reach. The room was very personalised and arranged exactly how Stadium Court Nursing Home DS0000026967.V303591.R01.S.doc Version 5.2 Page 11 she liked it. The lady was knitting and commented that this was her main interest and that the staff had been helpful in ensuring that she had the necessary tools to do this. All the above was outlined in her care plan. It was observed that she had a jug of water and some juice at hand and she commented that the staff ensured that this was replenished regularly. She chatted to the inspector stating that the staff gave her a bed bath daily and that she has a general bath at least weekly. The lady stated that the hairdresser comes into her room in order to do her hair on a regular basis. She confirmed that she is unable to stand properly and that the staff do use a hoist to move her whilst they change her bed. This was also documented in her care plan. She stated that “the staff are always very caring and I have no complaints about anything”. When asked if she thought that her dignity was maintained in the home she replied “yes – definitely”. She commented that she had not seen a GP since she came into the home in 2003. Examination of her care plan confirmed this. Further examination of this lady’s care plan identified that she had risk assessments in place including one for her electric bed. Tissue viability was assessed monthly. Monthly weight was assessed. Record of professional visits included Social Worker for annual review. Visit from Chiropodist and Optician were recorded. Dietary needs had been assessed as requiring a low fat diet due to the presence of gallstones. There was evidence of regular catheter care for her indwelling urinary catheter. It was noted that there was no entry of relatives’ comments in the Relatives Communication sheet since admission in 2003. Another resident was spoken with. He had just finished eating his breakfast and was sitting in the dining area. He was a wheelchair user. When asked about the care he received in the home he stated that he had no complaints and was generally happy. He could not think of any improvements, which would make his life in the home better. A care plan was examined in relation to a resident who was poorly and nursed in bed. Examination of the pre-admission assessment had indicated that this individual could mobilise with a Zimmer frame and two care staff. However, further documentation identified that the resident had been very reluctant to mobilise and refused to get out of bed. This resident’s mobility assessment had listed problems as swollen painful feet, difficult to hold and height a problem. The resident had been seen by the GP for not eating and drinking. Treatment of a pressure sore indicated that there had been some improvement in this. The next of kin had requested to see the GP in relation to the provision for Physiotherapy for her relative. This had been organised for her by the home. Stadium Court Nursing Home DS0000026967.V303591.R01.S.doc Version 5.2 Page 12 The inspector then visited Aynsley House. This unit accommodates up to 30 elderly residents with dementia and other related mental illnesses. In Aynsley House one care plan was examined and the inspector spoke at length with two visitors. Examination of the care plan identified that a thorough assessment of needs had been undertaken including an assessment from the Health Directorate Assessment Unit. A speech therapist assessment had been carried out and an easy chew diet recommended. The resident had been seen by the GP, Social Worker and Diabetes Specialist Nurse recently and advice had been obtained from them on a regular basis. The care plan had been regularly evaluated. A lengthy discussion with the husband and daughter of one resident identified that they were very happy with the services provided to their relative. They stated that the care was “excellent” and that they had been very apprehensive, as the resident had been transferred from another home where they had not been happy with the care. The daughter stated” we need not have worried as the care here is very good and we are kept informed of everything.” The inspector then visited Stafford House. This unit accommodates up to 30 elderly residents with dementia and other related mental health conditions. Two care plans were examined on this unit. One of the plans evidenced that a resident had become very poorly and had reached the final stages of dementia. There was documentation, including photographs of the development and progression of three pressure sores for this resident. In relation to one of these sores (the first one to develop) it was noted that there had been no medical intervention for 5 months (since first noted on 17/02/06). The staff in the home had continued to treat the sore but the sore had deteriorated. The resident’s nutritional intake was poor also and weight loss had been consistent each month. She was finally seen by the district nurse at the request of the GP on 23/06/06 after two more pressure sores had developed. There was no evidence of relatives input into the care plan since 13/03/04. There was no evidence of a review in medication having taken place. A second care plan was examined on this unit. This evidenced that this resident had also acquired a pressure sore. This resident had also suffered consistent weight loss and poor dietary intake. Intake was monitored on a daily intake chart. There were no entries on to the Relatives’ Communication sheet. This resident had been seen regularly by the GP. Inspectors were informed that all qualified staff has undertaken the Gold Standard Award Training in Palliative Care. Two nurses spoken confirmed this. Medication administration was inspected on each unit. The Deputy Manager carried out monthly medication audits. Each drug refrigerator was recording Stadium Court Nursing Home DS0000026967.V303591.R01.S.doc Version 5.2 Page 13 unacceptably high temperatures. The need to replace or repair each of the five fridges was discussed with the Manager. Stadium Court Nursing Home DS0000026967.V303591.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 - 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There was a range of social and recreational activities available within the home to meet the expectations of the service users. Visitors were welcomed and encouraged to be involved in care planning processes. Service users were able to exercise their rights to have control over their lives and make their own choices. The dietary needs of the service users were well catered for and a balanced and varied selection of food was available to meet service users individual tastes and needs. EVIDENCE: The home employed two activities co-ordinators who provided a range of activities for the benefit of the service users. The inspector was impressed by their detailed knowledge of individual service users and a document called a ‘Life Biography’ was in place which identified the history and likes and dislikes of each individual service user. In addition to this, a Resident Activity Report was seen which detailed those activities, which had been accessed by each individual service user to ensure that each person was included in some form of activity. Stadium Court Nursing Home DS0000026967.V303591.R01.S.doc Version 5.2 Page 15 Activities included: entertainers visiting the home including actors from a production company, trips to places of interest (on the day of the inspection some service users were going on a trip to Trentham Gardens), pub nights, fish and chip nights, special events covering the four seasons of the year, competitions, plates for painting, having favours for mothers day and fathers day made by the activity co-ordinators, a strawberry fair, trying different types of smoothies made by the service users with different fruits, reminiscence events, ‘pat to pet’ where greyhounds visited the home fortnightly, nail care, hand massages, facials, aromatherapy, make up sessions, shopping etc. One service user received letters from South Africa and one of the activities co-ordinators, on request from the service user, read the letters to her, took dictation from the service user and compiled a letter in response. Also for service users that were not able to take part in the majority of standard activities, the activities co-ordinators provided a number of tiles with different surface textures and a discussion took place regarding the feel of these. Recently a fete had taken place at the home and two of the service users were ‘King Henry’ and ‘Queen Mary’ for the day – costumes made by the activities co-ordinators. Service users confirmed how much they enjoyed the activities. One stated ‘I loved going to Trentham – we went on a boat – it was lovely’. Photographs of this trip were displayed on one of the units where it was clear that service users were enjoying themselves. The activities co-ordinators also made efforts to visit the service users who were bed bound and sometimes helped to feed those who could not do this for themselves and particularly when the service user did not wish to eat, offering encouragement and support. Religious needs were also accommodated and Holy Communion took place once per month. Local clergy also attended the home on request. Throughout the inspection, relatives were seen to be welcomed into the home and service users confirmed to the inspector that they were able to see their friends and relatives any time they wished. One relative said ‘we have had issues in the past but I have to say that they do sort things out quickly – the staff are generally very good’. She confirmed that her husband made his own choices. Catering standards were very good and all the documentation regarding food probe temperatures and fridge and freezer temperatures were seen to be upto-date and correct. Food storage areas were clean, tidy and well stocked with branded products. Lunch was served during the inspection and appeared to be well presented, nutritious and balanced. Service users who required assistance to eat were treated in a discreet and respectful manner. A choice of menus was available and the chef was very knowledgeable about the needs of the Stadium Court Nursing Home DS0000026967.V303591.R01.S.doc Version 5.2 Page 16 service users and spoke to them on a regular basis to find out their likes and dislikes. A recent Environmental Health inspection had taken place and all recommendations had been addressed. The Chef had set up a Food Focus Group, which included service users, relatives and staff, and minutes were seen of action taken in response to requests. In addition to this comment cards were provided to obtain feedback from service users and staff on the menu’s and quality of food provided. On the back of the form, the Chef signed and dated the card when the comments had been addressed. Menus were examined and included soft diet options. These were seen to be varied and nutritious. Tables in the dining areas were set up with tablecloths and flowers. Service users spoken to said how much they enjoyed the food. Stadium Court Nursing Home DS0000026967.V303591.R01.S.doc Version 5.2 Page 17 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 speaking to the staff team and accessing records. The complaints process is displayed within the units and contained in the documents available to the public, staff and residents. This ensured that any person with a concern could activate the process. Evidence confirmed that residents were protected via the training processes operational across the staff team. EVIDENCE: Each of the units on the complex was visited, some staff were spoken with and the records were checked which were contained in the main administration building. Staff confirmed that they were aware of the complaints process. They told the inspector that they would have no hesitation in speaking to the responsible person if they had concerns. Each of the staff spoken with confirmed that they had received training for the care of vulnerable adults. From the evidence provided it was identified that there had been six internal complaints dealt with by the management. From the records each complaint had been resolved to the satisfaction of each party. Stadium Court Nursing Home DS0000026967.V303591.R01.S.doc Version 5.2 Page 18 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): 19-24, 26 This quality outcome is good. This judgement has been made using available evidence including a visit to this service. Service Users live in a safe and wellmaintained environment with suitable facilities and equipment available to meet their needs. Standards of hygiene in the home were very good. EVIDENCE: Ainsley and Stafford units provide care and accommodation for up to 60 older persons who may have dementia or mental health condition. The General environment of both units was of a good standard with evidence of excellent standards in relation to cleaning and hygiene. Minor maintenance issues such as marked or scuffed paintwork and woodwork in communal areas detracted somewhat from the overall appearance of the units. It was noted that the decoration programme had been delayed due to other projects that had been given priority, this is a shame and it is hoped that the organisation will address these matters in a timely manner. Stadium Court Nursing Home DS0000026967.V303591.R01.S.doc Version 5.2 Page 19 Access to both units was via a coded keypad system, to ensure the security and well being of service users. A small reception/lobby area was provided where staff could meet and greet visitors to the unit. The unit sister’s office was located next to each main entrance. Both units had communal areas that included a large open plan lounge and dining area with a smoking area off one side. There was also a small quiet lounge that was domestic, homely and comfortable. During this visit the hairdresser was using the smaller lounge on Ainsley. The main lounge/dining room over looked the garden and there was an enclosed garden off the dining area that had a seating area. Dining space appeared to be limited; this was discussed with the senior sister for Ainsley unit, who indicated that the current arrangements did not meet the needs of service users if they all wished to use the dining facilities. A number of service users required additional support or received their meals in the lounge or in their rooms, dependent on choice and ability. Each unit had a kitchenette area, where staff could make snacks and drinks for service users. Equipment included a dishwasher, fridge, sink and storage facilities. Checks were carried out on a number of cross-corridor fire doors; advice was given regarding fire safety guidance. External fire doors at the end of corridors could not be opened unless the fire alarms were sounded, Each of the units provided assisted shower and bathing facilities, in sufficient numbers to meet the needs and numbers of service users. Most of the bath/shower rooms and wc’s had some type of signage indicating their purpose, there was one example where this was not the case and another where the signage was confusing as it appeared to indicate the room was a wc when in fact it was a bathroom. A number of bathrooms and wc’s were locked on Ainsley unit; the senior sister stated that they had experienced some problems with accidental flooding. It was suggested to the care manager that consideration should be given to reviewing the type of taps that were fitted, as this may reduce the risk without depriving service users of free access to wc’s. Particularly an issue on Ainsley as bedroom doors were locked during the daytime and therefore service users did not have access to en-suites. Bathroom and wc door locks tended to be the privacy type which when locked displayed the colour red, due to the age of some locks, it was not always easy to see the colour indicator, possibly through wear and tear over many years. The two units inspected had a range of assisted bathing facilities, and had walk in showers. Electric and manually operated hoists were also used. On Ainsley unit a support worker described the benefits for an individual, of using one type of hoist for a service user as opposed to another type. This was confusing, and discussed with the care manager at the feedback session. The query related to the manual handling risk assessment for service users when using a hoist, the inspector understood that risk assessments were generic and did not Stadium Court Nursing Home DS0000026967.V303591.R01.S.doc Version 5.2 Page 20 identify a specific type of hoist or sling for the individual. The concern was that if staff had identified that using a particular hoist and sling was more comfortable for an individual, this should then be recorded in the service users care records/risk assessment and where possible should be the equipment used for that person. It was accepted that staff had undertaken recent manual handling training and received additional training relating to the use of hoists. A range of pressure relieving equipment was also provided, for example mattresses and chair pads. Adjustable beds were provided, and bedsides fitted where appropriate and subject to carer agreements and risk assessment. In one example a specialist bed surround had been provided to ensure the safety and well being of a service user who had been assessed as at risk if sleeping on a bed, the surround was fitted around a base and mattress on the bedroom floor and secured to ensure there were no gaps between. Corridors widths were good, and handrails were located along both sides of all corridors for the benefit. Storage space for large items such as trolley’s and hoists was a real issue for staff, resulting in storage in toilets and bathrooms, which in effect deemed them unusable for service users, three out of the four bathing/shower rooms for each unit were usable. All bedrooms were for single occupancy and had en-suite toilet and handwashing facilities. On both units bedroom doors had the names of the service user on them and in some instances, on Stafford unit a picture reference depicting the hobbies, interests or past occupation of the service user. A sample of bedrooms were visited, some were personalised with evidence of ornaments, photographs, mementos’ and other possessions from their homes, creating a homely feel. Others were less well presented; the non-slip flooring provided in all of the bedrooms also detracted from the otherwise homely surroundings. All bedroom doors had locks fitted; there was evidence of a lockable facility in those bedrooms seen. It was reported that radiators in bedrooms had individual thermostatic controls fitted to them to enable staff or service users to change the temperature of the radiator if necessary. On the day of the visit, it was not necessary to have the radiators on, as the outside temperatures were high. Staff on Ainsley had closed curtains in bedrooms in an effort to keep room temperatures at a comfortable level. Freestanding fans were provided in communal areas of the home and in where service users were on bed rest in those bedrooms. It was noted that radiators or pipe work in bedrooms were not covered or protected, presenting a potential risk to service users when the radiators were on. In one room the pipes were next to the bed and ran from the floor to the ceiling. The laundry was set out to provide, an entrance for soiled laundry and separate exit for clean. This free flow system complied with guidance in relation to Infection Control. The service had three large washing machines, and two industrial dryers. It was clean and well organised. Stadium Court Nursing Home DS0000026967.V303591.R01.S.doc Version 5.2 Page 21 Four staff were deployed working between the hours of 7am-3 or 4pm in the afternoon, the room temperature on the day of the visit was 95f, in excess of comfortable working temperatures as outlined in Health and Safety at Work legislation. Several freestanding fans had been provided but did not appear to have an effect. The manager was asked to resolve the matter but was unable to present a satisfactory solution when discussed. It was accepted that it was an unusually hot day, but further thought should be given to the on going welfare and well being of the laundry staff, including risk assessment and solutions as outlined in Health and Safety guidance. Sluices: - Both units had two sluice rooms, not accessible to service users and appeared to be suitable for the purpose. Stadium Court Nursing Home DS0000026967.V303591.R01.S.doc Version 5.2 Page 22 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 - 30 Quality in this outcome area is adequate. This judgement was made using available evidence, observations of the staff practices, records, and from speaking to staff and residents. The provider had in parts ensured that the recruitment procedure was robust, there were some minor details omitted from the records to comply with the National Minimum Standards. From the evidenced observed in two units there needs to be a refresher course in the Moving & Handling of residents to ensure their safety and comfort. Staffing levels appeared adequate at this time to meet the needs of the Service Users. EVIDENCE: Service Users needs were being met by a committed group of staff that were supervised by qualified trained nurses. Within two of the unit were Student and Adaptation Nurses that were working as additional staff. Each of the units has a housekeeper. . The number of hours in total for the laundry staff was 180hrs a week. On going training for statutory training were evidenced. Staff confirmed that they had received the training in the majority of the elements and were aware that more was planned. On two of the units staff was seen to transfer a Service User into a wheelchair without foot rests and proceed to move them. This was pointed out and addressed. Stadium Court Nursing Home DS0000026967.V303591.R01.S.doc Version 5.2 Page 23 One unit staff demonstrated the incorrect method of handling/lifting two Service Users this was fed back to the registered manager later. It is recommended that where necessary, staff should receive refresher training, and access the care plan to ensure that moving is appropriate. Two of the senior sisters had recently been on a course for Dementia, POVA and Whistle Blowing and they will cascade this knowledge to the staff. Training had been made available for all the trained staff on the use and monitoring of syringe drivers. All the staff in the past two weeks with the exception of the staff on Stafford received fire training. The majority of the obligatory training was the company’s distant learning books. There was a need for the collator of the training to ensure training was current, the Inspector evidenced from the records that a small amount of training was out of date. There was a necessity for the staff to have infection control training. From the evidence in the records provided there were twelve staff with NVQ in Care level II and eight staff with level III, this is below the recommended 50 based on the staffing numbers. The inspectors were told that other staff was in the process of undertaking this qualification. Two staff records were chosen at random by the manager, neither of them had a photograph of the employee, copy of the birth certificate or passport (if available). This was discussed at the feedback. Stadium Court Nursing Home DS0000026967.V303591.R01.S.doc Version 5.2 Page 24 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, 36, 38 This quality outcome is good. This judgement has been made using available evidence including a visit to this service. The Registered manager is very efficient Nurse who follows policy and procedure to the letter, which ensures high standards of care practice in the home. There was evidence through Quality Assurance that the home was run in the best interest of the Service Users. No issues were raised relating to BUPA financial procedures. There was evidence that the health, welfare and safety of Service Users and Staff are promoted and protected. EVIDENCE: The Staff were again, at this visit, able to confirm to the inspector that they felt valued and that the management team were always approachable and were professional in their manner keeping their concerns or personal issues in strictest confidence. Stadium Court Nursing Home DS0000026967.V303591.R01.S.doc Version 5.2 Page 25 Staff meetings were being held. Minutes of these staff meetings were recorded and a copy of these was shown to the inspector. There were also relatives’ meetings held which were held about three monthly. These meetings focussed on specific subjects each time and the manager stated this way of holding meetings appeared to be more beneficial to all who attended. The supervision records examined on the day of the inspection did not meet with Standard 36.3 All care staff must receive formal supervision at least six times a year and all aspects of this must be documented and available at inspection when required. All records seen during the inspection were current and in good order and kept in line with the Data protection Act 1998. Further observation and discussions with service users on the units confirmed that the style of management within the units promoted an open and positive atmosphere, which created a relaxed environment for those who lived there. The unit maintained the necessary records relating to care practices and Service Users safety. The staff was maintaining records of accidents. Stadium Court Nursing Home DS0000026967.V303591.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 X 3 STAFFING Standard No Score 27 3 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 2 Stadium Court Nursing Home DS0000026967.V303591.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP8 Regulation 12 (1a) Requirement The Registered Person must ensure that the care home is conducted so as to promote and make proper provision for the health and welfare of service users; This is in relation to ensuring that residents receive medical intervention, treatment and advice where required. The Registered Person must where appropriate revise the service user’s plan. This is in relation to evidencing that representatives have been consulted and are in agreement with the plan – including any comments on the Relatives’ Communication sheet. The Registered Person must ensure that the required details contained in Schedule 2 are current. The Registered Person must ensure that persons working in the home receive training appropriate to their job with regard to moving and handling of Service Users. The Registered Person must DS0000026967.V303591.R01.S.doc Timescale for action 17/08/06 2 OP7 15 (2c) 17/08/06 3 OP29 Schedule 2 18 (1) (C)(i) 17/08/06 4 OP30 17/09/06 5 OP36 18 (2) 17/09/06 Page 28 Stadium Court Nursing Home Version 5.2 6 7 8 OP9 OP38 13 (2) 13 (4a) 12, 13 OP38 ensure that staff working at the care home is appropriately supervised. The medication refrigerators 17/08/06 must all be repaired or replaced. Garden furniture must be risk 17/08/06 assessed to ensure Service Users safety. The responsible person must 17/08/06 ensure that those staff working in the laundry are not at risk due to the high working temperatures (noted on the day of the inspection) by taking appropriate action to ensure their welfare and well-being. Health and Safety at Work Act 1984. 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 2 3 4 5 6 7 Refer to Standard OP1 OP38 OP10 OP14 OP24 OP24 OP38 Good Practice Recommendations The Statement of Purpose must be updated as changes are made in the home. Include the type of lifting hoist and sling to be used in each service users care records/risk assessment. Review the current practice on Aynsley of locking some of the bathroom and toilet doors and take action to reduce any risk of flooding. Ensure that service users are able to recognise the purpose of each room by providing appropriate signage. Reconsider the use of non-slip flooring in bedrooms. Give further consideration to supporting service users to create a more homely and personalised bedroom where appropriate. Provide written evidence that radiators are of a low surface temperature type. Stadium Court Nursing Home DS0000026967.V303591.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Stadium Court Nursing Home DS0000026967.V303591.R01.S.doc Version 5.2 Page 30 - 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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