CARE HOMES FOR OLDER PEOPLE
Stanbeck Stainburn Road Workington Cumbria CA14 4EA Lead Inspector
Nancy Saich Unannounced Inspection 17th January 2006 09:30 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 Stanbeck DS0000022615.V271302.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. Stanbeck DS0000022615.V271302.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Stanbeck Address Stainburn Road Workington Cumbria CA14 4EA 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) 01900 603611 Mrs Audrey Robinson Mrs Audrey Robinson Care Home 13 Category(ies) of Learning disability over 65 years of age (1), Old registration, with number age, not falling within any other category (13) of places Stanbeck DS0000022615.V271302.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection The home is registered for a maximum of 13 service users to include: up to 13 service users in the category OP (older people) One named person in the category of learning disability over 65 years of age LD(E) 9th August 2005 Date of last inspection Brief Description of the Service: Stanbeck is a modern purpose built house in a residential area of Workington. It is situated approximately half a mile from the centre of town and is on a bus route. Parking is at the front of the property. The home has a large garden and a patio area. Accommodation is on two floors with a passenger lift. Bedrooms are single occupancy with ensuite toilet facilities. There is a dining room on the first floor that leads out to the patio. The lounge is on the ground floor with access to the garden. The home is primarily for older people but may also take people in other categories as detailed above. The home is owned and managed by Mrs Audrey Robinson and her two daughters help her in this. Together they make up the management team. Mrs Robinson also runs a bed and breakfast business on the same site. Stanbeck DS0000022615.V271302.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection that lasted for over six hours. The lead inspector, Nancy Saich met with all of the residents, the staff on duty, visitors and the management team. The inspector toured all areas of the home and checked on documents that backed up what was said and what she saw. What the service does well: What has improved since the last inspection?
The staff team have improved the way they deliver personal care and residents said they get plenty of helping with their appearance and their personal hygiene. The home has been trying to offer the residents more activities and outings. The inspector felt that this was an improvement and hoped the staff would keep asking and encouraging residents to be more involved. One or two people were more involved in doing little jobs around the home Stanbeck DS0000022615.V271302.R01.S.doc Version 5.1 Page 6 The provider had made sure that the carpet in the main hallway upstairs had been stretched and repaired. Some good quality new bedroom furniture had been bought for the home. The provider has improved the way she checks that new staff are the right people to working in the home and caring for vulnerable people. The home had improved the content of the notes they keep about how the staff are working with residents. 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. Stanbeck DS0000022615.V271302.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Stanbeck DS0000022615.V271302.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 The home is good at making sure they can care for a new person before they admit them to the home. EVIDENCE: The inspector spoke to a number of new residents who said they had been visited before they came in. They also said that they were given the chance to visit the home before they decided to come in. Residents’ files showed that staff asked them about their needs. One or two people had completed questionnaires about this and thought it was a good way of making sure staff knew what they wanted. Stanbeck DS0000022615.V271302.R01.S.doc Version 5.1 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 Residents care needs would be improved if staff record properly when things change or don’t go to plan. EVIDENCE: Some of the written plans that help residents tell staff what they need help with and what they can do for themselves were detailed and had good instructions for staff to follow. One or two plans didn’t cover all of the residents needs. One resident who was being closely monitored didn’t have anything written into her plan about the reasons for this or the way it needed to be approached. Another person who had been in the home for more than six weeks didn’t have a plan other than the one the social worker had written before she came in. Residents did look well cared for and they were all well dressed. They said they were given good support with their appearance and their personal hygiene. Residents said that they saw the doctor or nurse when needed and were supported in any health care problems. The inspector checked on one person’s health care needs very thoroughly and there was evidence to show that the advice of the doctor and the district nurse were being followed properly.
Stanbeck DS0000022615.V271302.R01.S.doc Version 5.1 Page 10 The medicines kept on behalf of residents were checked and these were being looked after fairly well. There were some minor things that could be improved on and the inspector thought the staff team needed to be reminded of the procedures. Stanbeck DS0000022615.V271302.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 15 The provider had made some improvements to these issues and was encouraging residents to become more involved with activities. EVIDENCE: In general residents said that things in the home were running as they wished. They said that they could get up and go to bed as they wanted and could choose to spend time alone in their rooms. One or two people said they wanted to do more but couldn’t say what they wanted to do. Staff said that they had been trying to offer more activities and outings but that not all residents had taken these offers up. The inspector tried to encourage staff and residents to continue to work on this together. There was some evidence of parties and activities having happened and residents really enjoyed these things. The provider needs to keep on trying to find out what the residents might like to do. Residents said the food provided was very good, “tasty”, “good home cooking”. The inspector sat with the residents at lunchtime and they had two choices at both courses. The kitchen had good supplies of food available. Stanbeck DS0000022615.V271302.R01.S.doc Version 5.1 Page 12 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 Residents in this home felt that they could voice any concerns or complaints and that these would be dealt with promptly. EVIDENCE: Residents said they knew how to complain and they felt that the management team would listen to any of their concerns or complaints and deal with them in a sensible way. Relatives said they wouldn’t have a problem talking to management. The inspector felt that the residents could find a way of complaining to the management or to outside agencies. No one had any major issues during the inspection. Stanbeck DS0000022615.V271302.R01.S.doc Version 5.1 Page 13 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): 19,26 The home is generally comfortable for residents but the provider must make sure she helps residents to maintain their privacy in their own rooms. EVIDENCE: One resident who was spending a lot of time in their room was being monitored by the use of a closed circuit TV camera with the monitor being kept in the kitchen. The inspector was told that this was being done so that the resident could have assistance whenever needed. The inspector judged that the use of CCTV was taking away the resident’s right to privacy and was less than dignified. She also thought that the resident wasn’t able to make an informed choice about the use of this equipment. There was no risk assessment or care plan showing why the provider had decided to use this way of keeping the resident safe. The inspector told the management team that they had to find a more appropriate way of helping this person and should make this change bearing in mind the safety of the resident. Stanbeck DS0000022615.V271302.R01.S.doc Version 5.1 Page 14 Maintenance records showed that the provider looks after the fabric of the building well. The home is modern and purpose built and meets all the needs of people with poor mobility. Residents have single rooms with toilet and wash hand basin ensuite. There is a large sitting room on the ground floor that residents were not using as much as they had before. Upstairs there was a dining room and several people spent time there in the afternoon. Most people enjoyed spending time in their own bedrooms. Residents were happy with the way the home was decorated and furnished. The inspector noted that some new furniture had been purchased and that carpets had been stretched and repaired. The home was clean and pleasant in all areas if a little untidy in some places. Residents weren’t concerned about this and said they felt comfortable in the home. Stanbeck DS0000022615.V271302.R01.S.doc Version 5.1 Page 15 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): 29,30 Staff are recruited and trained in a way that makes sure residents are safe in the care of staff. EVIDENCE: The inspector checked the records of one new member of staff. The file showed that all the appropriate checks had been made to prove that this person was the right sort of person to work with vulnerable older people. Residents spoke warmly about this member of staff and though the right person had been given the job. Another file was checked and this was also in order. The management team discussed the training given to all the staff. The inspector saw certificates on file showing that staff had attended training courses on things that they would use in their work. Residents and staff thought that the team were properly trained to be able to meet residents’ needs. Stanbeck DS0000022615.V271302.R01.S.doc Version 5.1 Page 16 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36, 38 The home has satisfactory management systems in place that allow residents to live in the home without worrying about how things are managed. EVIDENCE: The home is owned and managed by Mrs Audrey Robinson. She has managed the home for a number of years. She has a lot of experience of running the home and in caring for older people. Her two daughters help her in this task and together form the management team. All three of these people have a qualification that helps them to manage a residential home. Staff and residents said they had confidence in the proprietor and her daughters. The home has a quality assurance system. Residents and visitors said they were asked their opinions on a regular basis. The management team just need to draw up their report for the year. They said they would send this to the inspector as soon as this was possible.
Stanbeck DS0000022615.V271302.R01.S.doc Version 5.1 Page 17 Most of the residents manage their own money or have help from family or solicitors. The provider helps one person to manage her money. The inspector discussed how this was managed and learnt that this was overseen by Social Services. The inspector checked that staff had private time when they could discuss their work with management. This formal, written ‘supervision’ was more detailed than it had been before. The inspector checked the fire logbook and saw the maintenance records. The health and safety issues in the home were being dealt with appropriately. Residents felt that the staff team were good at dealing with these things. Stanbeck DS0000022615.V271302.R01.S.doc Version 5.1 Page 18 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 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 X 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 2 X X X X X X 3 STAFFING Standard No Score 27 X 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 x 3 3 X 3 Stanbeck DS0000022615.V271302.R01.S.doc Version 5.1 Page 19 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. 2. Standard OP7 OP19 Regulation 15(1) 23 (2) (n) Requirement All residents must have up to date care plans. Closed circuit television must not be used in residents rooms Timescale for action 01/03/05 01/03/05 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 OP9 Good Practice Recommendations It is recommended that the provider reminds all of the staff of the correct procedures when recording ‘refused’ medication. Stanbeck DS0000022615.V271302.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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