Inspection on 15/08/06 for Stamford Nursing Centre

This inspection was carried out on 15th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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.

Other inspections for this house

Stamford Nursing Centre 03/08/10

Stamford Nursing Centre 13/01/10

Stamford Nursing Centre 14/07/08

Stamford Nursing Centre 09/07/07

Stamford Nursing Centre 13/02/06

Stamford Nursing Centre 04/07/05

Stamford Nursing Centre 08/12/04

Stamford Nursing Centre 02/07/04

Stamford Nursing Centre 26/02/04

Similar services:

Ashlong House

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Stamford Nursing Centre 21 Watermill Lane Edmonton London N18 1SU Lead Inspector Daniel Lim Key Unannounced Inspection 15th August 2006 10:30 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 Stamford Nursing Centre DS0000027823.V301089.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Stamford Nursing Centre DS0000027823.V301089.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stamford Nursing Centre Address 21 Watermill Lane Edmonton London N18 1SU 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) 020 8807 4111 020 8807 9479 ANS Homes Limited Care Home 90 Category(ies) of Dementia (33), Old age, not falling within any registration, with number other category (43), Physical disability (14) of places Stamford Nursing Centre DS0000027823.V301089.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The home will provide accommodation for up to 90 service users of either gender. 43 of the 90 service users will be over 65 years of age and require nursing care. To provide nursing care to 14 service users aged between 21 and 65 years of either gender. Care for these service users is to be provided in a `Young Adult Physically Disabled Unit` situated on the first floor of the home. The unit must have a team of staff specifically dedicated to it and this must be indicated on staff files and duty rosters. To provide a dedicated unit for people over the age of 50 years with a diagnosed dementia who also require nursing. Specifically to provide for 33 service users of either gender aged over 50 years of age. The unit being sited on the second floor of the existing building. The unit must have a team of staff specifically dedicated to it and this must be indicated on staff files and duty rostas. 13th February 2006 4. Date of last inspection Brief Description of the Service: Stamford Nursing Centre is a care home registered to provide nursing care for older adults and a specified number of younger adults with physical disabilities. The home was previously owned by ANS Homes Limited. BUPA purchased the home in October 2005. All the existing staff team were transferred under TUPE and so continue to work in the home. BUPA is a national organisation and provides similar care services across the UK. The home aims to provide a high quality of nursing care to adults convalescing after surgery or illness, older people who require nursing care, adults aged over fifty with physical disabilities and those requiring palliative care. The home is a large modern purpose built three storey building. The kitchen, laundry, reception and administrative offices are all located on the ground floor. The bedrooms are located on all three floors and all of them have en-suite facilities. Floors are connected by stairways and a passenger lift. Each floor has a lounge and separate dining room. There are two additional smaller lounges. Smokers use one of these lounges. Stamford Nursing Centre DS0000027823.V301089.R01.S.doc Version 5.2 Page 5 Fourteen younger adults are accommodated in a separate wing on the first floor. The home is located close to the North Middlesex Hospital and along the North Circular Road. It is within walking distance of shops; restaurants and transport facilities located the High Street in Edmonton. The fees charged by the home range from £474 - £915 per week. The provider must make information about the service available (including reports) to service users and other stakeholders. Stamford Nursing Centre DS0000027823.V301089.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out on 15 August 2006. A follow up visit was made the next day to view documents not available on the previous day. The inspection took a total of six hours to complete. The inspector found that the overall quality of care provided was adequate. During this inspection, the inspector was accompanied by manager (Ms Helen Moriarity) the newly appointed manager. The inspector was able to four residents and a relative. The feedback received from them indicated that they were generally satisfied with the care provided. The inspector attempted to interview a further two residents, but they were unable to comment on the services provided. Statutory records were examined. These included five residents’ case records, the maintenance records, accident records, complaints’ record and fire records of the home. The premises including residents’ bedrooms, treatment room, communal bathrooms, laundry, kitchen, gardens and lounges were inspected. Eight staff on duty were interviewed on a range of topics associated with their work. Staff records, including supervision records, evidence of CRB disclosures, references and training records were examined. Eight completed questionnaires were received from relatives / visitors to the home and one was received from a healthcare professional. These were all positive and indicated that the respondents were satisfied with the overall care provided. What the service does well: What has improved since the last inspection? Stamford Nursing Centre DS0000027823.V301089.R01.S.doc Version 5.2 Page 7 There was evidence that residents’ annual placement reviews had been carried out by the placing authorities to confirm the suitability of the home for residents concerned. The required references had been obtained for staff recruited. A new manager had been recruited. The required fire drills had been organised. 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. Stamford Nursing Centre DS0000027823.V301089.R01.S.doc Version 5.2 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 Stamford Nursing Centre DS0000027823.V301089.R01.S.doc Version 5.2 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): 1, 3, 6 The quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Satisfactory arrangements were in place to ensure that residents admitted there are appropriate. This ensured that the home can meet the needs of residents accommodated there. The statement of purpose and service user guide had not been updated to reflect management changes in the home. This is required. EVIDENCE: The four residents who were interviewed informed the inspector that they were well cared for and their care needs had been attended to. Stamford Nursing Centre DS0000027823.V301089.R01.S.doc Version 5.2 Page 10 Comments made by residents included, “staff treat me well”, “well cared for” and “staff are responsive”. A sample of five residents’ case records which was examined contained comprehensive assessments, including risk assessments and details of how residents’ needs had been met. The inspector observed that residents in the home were clean, appropriately dressed and appeared well cared for. The inspector was informed by the manager that the home had contracts to provide intermediate care. At the time of inspection, there were no residents in receipt of intermediate care. The statement of purpose and service user guide had not been updated to reflect management changes in the home. This was discussed with the manager and a requirement is made accordingly. Stamford Nursing Centre DS0000027823.V301089.R01.S.doc Version 5.2 Page 11 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, 8, 10 The quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. The arrangements for healthcare and personal care were generally satisfactory. This ensures that residents’ needs in these areas are met at the home. Improvements are however, required in care documentation. EVIDENCE: The five residents interviewed, indicated that their healthcare needs had been met. Comments made included, “I have seen the doctor” and “my medication has been given to me”. The sample of five case records examined were up to date and plans of care had been reviewed regularly. Records of medical and healthcare treatment including appointments with the doctor, dentist and chiropodist were documented. Stamford Nursing Centre DS0000027823.V301089.R01.S.doc Version 5.2 Page 12 The inspector noted that not all care plans examined addressed the mental, cultural and spiritual needs of residents. This is required to ensure that the holistic needs of residents are attended to. Residents were able to confirm that they had been given their medication. The home had a record of temperatures of the medication fridges and rooms where medication were stored. These were within the required temperature range. There was evidence that staff had been provided with training in the administration of medication. The company’s tissue viability nurse who was visiting the home was interviewed. She informed the inspector that training on pressure area care is being organised for staff. The monitoring chart of a resident with a pressure sore was examined. This had been appropriately filled in and signed. Nursing staff interviewed were knowledgeable regarding pressure area care. The fluid chart of a resident with a catheter on the ground floor was examined. This did not contain adequate information regarding the amount of fluid taken in by the resident and emptied from the catheter bag. This is necessary to provide the required information. This was brought to the attention of the nurse in charge who agreed to ensure that the information is recorded. Stamford Nursing Centre DS0000027823.V301089.R01.S.doc Version 5.2 Page 13 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, 14, 15 The quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. The daily life and routines of residents were on the whole, well organised. Improvements are however, required in the provision of meals. EVIDENCE: The home had a weekly programme of activities. These included music sessions, bingo, exercise and indoor games. Residents interviewed were generally happy with the activities provided. The bedrooms inspected had been personalised by residents with their personal items such as photos and souvenirs. The kitchen was clean and well equipped. The menu examined was varied and balanced. There was a choice of main dish provided. A record of daily fridge and freezer temperatures had been kept. These were satisfactory. There was evidence that staff had been provided with food hygiene training. Resident interviewed were generally satisfied with the meals provided. Stamford Nursing Centre DS0000027823.V301089.R01.S.doc Version 5.2 Page 14 The inspector noted that two of the racks for drying crockery were left on the floor. For hygiene reasons, these must not be left on the floor. Two of the residents (on the ground floor) interviewed stated that they were not offered a choice of main dish at meal times even though the menu indicated that an alternative main dish was available. A requirement is therefore made for the registered person to ensure that residents are made aware that such choice is available. Stamford Nursing Centre DS0000027823.V301089.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 The quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The arrangements for responding to complaints and for adult protection were satisfactory. This ensures that residents (and their representatives) are listened to and protected from abuse and harm. EVIDENCE: The complaints record was examined. There was documented evidence that complaints recorded had been promptly responded to. Staff interviewed were found to be knowledgeable regarding adult protection procedures. The four residents who were interviewed stated that they had been treated with respect. Stamford Nursing Centre DS0000027823.V301089.R01.S.doc Version 5.2 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, 23, 24, 25, 26 The quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The home was clean, well equipped and well maintained. This ensures that residents live in a pleasant environment. EVIDENCE: The premises were clean and on the whole, well maintained. The gardens were attractive. The communal areas were well furnished. Bedrooms inspected had been personalised by residents. Residents interviewed stated that they were happy with their accommodation. There was documented evidence that safety inspections had been carried out on the hoists, portable appliances, gas and electrical installations. Stamford Nursing Centre DS0000027823.V301089.R01.S.doc Version 5.2 Page 17 Bedlinen in bedrooms were inspected and noted to be clean. Stamford Nursing Centre DS0000027823.V301089.R01.S.doc Version 5.2 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, 30 The quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. The staffing arrangements were on the whole, satisfactory. This ensures that residents are supported by a competent and effective staff team. Further improvements are however required in the staffing arrangements. EVIDENCE: Residents who were interviewed indicated that staff were well mannered and had treated them with respect and dignity. The duty rota was examined. It indicated that in addition to the home manager, there was normally at least - 22 staff (including 6 nurses) during the morning shift - 17 staff (including 6 nurses) during the afternoon and evening shifts and - 12 staff (inclding 4 nurses) on waking duty during the night shifts. Staff who were on duty were interviewed on a range of topics associated with their work (such as health and safety, adult protection, fire procedures and the healthcare of residents). They were noted to be knowledgeable regarding their roles and responsibilities. Stamford Nursing Centre DS0000027823.V301089.R01.S.doc Version 5.2 Page 19 There was documented evidence that some staff had been provided with essential training. This included food hygiene, dementia care, pressure area care, and health and safety. The inspector noted that not all staff had received training in adult protection and the care of residents with challenging behaviour. A requirement is made accordingly. The staff records examined indicated that the required recruitment standards and procedures (including obtaining satisfactory CRB disclosures and references) had been followed. Some staff interviewed, informed the inspector that there were occasions (during the mornings and around meal times) when the staffing levels were inadequate. They explained that this was due to some residents requiring a high level of care. In view of the concerns expressed, the registered person must review staffing levels at the home with staff and residents / their representatives to ensure that the needs of residents are met during the day and night. A report of this review together with any action taken or planned must be forwarded to CSCI. Some staff informed the inspector that they had been subject to abuse and harassment from certain residents and relatives. This was brought to the attention of the manager. To ensure that staff are not subject to such treatment, the registered person is required to have an action plan for safeguarding staff. Stamford Nursing Centre DS0000027823.V301089.R01.S.doc Version 5.2 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, 35, 38 The quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Systems were in place to protect the interests and welfare of residents and staff. However, further improvements in health and safety are needed. EVIDENCE: The manager was appointed in July 2006. She informed the manager that she was a qualified nurse and had management qualifications. She stated that she was in the process of applying to be a registered manager with CSCI. Stamford Nursing Centre DS0000027823.V301089.R01.S.doc Version 5.2 Page 21 Compliments had been received from residents and relatives and these were available for inspection. Window restrictors were engaged in all rooms inspected. The electrical installations had been inspected by a qualified professional. A record of weekly health & safety checks had been maintained by the home. The fire log book was examined. The weekly fire alarm tests had been documented. Fire drills and fire training had been organised. The fire risk assessment was not available for inspection. The home is required to have a fire risk assessment. This must have been carried out or updated within the past twelve months. The home was also inspected by the LFEPA on 16 August 2006. Requirements were subsequently made for improving fire safety. These included addition smoke detectors and automatic door guards. A requirement is therefore made for these to be attended to. A current certificate of insurance was displayed. The financial records of residents were examined. These were well maintained and receipts were available for items / services purchased for residents. Stamford Nursing Centre DS0000027823.V301089.R01.S.doc Version 5.2 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 2 X 3 X x N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 2 Stamford Nursing Centre DS0000027823.V301089.R01.S.doc Version 5.2 Page 23 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 OP1 Regulation 6(a)(b) Requirement The registered person must ensure that the statement of purpose and service users guide are updated. This is requirement is restated. The previous unmet timescale was 13/04/06 The registered person must provide comprehensive care plans which address the holistic needs of service users (this must include mental, social, cultural and spiritual needs). The registered person must ensure that the fluid charts are filled in. The registered person must ensure that residents are aware that they can have a choice of main dish at meal times. Timescale for action 13/11/06 2 OP7 13(1) 14(1) 15(1) 20/10/06 3 OP7 12(1) 20/09/06 4 OP15 16(2)(i) 13/10/06 5 6 OP15 OP27 13(4)(c) The registered person must ensure that racks used for drying 13/10/06 cutlery are not placed on the floor in the kitchen. The registered person must review staffing levels (with staff and residents) at the home to DS0000027823.V301089.R01.S.doc 18(1)(a) 13/11/06 Stamford Nursing Centre Version 5.2 Page 24 ensure that the needs of residents are met during the day and night. A report following this review must be forwarded to the inspector. 7 OP30 18(1)(c) The registered person must ensure that all staff undertake training in : - the management of adults with challenging behaviour and - adult protection. The registered person must provide CSCI with an action plan for ensuring that staff are not subject to abuse from residents and their representatives. The registered person must ensure that the home’ has an up to date fire risk assessment. The registered person must ensure that requirements made by the LFEPA on 16 August 2006 are complied with. 01/12/06 8 OP27 13(4)(c ) 18(2) 21(1)(2) 23(4) 23(4) 01/11/06 9 10 OP38 OP38 13/10/06 01/11/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Stamford Nursing Centre DS0000027823.V301089.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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 Stamford Nursing Centre DS0000027823.V301089.R01.S.doc Version 5.2 Page 26 - 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!