CARE HOMES FOR OLDER PEOPLE
Stallingborough Lodge Care Home Station Road Stallingborough Grimsby North East Lincs DN37 8AJ Lead Inspector
Theresa Bryson Unannounced Inspection 09:30 7th February 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 Stallingborough Lodge Care Home DS0000002804.V277911.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. Stallingborough Lodge Care Home DS0000002804.V277911.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Stallingborough Lodge Care Home Address Station Road Stallingborough Grimsby North East Lincs DN37 8AJ 01472 280210 01472 280210 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) Shire Care (Nursing & Residential Homes) Limited Mrs Tracy Jayne Tindall Care Home 44 Category(ies) of Old age, not falling within any other category registration, with number (44), Physical disability (20), Physical disability of places over 65 years of age (20) Stallingborough Lodge Care Home DS0000002804.V277911.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 12th August 2005 Brief Description of the Service: Stallingborough Lodge Care Home is a purpose built establishment that is registered for 44 service users with problems of old age, physical disability over 65 years of age and under and also has a nursing registration for service users. The accommodation is set on the outskirts of a small village, near the larger town of Grimsby. It has some local amenities for service users to visit and the home is near a regular bus route into the town. The home is set in enclosed gardens, which are all accessible to wheelchair users. The home is part of a small group of homes, Shire Care Ltd, and is supported by a head office team and a visiting Director of Operations. It has the benefit of also having service users visiting from other local homes. The home has several groups of staff employed including;- professionally trained nurses, care assistants, domestic and laundry staff, kitchen staff, administrator, handyman and activities organiser. Stallingborough Lodge Care Home DS0000002804.V277911.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place over one day in February 2006 and was unannounced. Records were seen to ensure that staff employed by the Company were safe and trained to do their jobs. Paperwork was also seen to ensure the building was safe to live and work in. A selection of staff were spoken to including trained nurses, care assistants and kitchen staff. The Director of Operations for the Company was also spoken to during the day. The manager, Mrs.T.Tindall, accompanied the inspector throughout the visit. What the service does well:
Staff employed at the home were friendly and appeared to know a lot about the people who lived there. Paperwork completed by senior staff prior to an admission was well written and gave staff a good overview of a person’s needs. Staff were observed assisting people who live there in a variety of tasks, in a dignified and respectful manner. The home provides a variety of activities to enable the people who live there to fulfil their social and cultural needs. The food was prepared in a clean and tidy kitchen and a varied 4-weekly menu plan was available and the home could also provide for special diets. The home was clean and tidy and there was evidence that the owner was maintaining the building to a good standard and planning redecoration and renewal of equipment. As this will make a pleasant and safe environment for people to live in. The manager ensures that all personal allowance money records are well maintained and accessed on a need to know basis only. Stallingborough Lodge Care Home DS0000002804.V277911.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection?
The care plans of individual people living in the home had shown a marked improvement since the last inspection. The manager uses an audit tool to ensure staff are keeping the documentation up to date and each person’s needs are evaluated at least monthly. This will ensure all needs are being met. Staff had received training in the safe administration of drugs and the records kept appeared to be correct. This will ensure people are not put at risk from wrong drugs being given. The policy for the care of the dying person has been revised and all staff instructed to read the up date. All senior staff have also undertaken courses in palliative care and death awareness and the use of specialist equipment to ensure each person has a peaceful end to their lives. The required documentation to the local CSCO office after a person’s death has improved in the detail it contains. The staff have received training in the protection of vulnerable adults and all polices have been reviewed. This will ensure that the people living in the home are safe from the risk of abuse and staff are aware of how to refer a situation to the correct organisations. Staffing levels on the care staff rota have improved and staff instructed not to let the numbers fall below those calculated. The manager is keeping a watchful brief on the rotas to ensure there is adequate staff on duty to meet the needs of the people. The recruitment policies have been tightened up and all files seen showed that safety checks had been made on all current staff employed to ensure they are safe to work with the people who live in the home. The training records showed a marked improvement and also detailed training, which had actually taken place by different staff members. This included all the mandatory training updates and some service specific training to ensure staff were equipped with the latest knowledge to enhance the delivery of practical care. The quality assurance audits put in place by the Company had improved and showed that all staff and the Company were ensuring the delivery of care to the people who live there was being checked and that the building was safe and comfortable to live and work in. The policy manuals had been revised and were now presented in an easier format to understand and read. The most important subjects had already been
Stallingborough Lodge Care Home DS0000002804.V277911.R01.S.doc Version 5.1 Page 7 transcribed into an Eastern European language as the home was recruiting from this part of the European Union as well as locally. This will make it easier for staff to follow procedures and ensure they are making a safe environment in which to live and work and that all needs of the people who live there are being met. 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. Stallingborough Lodge Care Home DS0000002804.V277911.R01.S.doc Version 5.1 Page 8 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 Stallingborough Lodge Care Home DS0000002804.V277911.R01.S.doc Version 5.1 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 A comprehensive document is used to assess the needs of prospective service users prior to admission. EVIDENCE: The manager, Director of Operations or other manager’s assisting the home from the Company complete the pre-admission documentation. The home uses a comprehensive tool to ensure all the needs of prospective service users are identified prior to admission. This will assist them to settle in, as staff will have a full picture of their needs. The records seen showed this tool to be in place and had been signed by the service users, their next of kin and a staff member. Stallingborough Lodge Care Home DS0000002804.V277911.R01.S.doc Version 5.1 Page 10 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 and 11. The documentation on service users showed that the home was keeping up to date records of the delivery of care to them and staff were seen to assist service users in a variety of tasks in a dignified and sympathetic way. EVIDENCE: The documentation for the service users had greatly improved since the last visit. 3 care plans were tracked in depth. The records showed the delivery of care to each person, when it had taken place and when it had been evaluated. Details of specialist care recorded visits by other health care professionals. The daily report sheets appeared to be accurately written, but were scant in places. This was identified to the manager so she could identify staff members who may need more instruction. The manager now has an audit tool to identify outstanding issues with each document and this had been placed at the beginning of each folder for the key workers to correct. All training schedules had progressed well since the last inspection. The staff
Stallingborough Lodge Care Home DS0000002804.V277911.R01.S.doc Version 5.1 Page 11 records showed a variety of training had taken place and a plan for the whole home had been put together by the manager. The following had taken place; - syringe driver, palliative care, safe handling of medicines, PEG feeding and some general care plan training. Staff were seen to assist service users with a variety of tasks and this was done in a dignified and sympathetic manner. Service users expressed how caring the staff are to their needs. The care of the dying policy had been completely reviewed and was on display in the home. Each staff member has been instructed to read this and raise questions if necessary. The Regulation 37 notices had much improved in the detail recorded and were now sent promptly to the local CSCI office. Stallingborough Lodge Care Home DS0000002804.V277911.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): 12,13 and 15. A varied programme of activities is provided in the home to ensure service users are able to satisfy their social and cultural needs. EVIDENCE: The social care profiles were seen in the care plans tracked, plus details of actual activities which had taken place in another file. Each service user had their own plan, which detailed dates they had taken part in events, what that event was and their level of participation. This included events such as singers, disco, bingo, exercises, outings, quizzes and special events. The activities organiser, who works 16 hours each week, produces a what’s on guide for the forthcoming months. There were also posters around the home and ample evidence of books, games and craft materials. A senior cook escorted the inspector around the kitchen and storage areas. The environmental health officer had visited in January 2006 and the manager was having work completed as suggested by them in their report. All policies were in place and were in 25 different sections. Stallingborough Lodge Care Home DS0000002804.V277911.R01.S.doc Version 5.1 Page 13 Nutritional assessments were seen in individual care plans, but the kitchen staff were able to indicate the special needs of some service users. There were also information leaflets and dieticians’ advice sheets on display in the kitchen area. The cook spoken to was able to give a good précis of individuals needs. The kitchen works on a 4-week cycle of menus and plans the ordering well in advance. The storerooms were neat and clean and there was evidence of stock rotation. The cook explained the suppliers used and how the ordering takes place and stated she felt they provided a quality service. There was evidence that regular temperature control is kept and there appeared a good supply of kitchen pots and pans and utensils and crockery and cutlery for service users. The dining room was light and airy and staff were seen to assist service users in a dignified manner. Stallingborough Lodge Care Home DS0000002804.V277911.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 and 18. The protection of vulnerable adults polices ensures service users are protected from abuse. A more robust system needs to be in place to record complaints and ensure staff are aware of the policy. EVIDENCE: All staff had now undergone protection of vulnerable adults training to ensure they are aware of the method to refer cases should they see any form of abuse taking place. The policy is written in English and another language, as the home recruits Eastern European nurses. The manager is also providing aggression and stress training for all staff on her yearly planner. The complaints policy has been reviewed and was on display in the home. The manager stated she does not keep a log of complaints so this could not be evidence fully at this inspection. She had also been asked on a previous visit to ensure that all staff have received adequate training in dealing with complaints and this has not taken place. Stallingborough Lodge Care Home DS0000002804.V277911.R01.S.doc Version 5.1 Page 15 The home has recently been subject to a protection of vulnerable adults investigation and the final report has yet to be issued. Most requirements from the investigation which had been breached of Care Standards Regulations had however been met. Stallingborough Lodge Care Home DS0000002804.V277911.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 and 26. The home was clean and tidy and showed evidence that the Company was maintaining the building and ensuring it was safe and clean to live and work in. EVIDENCE: The manager accompanied the inspector on a tour of the home where all communal areas, toilets and bathrooms were seen and a selection of service users rooms. The home was clean and tidy and showed evidence that some redecoration had taken place. There was ample evidence that service users were able to personalize their own rooms, which they stated enabled them to settle in to the home quicker. The monthly checklist is now in place to ensure the home is being safely maintained. The business plan was given to the inspector and showed the home is forward planning to enable the building to remain safe and be a homely environment in which to live. The yearly redecoration plan was also
Stallingborough Lodge Care Home DS0000002804.V277911.R01.S.doc Version 5.1 Page 17 submitted and identified specific areas targeted for renewal and redecoration for the next year. Stallingborough Lodge Care Home DS0000002804.V277911.R01.S.doc Version 5.1 Page 18 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30. The Company has a robust system in place for recruitment and retention of staff and staff are trained to enable them to work safely with the service users. EVIDENCE: The rota system for care staff had improved and the Company was ensuring that adequate staff were on duty at all times to meet the needs of service users. The manager needs to ensure that this remains so and staff are instructed to maintain the staff levels. At the time of the inspection the home had vacancies for 2 fulltime care assistants. These hours were being fulfilled by local agency staff, who appeared to supply the same named staff as much as they were able to ensure continuity to service users. The home could produce evidence to show how many staff had completed their NVQ level 2 awards and which staff were progressing with the awards. These numbers have increased and show a marked improvement in staff’s motivation to gaining a qualification to enable them to enhance their practical skills. The organisation structure for the Company was seen and staff have a clear idea of delegated powers and how to use this system for disciplinary and complaint policies to be implemented. 3 staff files were checked in depth and all found to have the correct information to ensure they are safe to work with service users. The home has a robust recruitment policy to ensure staff are safe to work with
Stallingborough Lodge Care Home DS0000002804.V277911.R01.S.doc Version 5.1 Page 19 service users. The training records had much improved and there had also been a lot of training, which had actually taken place, which was confirmed with certificates seen and staff spoken to. 7 plans were looked at in depth. These showed what had taken place and what was planned for the future. All mandatory training had taken place as well as some service specific training. Including; Parkinson’s disease, arthritis, strokes, health and safety, infection control, health awareness, dementia, first aid and safe administration of medicines. This was by a variety of methods; - in house, courses and study days attended and distance learning. This enables staff to understand the needs of service users and have up to date information on each person to enhance the delivery of practical care. Stallingborough Lodge Care Home DS0000002804.V277911.R01.S.doc Version 5.1 Page 20 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,34,35,36,37 and 38. The home has a robust system in place to ensure the quality of care is maintained and the building is safe to work and live in. Except closer monitoring of water temperatures are required to ensure service users are not put at risk. EVIDENCE: The manager has completed her Registered Manager’s Award and now stated she feels more in control of the management of the home and is supported by the Director of the Company. She completes a weekly report and has developed her own training plan. This will ensure she has control of the whole building and any problems can be identified at an early stage so service users can feel safe living at the home. The quality assurance programme has been better developed and a full manual is now in place. Audits appeared to be more concisely completed and action
Stallingborough Lodge Care Home DS0000002804.V277911.R01.S.doc Version 5.1 Page 21 plans formed if necessary. The Regulation 26 notices are being received on a more regular basis by the local CSCI office and identify who has visited the home and what they have audited. This ensures the owner has an overview of the needs of the home and can address them through a business plan and meetings with senior staff. The personal allowance records of service users were seen and 3 checked in depth. The records appeared to be correct and are accessed on a need to know basis only. The manager stated there were no bad debtors at the time of the inspection. The “comfort fund”, to enable staff to buy in social services for service users had a healthy balance and all records appeared to be correct. These are checked randomly by other Company personal and their findings recorded. A revised supervision policy is in place and each staff member has signed an agreement to state they understand this policy. The records had much improved and showed outcomes to sessions and were open for inspection. Staff stated sessions were helping them to plan training and see any shortcomings in their job role. The policy manuals had been completely revised and now had been set out in a more easily understood format. They were also being transcribed in an Eastern European language as the home was recruiting from this part of the European Union. The most important ones to assist staff in the delivery of care to service users had been transcribed first. The manager was able to produce evidence to show that the home was being adequately maintained and was safe to live and work in. All certificates were seen. The water temperatures in some water outlets were a little erratic and the manager was asked to monitor them a kittle more closely to ensure service users were safe. Stallingborough Lodge Care Home DS0000002804.V277911.R01.S.doc Version 5.1 Page 22 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 X X X X X X X STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 3 3 3 3 2 Stallingborough Lodge Care Home DS0000002804.V277911.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 OP16 Regulation 22(3) Requirement The registered person must ensure that all staff are aware of the reporting procedures for complaints and these are passed on to the appropriate person. (Previous time scales of 30/12/05 not met). The registered person must ensure that all water outlet temperatures are recorded on a regular basis. Timescale for action 30/03/06 2 OP38 23.2.c. 30/03/06 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 Refer to Standard OP28 Good Practice Recommendations The manager should ensure that 50 of staff have obtained their NVQ level 2 or above by the specified time scale. Stallingborough Lodge Care Home DS0000002804.V277911.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Hessle Area Office First Floor 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
© This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Stallingborough Lodge Care Home DS0000002804.V277911.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
