Inspection on 15/03/10 for Stainton Way Care Home

This inspection was carried out on 15th March 2010.

CQC found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Stainton Way Care Home 02/11/09

Stainton Way Care Home 19/02/09

Stainton Way Care Home 10/03/08

Stainton Way Care Home 26/02/07

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 03/06/2010.

Key inspection report Care homes for older people Name: Address: Stainton Way Care Home Stainton Way Hemlington Middlesbrough TS8 9LX     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Katherine Acheson     Date: 2 2 0 3 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 32 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 32 Information about the care home Name of care home: Address: Stainton Way Care Home Stainton Way Hemlington Middlesbrough TS8 9LX 01642599157 01642596481 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): North East Care Homes Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: care home 67 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 67 The registered person may provide the following category of service only: Care home only - Code PC 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 - Code OP, maximum number of places: 49 Dementia - Code DE, maximum number of places: 18 over age of 55 years Date of last inspection Brief description of the care home Stainton Way Care Home is situated in the village of Stainton on the outskirts of Middlesbrough. The home is purpose built and registered to provide care to a maximum number of 67 older people, 18 of whom may have dementia. The home is divided into four units. Each unit has lounge, dining facilites, toilets and bathing Care Homes for Older People Page 4 of 32 Over 65 0 49 18 0 1 8 1 1 2 0 0 9 Brief description of the care home facilities. Bedrooms are single in nature and have ensuite toilet facilities. A Passenger lift enables accesss to the first floor. The cost of care at the time of the inspection visit ranged from £428 to £435 a week. Care Homes for Older People Page 5 of 32 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: one star adequate 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 Quality rating for this service is one star. This means that people that use the service experience adequate quality outcomes. This unannounced key inspection took place on 15 and 22 March 2010. A pharmacy inspection to look at medication systems and practice also took place on 15 and 22 March 2010. The acting manager completed and returned an Annual Quality Assurance Assessment, (AQAA). The AQAA is the services self assessment on how they think that they are meeting National Minimum Standards. This information was received before the inspection and was used as part of the inspection process. Before this inspection visit we looked at all of the information that we have received since last inspection of the service in November 2009. Care Homes for Older People Page 6 of 32 The reason for this inspection was to check/monitor compliance of requirements identified at last inspection in November 2009 and to see how good a job the home does in meeting the National Minimum Standards set by the Government for care homes. Numerous records were examined including care records of people living at the home, medication records, risk assessments, complaints and staff records. People living the home, relatives and staff working there were also spoken to. Discussion also took place with the acting manager, deputy manager, a senior manager of the service and the responsible individual. Before the inspection surveys for people that use the service and staff were sent out to the home for the acting manager to distribute . Surveys for people that use the service asked for comments on care received. Surveys for staff asked for comments on what it was like working at the home and training received. We received six surveys from people that use the service and ten from staff. Comments in surveys received can be read in the main body of the report. Care Homes for Older People Page 7 of 32 What the care home does well: What has improved since the last inspection? Significant improvements have been made since last inspection of the service in November 2009. Last inspection highlighted the need for care plans to be developed to include more detail, be specific to the person and for those people who have dementia care plans needed to include the level of the dementia and impact of the dementia on life. Care plans are records used by care services to show what sort of help each person needs and how staff will provide that care. Care plans looked at during this inspection provided clear guidance to staff about how to meet the needs of the person and included evidence of personal choice. One plan of care contained good detail about making sure that a person had sufficient to eat and included action that staff should follow to help to maintain the independence of the person. Care files of people who resided on the dementia unit that were looked at during the visit clearly described the impact that their dementia had on life and how Care Homes for Older People Page 8 of 32 staff could help them. Care plans had been reviewed and evaluated on a monthly basis. Risk assessments, nutritional risk assessments and moving and handling assessments were up to date and had been reviewed on a regular basis. Since last inspection steps have been taken to improve the quality assurance and quality monitoring of the home. Surveys were sent out to people that use the service and relatives in December 2009. The results of the survey are given to people that use the service and relatives and also displayed on the notice board in the corridor for everyone to see. The last inspection of the home highlighted that records of visits required under Regulation 26 were not available in the home. The purpose of the visit required under Regulation 26 is to inspect the premises, its record of events, complaints and speak to people and staff about the home. Records were available during this inspection to confirm that Regulation 26 visits had been carried out in December 2009 and January and February 2010. At this inspection we looked at the arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. We looked at service users medication. Examination of medication records and discussion with staff highlighted that progress has been made since the inspection in November 2009. Senior care staff that are responsible for the administration of medication have received medication training. Some improvement had been made with record keeping. The temperature of medication rooms is now being monitored. The acting manager said that induction training for newly appointed staff has been developed to meet with that required by Skills for Care. She said that a training company visit the home for a full day over a five week period and complete the induction with staff. What they could do better: At this inspection we looked at the arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. We looked at service users medication. Examination of medication records and discussion with staff highlighted that progress has been made since last inspection of the service, however in some areas insufficient improvement had been made. At the previous inspection of the service in November 2009 we identified that the home did not have a system in place to check expiry dates of medicines and to add a date of opening when necessary. We identified that medication was not always given as prescribed and a record made at the time that it was given. At the inspection on 15 and 22 March 2010 we found that there is still not a system to check expiry dates of medicines and add a date of opening when necessary. We found that medication is not always given as prescribed or make a record at the time that it is given. Examination of records at this inspection identified that there is not an effective system to request, obtain and retain adequate supplies of medication for people that use the service As a result of these breaches we held management review meeting where it was decided that we would send a warning letter to the registered provider. Care Homes for Older People Page 9 of 32 Formal agreements regarding the expenditure of those people that use the service and receive one to one social hours should be reviewed to safeguard people and staff. All staff working at the home must be up to date with mandatory training. This will help to ensure they have the appropriate knowledge and skills to carry out their work. A full employment history of staff who are to work at the home should be obtained. Any gaps in employment should be explored. This will help to ensure the safety of people that use the service. 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 on page 4. 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 32 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 32 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. Assessments of people who are to use the service are carried out before they move into the home to ensure all needs can be met. Evidence: The acting manager said that people who are to use the service are assessed before coming into the home. First they receive an assessment from a social worker. This assessment is sent to the home for the acting manager to look at. Once this assessment has been reviewed the acting manager or deputy manager then visit the person at home or in hospital to carry out a further assessment. These assessments are used to decide if the home can meet their needs. If a person is funding their own care an assessment is usually only undertaken by the acting manager or deputy manager of Stainton Way. People are encouraged to visit the home before they move in. The acting manager Care Homes for Older People Page 12 of 32 Evidence: said that people can stay for lunch. People who are to use this service are offered a trial period of up to six weeks. At the end of the trial period a review takes place to make sure that the placement is both successful for the person using the service and the home. One person spoken to during the visit said, My daughter visited the home to see if it was suitable. She thought that it was very nice and told me that the staff were very friendly and helpful. Care Homes for Older People Page 13 of 32 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People that use the service receive good support and are happy with the care that they receive. Medication administration and recording practices are not robust enough to ensure that people will always receive their medicines accurately as prescribed. This means that treatment to their medical condition could be affected. Evidence: The care files of four people that use the service were looked at during the visit, two care files of people that reside on the dementia unit and two care files of people that reside on the older persons unit. It was evident that the acting manager and staff had worked very hard since last inspection to improve the standard of care planning for people that use the service. Last inspection of the service in November 2009 highlighted the need for care plans to be developed to ensure that they were individual and specific to the person. Care plans for those people with dementia did not include the level of the dementia or impact of the dementia on life. Care plans for those people with aggression did not detail in what way the person could be aggressive, the triggers to the aggression or Care Homes for Older People Page 14 of 32 Evidence: action to take to manage the aggression. Not all care plans had been evaluated and updated on a monthly basis and risk assessments were not clear or reviewed regularly. Assessments looked at during this inspection contained good detail and were informative. Care plans provided clear guidance to staff about how to meet the needs of the person and included evidence of personal choice. One plan of care contained good detail about making sure that a person had sufficient to eat and included action that staff should follow to help to maintain the independence of the person. Another care plan for a person described how to assist the person with washing and dressing and advised how the person could become upset and distressed if more than one care staff member assisted. The two care files of people who resided on the dementia unit clearly described the impact that their dementia had on life and how staff could help them. Care plans had been reviewed and evaluated on a monthly basis. The last inspection highlighted that the homes nutritional risk assessment was confusing and that reviews of a persons nutritional risk assessment did not detail why a person was at risk of malnourishment or why the risk had increased or decreased. The acting manager said that since last inspection the home have changed the nutritional risk assessment that they use to identify if a person is malnourished or at risk of malnourishment. The acting manager said that if the nutritional risk assessment highlights that a person is malnourished or at risk of malnourishment a care plan is developed to identify action that needs to be taken. The acting manager said that the nutritional care plan is then updated/reviewed on a regular basis to ensure that the appropriate treatment is received to ensure wellbeing. Care files looked at during the visit confirmed that this was the case. Risk assessments looked at during the visit were clear and contained action to be taken to reduce/prevent highlighted risk. The acting manager said that since last inspection new moving and handling assessments have been introduced. Moving and handling assessments looked at during the visit gave details of the how mobile the person was, limitations, any equipment required to assist with moving and handling and intervention required by staff. The acting manager said that the home have purchased new care plan documentation and assessments. New documentation is to be introduced after care staff have received training. Care Homes for Older People Page 15 of 32 Evidence: Files looked at during the inspection contained a detailed history of the person including childhood, family, working years and interests. This is particularly useful when caring for a person with dementia. There was clear evidence of the involvement of GPs, district nurses and other health care professionals such as chiropodists. People living at the home confirmed that if they were feeling unwell, the GP would be called. During the inspection visit the acting manager and staff were observed to interact well with people that use the service and visitors. Staff approached people in a supportive and respectful way. People spoken to during the visit and surveys received in were complimentary about life in the home and care received. Comments made included, Most of the staff go out of their way. A big plus is the communication. Staff are really good at ringing and letting me know when the GP has been I think that the home is very good and staff are very receptive Friendly, obliging, extremely helpful staff ensure that my wifes care leaves nothing to be desired. A very lovely caring place I took some settling. The staff are lovely, but they dont have time for conversation They look after me very well indeed At this inspection we looked at the arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. We looked at service users medication. Examination of medication records and discussion with staff highlighted that progress has been made since last inspection of the service, however in some areas insufficient improvement had been made. Since last inspection senior care staff that are responsible for the administration of medication have received medication training. Two senior care staff have been given overall responsibility for the ordering and record keeping of medication. Some improvement has been made in the recording of medication. The quantities of medication received into the home or carried forward each month are now recorded making it easy to check whether sufficient quantity is available and to enable the audit of medication. There is greater consistency in handwritten entries and changes made to medication. The temperature of medication rooms is now being monitored. People Care Homes for Older People Page 16 of 32 Evidence: that use the service now have a photograph alongside their Medication Administration Record which reduces the risk of medication being given to the wrong person. At the previous inspection of the service in November 2009 we identified that the home did not have a system in place to check expiry dates of medicines and to add a date of opening when necessary. We identified that medication was not always given as prescribed and a record made at the time that it was given. At the inspection on 15 and 22 March 2010 we found that there is still not a system to check expiry dates of medicines and add a date of opening when necessary. We found that medication is not always given as prescribed or make a record at the time that it is given. Examples of this included, eye drops for one person had a pharmacy label dated 22 February 2010; however did not have a date of opening recorded. Medication for another person had a pharmacy label dated 1 February 2010; however did not have a date of opening. This medication needed to be used after twenty eight days of opening. The Medication Administration Record for a person had been signed to confirm that a cream had been applied on 22 March 2010; however the cream was not in stock. The Medication Administration Record for a person had eight gaps where staff had failed to sign to confirm that they had been applied eye drops. Examination of records at inspection on the 15 and 22 March 2010 identified that there is not an effective system to request, obtain and retain adequate supplies of medication for people that use the service. The Medication Administration Record for one person detailed that one or two tramadol 50mg capsules had been prescribed four times daily. Records were available to confirm that the home had received one hundred tramadol 50mg capsules. There were twenty eight capsules in three blister packs for morning, teatime and night, which meant there was only enough medication to give one capsule. The lunchtime blister pack only contained sixteen capsules. The Medication Administration record for the lunchtime administration had been signed by staff on seventeen occasions to confirm that they had administered the medication. The Medication Administration chart was then marked as out of stock for the rest of the month. A Medication Administration Record for another person detailed that domperidone 10 mg tablets was prescribed one tablet three times daily. Records were examined to confirm that the home had received thirty tablets. Staff had signed on thirty two occasions to confirm that they had administered the medication then marked out of stock. As a result of these breaches We held management review meeting where it was Care Homes for Older People Page 17 of 32 Evidence: decided that we would send a warning letter to the home. Care Homes for Older People Page 18 of 32 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 that use the service lead fulfilling lifestyles through exercising choice and control over how they spend their day. Food provided is enjoyed, which helps to maintain wellbeing. Evidence: The home employs three activity co-ordinators to plan, arrange and take part in activities for people that use the service. Some people that use the service have been assessed as needing individual activities and outings on a one to one basis. One of the activity co-ordinators has been appointed to provide this service, however people receive additional funding from the local authority for social hours. Activities and outings taking place include going to the pictures, shopping, eating out, doing jigsaws, boardgames, quizzes and word searches. Last inspection of the service highlighted the need for the home to make formal agreements regarding the arrangements and expenditure for those people who use the service and are receiving one to one social hours. The acting manager said that she had consulted with the local authority and come up with an agreement regarding expenditure. This agreement was available for inspection and had been signed by the activity co-ordinator. This agreement was looked at during the visit, Care Homes for Older People Page 19 of 32 Evidence: however it was not specific enough. The agreement advised that if the person receiving one to on hours wanted to go out for a meal then they would pay up to £4 for the activity co-ordinators meal and drink. Although the amount was specified it did not say how many times a week this was limited to. The office administrator said that she carefully observed the expenditure of the person and everything was receipted. The two other activity co-ordinators work Monday to Friday with one of which or occasionally both being on duty from nine in the morning until four in the afternoon. Activities taking place on a daily basis include, dominoes, musical bingo, arts and crafts and movie afternoons. People that use the service and staff celebrated valentines day. Dining tables were decorated with hearts and balloons and chocolates were put on the tables. The home hosted a pie and pea supper and quiz night on 10th March 2010. At the time of the inspection the home were busy planning for Easter. On 1 April 2010 the home were hosting a party and Easter bonnet parade, a singer/entertainer had been booked. The acting manager said that a trip to Dormans Museum was planned for early April 2010. People that use the service have expressed a wish to spend more time in the garden. The acting manager said that people that use the service are to grow flowers and vegetables from seed. One person spoken to during the visit said, I have been out in the garden and helping to clear up. I really enjoyed being outside and the fresh air. The mobile library bus visits on a monthly basis and leaves a plentiful supply of books. The acting manager said that there are regular visits from representatives of the local Church of England, Roman Catholic, Baptist and Methodist Churches. She said that the family of two people that use the service take them to church on a weekly basis. A hairdresser visits the home every Monday, Tuesday and Wednesday. Visitors are welcome at any time. There was a plentiful supply of visitors on both inspection days. A relative spoken to during the visit said, When I visit I always get a cup of tea. Food provided by the home is enjoyed by people that use the service. On the first day of the inspection the lunch time of people on the dementia unit was observed. The lunch time menu of the day was beef stroganoff or turkey casserole both were served with sprouts, turnip and mashed potato. People were observed to be enjoying the food Care Homes for Older People Page 20 of 32 Evidence: provided. Tables were nicely set with table cloths and napkins, salt and pepper pots were available on each dining table. Appropriate background music was playing in the dining room. Orange or blackcurrant juice was served with lunch. Staff were assisting those people that needed help. Mealtime was relaxed. One person had chosen to eat in their room and another person was observed to be enjoying their meal in the open space and quietness of the wide corridor area. The acting manager said that new menus were introduced at the beginning of March and are to be evaluated at the end of the month. People spoken to during the inspection and surveys received spoke highly of the food provided comments made included, The food is very good The food is excellent and plenty of it The staff are really good at knowing her likes and dislikes. They know that she doesnt like vegetables and will substitute one for another. Care Homes for Older People Page 21 of 32 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. People who use the service are confident that their complaints would be listened to, taken seriously and acted upon. Staff working at the home receive adult protection training which will help to ensure the safety of people living at the home. Evidence: The home has a complaints procedure, which details how to make a complaint, who to contact and timescales for action. This procedure also informs people of their rights to contact funding authorities. People spoken to during the visit said that they would feel comfortable and confident in raising any concern that they may have with the acting manager of the home. Information in the AQAA indicated that there have been thirteen complaints in the last twelve months. The home has an adult protection procedure, which advises staff of action to follow if abuse is suspected. The acting manager said that all but one of the staff working at the home has recently undertaken adult protection training. People living at the home said that they felt safe. Care Homes for Older People Page 22 of 32 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 standard of the environment is good providing people that live there with an attractive, homely and comfortable place to live. Evidence: Stainton Way is a purpose built care home, which is situated in the village of Stainton on the outskirts of Middlesbrough. The home is registered to provide care to a maximum number of sixty seven people, eighteen of who have dementia. The home is divided into four units. The ground floor of the home has two units named Daisy Chain and Memory Lane. Daisy Chain can accommodate a maximum number of seventeen older people. There are fifteen single bedrooms and one double bedroom all of which have ensuite toilet facilities. Communal space consists of a lounge and a dining room. Memory Lane can accommodate a maximum number of sixteen older people. All bedrooms are single and have ensuite toilet facilities. Communal space consists of a combined lounge diner. On the first floor of the home there is a further two units named Lavender and and Peace Haven. Care Homes for Older People Page 23 of 32 Evidence: Lavender can accommodate a maximum number of eighteen people with dementia. There are sixteen single bedrooms and one double bedroom all of which have ensuite toilet facilities. Communal space consists of a lounge and dining room. Peace Haven can accommodate maximum number of sixteen older people. All bedrooms are single and have ensuite toilet facilities. Communal space consists of a combined lounge diner. Toilet and bathing facilities are available on each unit. A passenger lift enables people to access the first floor. There is an enclosed garden area for people to use. There is a designated lounge on the ground floor of the home for people who wish to smoke. During the visit the Inspector walked around the home with the acting manager. The home is well maintained with good quality furniture. The acting manager said that people that lived on Peace Haven unit had expressed a wish for a pet. She said that two budgies had been purchased. A person that uses the service that was spoken to during the inspection said, I love the budgies and enjoy helping to look after them. Appropriate laundry facilities are in place. Staff said that there was a plentiful supply of protective clothing. On the day of the inspection the home was clean and odour free. Care Homes for Older People Page 24 of 32 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. 67 of staff working at the home have achieved a NVQ level 2 in Care, the acting manager needs to continue with her action plan and ensure that all staff are up to date with mandatory training to ensure that all staff have the appropriate skills and knowledge to carry out their work. Evidence: At the time of the inspection there were sixty one people who were using the service, fifteen people on Peace Haven, fifteen people on Memory Lane, fourteen people on Daisy Chain and seventeen people on Lavender. Duty rotas looked at informed that there are three care staff on duty during the day on each unit, one of which is a senior care assistant. On night duty for all units there are between five to six care staff on duty, two of which are senior carers. In addition to care staff on duty the acting manager works full time Monday to Friday. We received six surveys from people that use the service all of which stated that people receive the care and support needed and that staff were available when they needed them. In general people spoken to during the inspection thought that there were sufficient staff on duty, however one person said, Sometimes they are a bit thin Care Homes for Older People Page 25 of 32 Evidence: on the ground. The manager said that twenty seven out of forty care staff employed at the home have achieved a minimum qualification of NVQ level 2 in Care. Three files of newly recruited staff were looked at during the visit. Records were available to confirm that appropriate checks are carried out on staff before they start working at the home. Files looked at contained evidence that references and Criminal Record Bureau Checks had been obtained. The acting manager said that staff commence induction on receipt of a satisfactory POVA first check, however do not care for people that use the service until she has received a satisfactory Criminal Record Bureau check. Of the three files looked at during the visit two contained a full employment history, gaps in employment for one person had not been explored. Evidence was available to confirm that newly appointed staff receive induction. The acting manager said that induction training meets with that required by Skills for Care. She said that a training company visit the home for a full day over a five week period and complete the induction with staff. The acting manager said that since last inspection she had set up a rolling programme of mandatory training, which included moving and handling, first aid, health and safety, basic food hygiene, infection control and fire training. At the time of the inspection the acting manager said that twenty four out of sixty staff had completed all of the mandatory training. She said that majority of the sixty staff had attended moving and handling training and that all of the sixty staff will have received fire training and health and safety by the 16th April 2010. Staff working at the home are then to complete first aid, basic food hygiene and infection control training. The acting manager said that she had hoped that staff would have completed mandatory training sooner, however due to the Christmas holidays training had been delayed. Care Homes for Older People Page 26 of 32 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. People that use the service, relatives and staff are happy with the way the home is run. Quality assurance monitoring is taking place which ensures that the home is run in the best interests of people that use the service. Evidence: The acting manager started working at the home in October 2009. She has many years of experience of working in social care and has achieved an NVQ level 4 in Care and Management. The acting manager said that she is aware of the need to apply for registration with the Care Quality Commission. She said that he application is almost complete and will be applying for registration withing the next couple of weeks. Since last inspection a deputy manager has been appointed to assist in the day to day management of the home but to also provide care to people that use the service. Staff surveys received spoke positively of the acting manager and deputy manager, comments received included, Care Homes for Older People Page 27 of 32 Evidence: I am happy with the way things are running. I am pleased with our new managers who support us continually I think that the manager and new deputy manager have improved the way in which the home is run The management team know exactly what is needed and are taking the right steps People that use the service and relatives spoken to during the inspection said, The manager is approachable and listens and The manager and staff are lovely. Since last inspection steps have been taken to improve the quality assurance and quality monitoring of the home. Surveys were sent out to people that use the service and relatives in December 2009. The results of the survey are given to people that use the service and relatives and also displayed on the notice board in the corridor for everyone to see. The last inspection of the home highlighted that records of visits required under Regulation 26 were not available in the home. The purpose of the visit required under Regulation 26 is to inspect the premises, its record of events, complaints and speak to people and staff about the home. Records were available during this inspection to confirm that Regulation 26 visits had been carried out in December 2009 and January and February 2010. The home looks after small amounts of money belonging to some people that use the service. Appropriate records of transactions are kept. A sample of health and safety records were examined and found to be in order. Records were available to confirm that the gas boiler had been tested and serviced in November 2009 and the fire extinguishers in March 2010. The acting manager said that the fire alarm had been tested on March 11th 2010 and was awaiting certification. Records were available to confirm that weekly tests of the fire alarm system are taking place. Records were available to confirm that weekly testing of water temperatures takes place to ensure that they are within safe limits. Care Homes for Older People Page 28 of 32 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 9 13 Medication must be given as prescribed and a record made at the time that it is given. This will ensure that people receive their medications correctly and the treatment to their medical condition is not affected. 02/11/2009 2 9 13 A system must be in place to 01/12/2009 check expiry dates of medicines and to add a date of opening when necessary. This makes sure that medication is safe to administer. Care Homes for Older People Page 29 of 32 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 9 13 Medication must be given as 28/04/2010 prescribed and a record made at the time that it is given. This will help to ensure that people receive their medication. (PREVIOUS TIMESCALE FOR ACTION OF 02/11/2009 NOT MET) 2 9 13 A system must be in place to check expiry dates of medicines and to add a date of opening when necessary. This makes sure that medication is safe to administer. (PREVIOUS TIMESCALE FOR ACTION OF 01/12/2009 NOT MET) 28/04/2010 Care Homes for Older People Page 30 of 32 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 3 9 12 There must be an effective 28/04/2010 system to request, obtain and retain adequate supplies of medication for people that use the service. To ensure that treatment to their medical condition is not affected. 4 30 18 All staff working at the home 31/05/2010 must be up to date with mandatory training. This will help to ensure they have the appropriate knowledge and skills to carry out their work. 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 12 Formal agreements regarding the expenditure of those people that use the service and receive one to one social hours should be reviewed to safeguard people and staff. A full employment history of staff who are to work at the home should be obtained. Any gaps in employment should be explored. This will help to ensure the safety of people that use the service. The acting manager should apply for registration with the Care Quality Commission. 2 29 3 31 Care Homes for Older People Page 31 of 32 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. 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