CARE HOMES FOR OLDER PEOPLE
Stanbeck Stainburn Road Workington Cumbria CA14 4EA Lead Inspector
Nancy Saich Unannounced Inspection 23rd May 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.V289336.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.V289336.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.V289336.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) 17th January 2006 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. Information about the home can be obtained from the provider. The home does not have a website or an e-mail address. The home charges £368 per week. Stanbeck DS0000022615.V289336.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. Nancy Saich, the lead inspector for the home, conducted this ‘key inspection’. She wrote to the provider some weeks before the inspection and asked for information about the home. This was gathered on the day of the visit. The inspector had no questionnaires returned. A site visit was held on the date above where the inspector toured the building, met all the residents, spoke to staff and saw documents and files that backed up what she saw and what she observed. What the service does well:
The home makes sure that they only take new residents who they know they can care for and who will fit in with the rest of the group. The staff are good at supporting residents to get the right kind of health and personal care. Medicines held on behalf of residents were being looked after properly. The residents were happy with the activities and entertainments provided. They said they preferred a quiet life and enjoyed living in a small family run home. All of the residents said they enjoyed the food provided. The inspector joined them for a very nicely prepared lunch which all of the residents enjoyed. The people who live in this home looked well and were well groomed and relaxed in the place they thought of as home. Residents had no major complaints and said they could make their opinions known to the staff or the provider ‘without it being held against us’. The residents were very open and able to talk about how things were in the home. They said that staff were “grand” and that no one behaved badly towards them. They were confident that if something were wrong Mrs Robinson would deal with it quickly. The home is managed in a simple but efficient way and the residents’ needs are central in the way things are done. Things like routine maintenance and safety checks are being done properly. Residents felt safe and relaxed knowing that Mrs Robinson and her daughters were running the home. Stanbeck DS0000022615.V289336.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Stanbeck DS0000022615.V289336.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.V289336.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home is good at only admitting new residents that they can care for and who will fit in with the existing residents EVIDENCE: There had been no new admissions to the home since the last inspection but residents spoke about how they came to the home. They were happy with the way this had happened. Their files showed that they had been visited before they came into the home and had a chance to look around before they came in. The mix of residents was good and everyone lived quite happily together. Stanbeck DS0000022615.V289336.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): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home provides good levels of care to all the residents. EVIDENCE: The inspector read all of the written plans that help staff to deliver good standards of care to the residents. These were up to date and very detailed. Residents were aware of their plans and had agreed to the contents of these written plans. Residents looked well and said that they could see the Doctor or nurse when they needed and that this helped them to stay as well as possible. A number of people said it was the good food provided that kept them well. There was evidence in the files to show that residents got good health care. The inspector checked on the medicines kept on behalf of the residents. These were all in order. The files explained what each medicine was for and these had been checked out by the doctor to make sure the residents were getting the right medicines. Staff understood the system and some people had completed a certificate on safe handling of medication.
Stanbeck DS0000022615.V289336.R01.S.doc Version 5.1 Page 10 The inspector saw staff treating people in a respectful way. They knocked on doors and asked residents what they wanted in an easy but polite way. She saw people being gently reminded or persuaded. Residents said that the staff were “grand”. There was a lot of praise for individuals on the team and the residents valued their different skills and approaches. Stanbeck DS0000022615.V289336.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, 13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home is good at giving the residents the kind of lifestyle they want. EVIDENCE: Residents said that they could spend their time much as they wanted. People discussed their preferred times of getting up and going to bed. They said that the staff respected their choices. One person in the home likes to spend all their time in their room, as they are a very private person. The visitors’ book shows that there is a good level of visitors to the home. Residents said their friends and family were made very welcome in the home. They also said that the local priest came to the home to give them spiritual support. Residents have their own TVs in their rooms and one person has a pet. The residents had newspapers delivered during the visit to the home. One person goes out to a day centre once per week. They had enjoyed an entertainer who came to the home and liked to have celebrations for birthdays or other important events. Staff said they offered crafts, games and entertainments. Residents said they were not very interested in activities but ‘gave them a try’. One or two people were interested in having a day trip out. One person had been out to the local
Stanbeck DS0000022615.V289336.R01.S.doc Version 5.1 Page 12 bingo and other people had gone out shopping. The inspector judged that the staff were working well on trying to find things for residents to do. The inspector joined the residents for a well-prepared lunch that included a fresh salad and fruit. Everyone said they had plenty of choice and were happy with the way the meals were presented. Stanbeck DS0000022615.V289336.R01.S.doc Version 5.1 Page 13 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home is good at listening to residents and preventing them from being abused. EVIDENCE: There had been no formal complaints sent to the inspector and no complaints made to the home. The residents said they had nothing to complain about. They did say that staff listened to their minor concerns and the provider said that people did have day-to-day issues but these were dealt with in the normal course of events. Residents said they trusted the provider to deal with any major concerns and everyone had access to help and support to do this. Residents were asked about matters relating to abuse. They said that there was nothing of concern in the home and that the provider wouldn’t let anything abusive happen. Staff understood what abuse was and how to deal with it. The home has policies and procedures in place telling people how to protect vulnerable residents from harm. Stanbeck DS0000022615.V289336.R01.S.doc Version 5.1 Page 14 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The home was comfortable but the provider needs to make sure the furnishings and floor coverings in the home are of a good standard. EVIDENCE: The home is a modern building. One side of the building is run as a bed and breakfast business. This is separate from the residential home. The provider lives on site. There are two bedrooms, assisted bathroom and a large lounge downstairs. The other bedrooms are upstairs. The home’s kitchen and dining area are also upstairs. The lounge leads out to the large garden and upstairs there is a patio leading from the dining room. All of the bedrooms are single occupancy and have toilet and wash hand basin ensuite. Some of the bedrooms and the main lounge had good quality furniture and décor. Other areas of the home had carpets and furniture that were beginning to show some signs of wear and tear. The inspector asked the
Stanbeck DS0000022615.V289336.R01.S.doc Version 5.1 Page 15 provider to check all of the furniture and repair or replace anything that was past its best. The home was clean and reasonably tidy. The residents were happy with the way things were and had no complaints to make. They liked their rooms and most people spent a lot of time in them. The staff understood the need to control cross infection and all the necessary precautions were in place. The residents were happy with the way their clothes and bed linens were kept clean and fresh. Stanbeck DS0000022615.V289336.R01.S.doc Version 5.1 Page 16 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home has appropriate staffing to meet the residents needs. EVIDENCE: The inspector saw rosters going back over a number of months. There is always one care assistant on duty by day and night. Mrs Robinson and her two daughters work alongside them. Residents thought that this ratio was fine. When there are more residents in the building there is a second carer on duty. Staff on duty said they could manage to care for residents with these hours. The inspector was told that around 60 of staff had a National Vocational Qualification in care at level 2. There had been no new recruitments since before the last inspection. Staff files were read and all of those seen had been recruited properly. All the checks had been made to ensure that the staff team were decent people who could be trusted to care for older people. The provider had a simple training plan so that staff had all the basic training needed to care for residents. The staff spoken to felt they were competent in moving and handling people, making sure the residents were safe and in giving the right kind of care. Stanbeck DS0000022615.V289336.R01.S.doc Version 5.1 Page 17 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The homes management systems are functioning well allowing residents to feel safe and relaxed in the home. EVIDENCE: The provider is also the registered manager. She lives on site and works in the home every day. She is a mature person who is experienced in caring for older people. She is a person of good character and integrity. She has the Registered Managers Award at NVQ level 4. Her two daughters also have this award and they assist her in the management of the home. This home is run very much as a family business and residents like this approach. The home has a quality assurance system whereby the staff check that all the systems are working properly and that residents get what they want. The inspector confirmed this with residents and looked at the paperwork that went
Stanbeck DS0000022615.V289336.R01.S.doc Version 5.1 Page 18 with it. The provider agreed to send an audit of the system when it was completed later in the year. Most of the residents manage their own money or have relatives do this for them. One person has their finances managed by social Services. The inspector asked the provider to talk to them about making the arrangements simpler so that the resident could deal with money as independently as possible. Staff said they had the chance to sit down with one of the management team to talk about their work. This ‘supervision’ happened every couple of months and included the opportunity to talk about their training needs and anything that worried them about the care of the residents or how things were in general in the home. The inspector saw the notes of these meeting and they were detailed and related to the work staff were doing. The inspector looked at the health and safety systems and this were running smoothly. The provider had started a new system to make food hygiene even safer. The inspector had received a report from the fire officer saying that everything was in order. Staff said they had been trained in health and safety matters. Stanbeck DS0000022615.V289336.R01.S.doc Version 5.1 Page 19 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 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 X X 3 Stanbeck DS0000022615.V289336.R01.S.doc Version 5.1 Page 20 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP19 OP35 Good Practice Recommendations It is recommended that the provider assess all the furniture and floor coverings in the home with a view to repairing or replacing anything that is shabby. It is recommended that the provider help one person to become more independent in managing money. Stanbeck DS0000022615.V289336.R01.S.doc Version 5.1 Page 21 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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