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Inspection on 06/02/06 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 6th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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

This was a very positive unannounced inspection where standards of care were found to be high throughout all the units. The residents were complimentary throughout the units in their comments about the staff and the care they received. They felt the staff were caring and friendly and met their needs very well. The visitors spoken to were also complimentary about the home and the services provided. The units were very clean and hygienic throughout. This was especially commendable on the mental health units where such a high standard of hygiene can be difficult to constantly maintain. The provision of dedicated domestic hours is good in the home and this, together with the efficiency of the domestic staff, ensures that high standards of cleanliness are maintained. The monitoring and meeting of individual health care and nursing needs was very good with evidence of multidisciplinary working throughout.The involvement of representatives with the care of their loved ones was evident and staff promoted this. The provision of specialist dementia and mental health care in the two selected units was very good. Staff had received training in this specialist area and were knowledgeable and dedicated. Residents had their needs very well met on these units.

What has improved since the last inspection?

Aynsley Unit had been refurbished throughout, new furniture had been supplied in the lounge and dining areas, new bed linen provided, a new hoist had been purchased and new carpets provided along the corridors. The previous requirement and recommendations have been addressed

What the care home could do better:

There was a need to assess fire safety and risk assess for passive smoking in relation to the lack of the provision of doors on the smoking rooms in each unit. Aynsley unit should be provided a copy of the National Minimum Standards for Older People at all times. Staff meetings appeared to be heard on an ad hoc basis, long serving care staff informed the inspector that they would attend such meetings if they were informed of dates and venues. Formal staff supervision needs to be reassessed and further developed. Residents accommodated in the general nursing units should be reassessed when their behaviour and needs change and should be offered a placement on one of the mental health units if this is required.

CARE HOMES FOR OLDER PEOPLE Stadium Court Nursing Home Greyhound Way Cobridge, Hanley Staffordshire ST6 3LL Lead Inspector Yvonne Allen Unannounced Inspection 6th February 2006 10:00 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.V279520.R01.S.doc Version 5.1 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.V279520.R01.S.doc Version 5.1 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 01782 266027 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.V279520.R01.S.doc Version 5.1 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 20th September 2005 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.V279520.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took five inspectors five hours to complete. The inspectors involved were – Yvonne Allen, Jane Capron, Wendy Grainger, Sue Mullin and Lynne Gammon. Not all of the standards were assessed during this inspection but those not examined last time were assessed together with any, which had not fully met the standard previously. Each unit received a visit from an inspector and discussions were held with staff, residents and some visitors. Relevant documentation and records were examined as supporting evidence. Discussions were held with the registered manager and inspectors met with the newly appointed deputy manager. Verbal feedback was given from each inspector at the end of the visit. What the service does well: This was a very positive unannounced inspection where standards of care were found to be high throughout all the units. The residents were complimentary throughout the units in their comments about the staff and the care they received. They felt the staff were caring and friendly and met their needs very well. The visitors spoken to were also complimentary about the home and the services provided. The units were very clean and hygienic throughout. This was especially commendable on the mental health units where such a high standard of hygiene can be difficult to constantly maintain. The provision of dedicated domestic hours is good in the home and this, together with the efficiency of the domestic staff, ensures that high standards of cleanliness are maintained. The monitoring and meeting of individual health care and nursing needs was very good with evidence of multidisciplinary working throughout. Stadium Court Nursing Home DS0000026967.V279520.R01.S.doc Version 5.1 Page 6 The involvement of representatives with the care of their loved ones was evident and staff promoted this. The provision of specialist dementia and mental health care in the two selected units was very good. Staff had received training in this specialist area and were knowledgeable and dedicated. Residents had their needs very well met on these units. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Stadium Court Nursing Home DS0000026967.V279520.R01.S.doc Version 5.1 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.V279520.R01.S.doc Version 5.1 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): 4 Residents and their representatives can be assured that this home will meet their assessed needs. EVIDENCE: Through direct observation, discussions with residents and visitors and examination of documentation, it was identified that the needs of the residents were being met by the staff in the home on a continuous basis. On Spode Unit, there were two residents who were exhibiting extreme behaviour and appeared to need specific dementia care. It is recommended that the individual residents undergo a reassessment of their needs, as this unit is not registered to care for residents with these needs. Stadium Court Nursing Home DS0000026967.V279520.R01.S.doc Version 5.1 Page 9 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 and 10 The personal and nursing care needs of individuals are met with dignity and respect. EVIDENCE: On Wedgwood Unit care plans were sampled; there was evidence that the plans had been evaluated on a regular basis. One of the care plans was crossed referenced with one resident. Records confirmed that her care was consistent to the written plan. There was a recommendation to continue displaying photographs on the plans. There was a need for Wedgewood to have their own set of scales to continue the monthly weights, records identified that scales were “out of order” on a number of occasions. Transferring scales around the complex can cause them to de-calibrate. Stadium Court Nursing Home DS0000026967.V279520.R01.S.doc Version 5.1 Page 10 The healthcare needs were fully met on Aynsley unit. Care plans demonstrated identified needs and detailed how those were to be met. No one was receiving care from the district nursing services, as there were no residents on the unit receiving personal care only. Three residents remained in bed over the 24-hour period and staff paid excellent attention to them. Two members of care staff engaged in conversation informed the inspector in detail of each resident’s daily requirements. Both had a very good sound knowledge of the residents current conditions and how best to provide good quality continuity of care. Fluid balance and turn charts were in place and these were examined; all showed regular input in line with written requirements outlined in the main body of the care plans. All three residents were seen by the inspector and looked very peaceful, warm and comfortable. The nursing staff met wound care needs and appropriate pressure relieving devices were in place in all three incidences. Advice was sought by external professionals where required and this was documented. All NHS entitlements were facilitated and private chiropody was also available. A ‘foot nurse’ also accompanied the chiropodist and provided further treatment. The unit deals with seven different GP practices and staff explained that some practices provided a more efficient service than others; however, when any concerns were raised regarding the physical or mental condition of individual’s medical advice was always sought immediately. If a resident is admitted who was receiving input from a CPN, regular communication was maintained to ensure the CPN was aware of the progress and the CPN was also invited to the six weekly reviews. Relatives and significant others were encouraged to have input in to the care planning of individuals and they were also invited to attend any reviews held at the home. Primary nurses and key workers were allocated to each resident and would liaise with family members regarding care issues or when resident’s toiletries or clothing stocks were low. The level of personal hygiene provided in the home was very good. Key workers maintained diaries of bathing/showering etc and would pass on any information to the oncoming shift. Effective communication was evident throughout the unit. Staff were diligent, professional, unhurried in their approach when providing care to residents. It was pleasing to see how much the staff cared for the residents in an affectionate and dignified manner. Stadium Court Nursing Home DS0000026967.V279520.R01.S.doc Version 5.1 Page 11 Camaraderie was evident throughout the visit. The medication procedure was examined on Wade Unit and the administration, storage and disposal of all drugs were in order. MAR charts were examined and had been completed in line with NMC requirements. The storage and administration of controlled medication was examined and stocks in the bottles were checked and tallied with the register stock levels. All residents had a current photograph in place on the MAR sheets and a list of staff specimen signatures was in place for the on-going protection of the service users.. Stadium Court Nursing Home DS0000026967.V279520.R01.S.doc Version 5.1 Page 12 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 and 14 Residents are offered choices in relation to social, recreational and religious interests and individuals are helped to exercise choice and control over their lives in the home. EVIDENCE: Staff on Wedgewood were committed to raising funds for the unit, at the time of this inspection arrangements were in place for a Valentines raffle, Mothering Sunday, Easter, and quiz night in May. Funds raised went to the unit’s comfort funds. The activity organiser worked up to 15 hours on Aynsley unit and explained that she varied the programme to suit the needs of the residents. Many residents were profoundly demented and could not take part in certain planned activities and the activity organiser would have one to one sessions, sitting with them, taking them for walks or have group activities with a musical theme. Stadium Court Nursing Home DS0000026967.V279520.R01.S.doc Version 5.1 Page 13 The home made efforts to ascertain residents’ likes and dislikes and to find out about their previous lifestyle. A discussion with a relative confirmed that the home was aware of her relative’s preferences and certain issues important to the resident had been included in the care plan. The home tried to provide as flexible routine as possible where residents could make choices over their lives. There was flexibility over times for getting up and going to bed and residents that were able chose whether to spend time in their bedroom or in the communal areas. Choice was available at mealtimes but it was not always clear whether all residents were aware of the full range of choices. The home employed activity staff for 60 hours per week. This provided each unit with 10 hours dedicated activity time a week. Within this time the activity staff were provided activities including arts and craft, sing a longs, games, gentle exercise and nail care. Evidence of art and craftwork was seen on unit walls. The activity staff were providing some individual and small group sessions for residents in the EMI units and this included such activities as reading, looking through old photographs and hand massage. Due to the staffing level residents were only able to have this individual attention occasionally. Additional activities included the hairdresser visiting every week and a church service once a month. The home also brought in entertainers and a dog was brought to the home by its owners every month. The home also organised trips out and last year there had been trips to Blackpool, Walsall, Trentham Gardens and to West Midlands Safari Park. The care staff on units also undertook activities when they were able and during the inspection one care assistant was observed going through the daily paper with three residents. Care staff also arranged parties and raffles on their units. Pictures were seen of residents enjoying a Halloween party last year. Stadium Court Nursing Home DS0000026967.V279520.R01.S.doc Version 5.1 Page 14 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): 16,17 and 18 Residents are protected from harm or abuse by the systems in the home and can be assured that any concerns they have will be listened to and taken seriously. Individual legal rights are protected. EVIDENCE: Two residents residing on Wedgewood confirmed that they had their rights protected, postal voting would be arranged if they requested. At the time of this inspection no advocacy service was required. The complaints procedure was contained in the relevant documents and displayed within the unit. Residents spoken with felt that they could raise concerns and that the senior staff would address them. The majority residents on Aynsley unit did not have capacity to vote or exercise their legal rights. However, an advocacy service was available where required. Relatives were encouraged to assist in this area. Stadium Court Nursing Home DS0000026967.V279520.R01.S.doc Version 5.1 Page 15 The Local Authority was informed each year of any new service users living in the home in order to update the electoral register. On Wade Unit staff confirmed that most service users participated in the electoral process by postal vote; a few others who wished to were supported to visit the polling stations to vote. Staff informed the inspector that telephone facilities were available and all mail was given to residents un opened, if required a member of the care staff would open the letter in the presence of the resident, in particular with out patients appointments. The manager explained that there was new POVA training in place for staff, which had been recently introduced by the Company. Staff were familiar with the VA procedure and were aware of the Whistelblowing Policy when questioned. Protection of Vulnerable Adults was discussed with new staff on Wade Unit and the abuse awareness documentation was seen to be very detailed and comprehensive. Stadium Court Nursing Home DS0000026967.V279520.R01.S.doc Version 5.1 Page 16 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, 20,21, 22, 24, 25 and 26 The home provides a comfortable, clean and safe environment for the residents who live there, and has been adapted to meet individual needs. EVIDENCE: Wedgewood and Spode Units were registered to offer nursing care to thirty older people. Accommodation was in a single storey building. The décor on these units was only adequate; it was showing signs of aged buildings. There was a need to consider Wedgewood or Spode for the next total decoration and refurbishment. In spite of this, both of the units were seen to have excellent standards of cleanliness and hygiene. Sufficient toilet and bathing facilities were provided to meet the needs of the residents; each bedroom had an en-suite facility. Stadium Court Nursing Home DS0000026967.V279520.R01.S.doc Version 5.1 Page 17 Bedrooms were personalised to suit individuals, no bedroom had a carpet, each room had a non slip flooring which, while in some cases was suitable but this flooring did detract from the more homely surroundings. There was a need to seek advice from the local Fire Officer in respect of the smoking area located in the lounge. This area was without a door and one person on the unit was receiving oxygen on a permanent basis. This set up was the same on all units, it was observed, on Spode Unit, that one of the residents, who had a chronic chest condition, was sitting very close to the entrance to the smoking room. The presence of smoke in the lounge area was noted and it is recommended that doors be provided on smoking rooms. It was evidenced in the data material COSHH documents, on Wedgewood Unit, that some products were now not in use. It is important that all data is current and applicable. Aynsley unit had recently benefited from a full refurbishment and appeared very pleasant and well presented. New furniture has replaced the old lounge and dining room chairs and tables. New carpeting has been laid down throughout the corridors and the curtains washed and put back into place. All fixtures and fittings were of a good quality, bright and comfortable. Grab rails were in place and doors wide enough to facilitate wheelchair access. Staff confirmed that only one resident was able to use a buzzer but regular checks of residents are carried out when individuals are in their bedrooms. There were no malodours anywhere in the unit despite the vast majority of residents being incontinent. All waste was disposed of in line with infection control guidelines. The whole unit was very clean a credit to the domestic team. The unit shares a secure garden with the adjacent EMI Unit. Gardens looked well tendered and safe. On Wade Unit the bedrooms were clean, homely and safe, with new carpets and curtains in place. Service users had many of their own possessions in their rooms, however some rooms needed new furniture. The lounge and dining room were bright and open with comfortable furniture and a smoking room and a separate quiet room was available if required. A variety of equipment and adaptations were provided to maximise the independence of the service users. These included: pressure mattresses, hoists, grab rails, walking aids etc. Toilets and washing facilities were sufficient to meet the needs of the service users and the unit was very clean and hygienic. Stadium Court Nursing Home DS0000026967.V279520.R01.S.doc Version 5.1 Page 18 Stafford Unit provided residents with good quality accommodation. Bedrooms were if a suitable size and were suitably decorated and furnished. Rooms were personalised with pictures and ornaments. The corridors were suitable decorated and there were a range of pictures of residents both current and in their younger days on the walls. There were also pictures of residents enjoying parties held on the unit. The communal areas provided a large open plan lounge and dining area with a smoking area off one side. This had been arranged and decorated to appear quite domestic in style. Furniture and furnishings were of a good quality and there were a range of places to sit. The communal areas over looked the garden and there was an enclosed garden off the dining area that had a seating area. There was also a small quiet lounge that was domestic homely and comfortable. The cleanliness of Stafford unit was of a high standard and all areas seen were spotless. The unit had two housekeepers providing 70 hours per week. There were cleaning schedules in place and the housekeeper spoken to was fully aware of the standards regarding hygiene and the control of infection. Stadium Court Nursing Home DS0000026967.V279520.R01.S.doc Version 5.1 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28 and 30 Staff are provided in sufficient numbers and have the necessary skills and expertise to meet the needs of the residents accommodated in the home. EVIDENCE: Staffing levels during the inspection of Wedgewood included one senior sister; one registered general nurse, one senior care and four care staff. This reduced by two for the afternoon shift until 7pm when it reduced again by one. Three waking staff including a trained nurse covered the night shift. Two of the staff confirmed their training was current; some training was out of date including Moving & Handling, Health & Safety and COSHH. The inspector was informed that there is to be an increase in training commencing in April in relation to Moving & Handling. The senior sister on Wedgewood was qualified to provide this training. She is also commencing Pathway training to enable nursing staff to verify death. There were 30 residents accommodated on Spode Unit and for the morning shift there were six care staff working alongside the nurse in charge. This number dropped by two in the afternoon shift and at nighttimes there was one nurse and two care staff on duty. There were 29 nursing residents on Aynsley Unit on the day of the inspection with one vacancy. One resident was in hospital leaving 28 sleeping on the unit. Stadium Court Nursing Home DS0000026967.V279520.R01.S.doc Version 5.1 Page 20 Over a 24- hour period there is a qualified nurse on duty, additionally on the early shift there are seven care staff and on the late shift there are five care staff. During the night from 10pm onward there are two care staff. The qualified staff have a dedicated handover period which promotes good communication throughout the unit. There are 10 hours per day domestic input in to the unit. A hairdresser visits weekly and was on the unit, cutting and styling hair on the day of the inspection. Two care staff reported reluctance to undertake NVQ training as the home had previously experienced a problem with getting NVQ assessors to check work completed. This was discussed during feedback and the home is now putting in a new system of NVQ assessment, which will be checked on the next inspection. All staff spoken to confirmed that they had received mandatory training with the exception of the domestic who stated that she had not received load management training. This was also discussed at feedback and the care manager stated she would look in to this and ensure that all ancillary staff have undertaken this training. A requirement has been made to this effect. Staff engaged in conversation described the best things about the home ‘ the residents are wonderful, such characters’, ‘ You wouldn’t find another care home that looks after the residents the way they are looked after here’. ‘We all work together as a team, we have a great set of staff here’. When they were thinking about a negative point of the unit, some time passed before one member of staff said’ The worst thing about this home is when a resident is ill or upset’ another stated’ we get so attached, it is very upsetting when pass away’. Such is the care on Aynsley unit. On Wade Unit, there was a senior sister on duty all day till 8 pm, with two senior carers and four care assistants in the morning, one senior carer and four care assistants in the afternoon and one registered nurse and two carers on night duty. There were 29 service users living in the unit at that time and these staffing levels were considered satisfactory to meet their needs. Discussion with staff evidenced that there had been a considerable turn over of staff within the unit over the last few months; however, staffing levels appeared to be more stable. Staff were very supportive of the senior sister and of the support of the Deputy Matron, who was taking a lead on sorting out training, job descriptions etc. Stadium Court Nursing Home DS0000026967.V279520.R01.S.doc Version 5.1 Page 21 The unit staff were not aware of any induction training provision within the home at the present time, however, the senior sister confirmed that staff were supervised by a senior carer for a week and were made aware of fire safety procedures, abuse awareness etc. Stafford Unit had experienced some staffing difficulties due to vacancies and ill health. The home was in the process of recruiting new staff. The unit was able to maintain safe staffing levels through the use of staff from other units, staff working extra hours, bank staff and on some occasions through the use of agency staff. The unit staffing levels were always above the minimum levels required for the number of residents due to the unit having two residents who were receiving one to one care during the day. One the day of the inspection there was one nurse on duty and five care staff but this level had been increased through the addition of a care staff member from another unit spending some time on the unit to help get residents up and to help at lunchtime and the deputy manager working on the unit for several hours in the morning. In the afternoon/ evening the unit was three short but the home had organised the necessary cover to ensure that the unit was suitably staffed. The unit had three staff on duty during the night. Discussions with staff on Stafford Unit confirmed that staff were provided with the opportunity to undertake NVQ training. The senior care worker on duty had obtained her NVQ level 3 and another staff was currently undertaking her NVQ 2. The staff on Stafford unit confirmed that they were provided with induction training when they started work and received ongoing training including working with residents with dementia. However the training records kept on the unit did not clearly show that all staff had received the necessary mandatory training. Stadium Court Nursing Home DS0000026967.V279520.R01.S.doc Version 5.1 Page 22 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): 32, 36, 37 and 38 The home is very well managed and run in the best interests of the residents who live there. EVIDENCE: The senior sister on Wedgewood leads by example, the unit had a very relaxed atmosphere. The staff told the inspector that they felt well supported by her and found her very approachable. Staff confirmed that they received supervision; the only comment would be that the forms used were task based and could be further developed to be more focussed on personal development. On Aynsley Unit Records were stored within the office, where necessary a locked facility was used. Stadium Court Nursing Home DS0000026967.V279520.R01.S.doc Version 5.1 Page 23 Staff confirmed to the inspector that they felt valued and that the management team were approachable and would maintain their concerns or personal issues in confidence. Staff stated ‘our philosophy of the home is to provide 110 care to all of our residents’. Staff meetings appeared to be heard on an ad hoc basis, long serving care staff informed the inspector that they would attend such meetings if they were informed of dates and venue. Minutes of staff meetings were recorded and a copy of these was shown to the inspector. There were also relatives’ meetings held which would be moving to three monthly. These meetings focussed on specific subjects each time and the manager stated this way of holding meetings appeared to be more productive. The supervision records examined on the day of the inspection did not meet the criteria laid down in standard 36.3 All care staff must receive formal supervision every two months, all aspects of this must be documented and available at inspection when required. Due to the severity of dementia suffered by some residents, access to their own records was limited, however relatives were encouraged to have input into the care planning systems of their loved ones. All records seen during the inspection were current and in good order and kept in line with the Data protection Act 1998. Direct 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. No formal supervision sessions took place on Wade unit, however, informal records were seen. It is a requirement of this report that all care staff are appropriately supervised and a recommendation that this supervision takes place at least six times per annum. Staff meetings had been postponed during the last few months but these had been resurrected and a notice on the board evidenced that one was planned for 15th February 2006. The senior sister confirmed that these would take place each month for the foreseeable future and intended that they would be open and inclusive to give staff the opportunity to contribute to the running of the unit. The staff on Stafford Unit spoken to were very positive about working at the home and were committed to providing a good service. All the care staff spoken to stated that they enjoyed working with residents with dementia. They Stadium Court Nursing Home DS0000026967.V279520.R01.S.doc Version 5.1 Page 24 felt the home had an open management style and that they felt supported by their colleagues. There was an easy relaxed atmosphere within the unit. Staff spoken to on Stafford Unit stated that they were receiving supervision that related to issues such as learning about procedures and care practices. 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. Stadium Court Nursing Home DS0000026967.V279520.R01.S.doc Version 5.1 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x x 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 4 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 3 18 3 3 3 3 3 3 3 3 4 STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x 4 x 3 x 2 3 2 Stadium Court Nursing Home DS0000026967.V279520.R01.S.doc Version 5.1 Page 26 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 38 Regulation 18(1)(1) Requirement The registered person must ensure that all ancillary staff have undertaken load management training. All care staff must receive formal supervision six times per year. That advice is sought from the fire safety officer in relation to the absence of doors on smoking rooms. The fire door located next to the kitchen on Stafford Unit must be made good. Timescale for action 20/04/06 2 3 36 38 18(2) 23(4)((c) 20/04/06 20/03/06 4 38 23(4)(c) 20/03/06 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 Refer to Standard 7 8 36 Good Practice Recommendations To ensure that all care plans contain a photograph of the resident with their permission. Each unit should have its own set of scales. Formal staff supervision form should be further developed to focus on personal development needs. DS0000026967.V279520.R01.S.doc Version 5.1 Page 27 Stadium Court Nursing Home 4 5 19 4 The programme of redecoration/refurbishment should be centred on Wedgwood or Spode Unit this year. The residents on Spode Unit who are exhibiting extreme behaviour should have a reassessment of their needs. Stadium Court Nursing Home DS0000026967.V279520.R01.S.doc Version 5.1 Page 28 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. 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