Inspection on 09/08/05 for Stanbeck

This inspection was carried out on 9th August 2005.

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

Stanbeck 05/12/07

Stanbeck 23/05/07

Stanbeck 23/05/06

Stanbeck 17/01/06

Stanbeck 14/01/05

Stanbeck 27/05/04

Stanbeck 12/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Clover House

Langrigg House

Parkside

Dystlegh Grange

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

CARE HOMES FOR OLDER PEOPLE Stanbeck Stainburn Road Workington Cumbria CA14 4EA Lead Inspector Nancy Saich Unannounced 09 August 2005 13:00 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 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 F58 F10 s22615 stanbeck v235956 090805 ui stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Stanbeck Address Stainburn Road Workington Cumbria CA14 4EA 01900 603611 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Audrey Robinson Care Home 13 Category(ies) of 13 OP - Old Age registration, with number 1 LD(E) - Learning Disability, over 65 of places Stanbeck F58 F10 s22615 stanbeck v235956 090805 ui stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 2. 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) Date of last inspection 14 January 2005 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. Accomodation 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 she is helped in this by her two daughters. Together they make up the management team. Mrs Robinson also runs a bed and breakfast business on the same site. Stanbeck F58 F10 s22615 stanbeck v235956 090805 ui stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection conducted by Nancy Saich. The visit started around 1p.m and lasted until just after six. The provider was unavailable but one of her daughters was running the home on the day. The inspector spoke to residents in the dining room in a group and spoke to other people on their own in their own rooms. She also spoke to staff on duty. The inspector checked all areas of the home and also looked at some documents that confirmed what was discussed during the visit. What the service does well: The home deals with residents’ medication properly allowing for the medicines in the home to be stored securely and administered properly. The staff group are good at treating residents respectfully and the residents had a lot of positive examples of the way staff treated them with dignity and kindness. The home is good at providing nicely prepared, home-cooked food. Residents were all very satisfied with the meals provided. The home is good at protecting residents from potential abuse and has arrangements in place for managing formal complaints. The lounge, dining room and the outdoor areas provide spacious and comfortable places for residents to relax in together. The garden and patio areas were particularly attractive with plenty of seating areas for residents to spend time outside. The provider and her two daughters are in the home every day and the time they spend in the home supplements the adequate staffing levels. The home provides good levels of training to care staff and this means they have the necessary knowledge to fulfil their job roles. The arrangements for maintenance of services and food and fire safety were in order providing overall safety in the environment. Stanbeck F58 F10 s22615 stanbeck v235956 090805 ui stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better: The written plans of care are not based on what the residents themselves want. A ‘person-centred’ approach supporting residents to make their own choices should be followed. The residents need to be aware of what is in their plans so that they can participate in their care. There was evidence to show that levels of personal care in things like frequency of bathing and shaving were not to the optimum level for residents. The provider needs to ensure that personal care is tailored to individual needs and choices. A number of residents said they wanted more lifestyle choices. There was a lack of activities and entertainments in the home and residents were only rarely offered the opportunity to go out. Some of the décor and furnishing need upgrading. The hall carpet had stretched and was loose. The provider needs to deal with this before it becomes a danger to residents. Some residents’ bedrooms could do with redecoration and new furniture and the inspector was told that this was in hand. The toilets and bathrooms were untidy and levels of hygiene were unsatisfactory. There was a risk of cross-infection for residents in these areas. The home must not allow new staff to work with residents until all the necessary references and checks are completed. This must be done to ensure that residents are protected from unsuitable staff members. The care needs of the residents might be improved by the introduction of a named worked system. This ‘key worker’ scheme would help to individualise the care planning in the home and give residents their own member of staff who could ensure that the entire team meet the individual needs of each person. This individualised approach needs to be recorded in the regular development meetings that are held with staff. Stanbeck F58 F10 s22615 stanbeck v235956 090805 ui stage 4.doc Version 1.40 Page 7 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 F58 F10 s22615 stanbeck v235956 090805 ui stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Stanbeck F58 F10 s22615 stanbeck v235956 090805 ui stage 4.doc Version 1.40 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 standard(s) 3 This home has become much better at ensuring that they only admit new residents who they can care for properly. EVIDENCE: The inspector spoke to one new resident who confirmed that a member of staff had visited prior to admission, that the social worker had helped with the admission to the home and that the care and services provided were satisfactory. The inspector also checked documents about this on file. These were of a good standard and showed that the staff had made sure that they could care for this person. The inspector also spoke at length with the person in charge and judged that the senior team were much more careful about this process so that they would only admit people within the categories they are registered for. Stanbeck F58 F10 s22615 stanbeck v235956 090805 ui stage 4.doc Version 1.40 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 standard(s) 7,8,9,10 Residents in this home are not fully involved in planning their own care and at times do not receive appropriate personal care. Health care matters were being managed quite well allowing for residents to maintain good health. EVIDENCE: The inspector asked approximately half of the residents about who planned their care. They all said that staff and management made the decision. None of those spoken to said they had seen their care plans and had not signed them. Some people did say they were asked about their needs but they also felt that some of their needs were not carried through in these ‘care plans’. The inspector read all of the care plans. She judged that the content was much more detailed and the plans were all up to date. Some of the things that residents needed or wanted were not included and there was scant evidence of residents having agreed and signed them. There was good detail on things like health and personal care but perhaps not enough on some of the other aspects of residents’ lives. One resident said “This home cant decide if it’s a hospital or a care home…being old is not just about being ill…some of us need more than just being looked after…” Stanbeck F58 F10 s22615 stanbeck v235956 090805 ui stage 4.doc Version 1.40 Page 11 At the start of the inspection at 1 p.m at least two of the male residents had not been shaved and it looked as if they had not been shaved the day before. Two residents said they had not had a bath for at least a week and another person said that sometimes it seemed that some people didn’t get enough attention paid to their personal hygiene. The person in charge said this might happen, as they did not want to force people into accepting personal care. The home needs to review their strategies for the delivery of care so that all residents get suitable levels of personal care given to them in a manner that they find acceptable. A requirement was made about this matter. Residents said they could see the doctor or the district nurse when they were unwell. There was evidence in files that showed that health care professionals visited residents on a regular basis. The inspector checked the medication kept on behalf of residents and this was being properly managed. Residents said the staff treated them with respect and were mindful of their privacy and dignity. They had a lot of very positive things to say about how staff spoke to them and how they were treated. A couple of people said they had built up relationships with specific staff but also said that they had no specific named person who was allocated to them as their own special worker. A good practice recommendation was made that the home consider setting up a ‘key worker’ system so that each resident would have their own worker who would help with their care planning and make arrangements for supporting them in things like activities and personal care. Stanbeck F58 F10 s22615 stanbeck v235956 090805 ui stage 4.doc Version 1.40 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 standard(s) 12,13,14,15 Daily life and social activities in this home do not offer residents a good range of options in terms of activities and entertainments appropriate to their needs. EVIDENCE: Some residents were content with a very quiet and uneventful life. Some people spoke about going out with their families and one person went out weekly. Some residents said they enjoyed sitting in the garden. Other people said that they were bored and wanted to go out more or have more things to occupy their time. The home is near to the amenities of Workington and is within easy distance of other towns or beauty spots. No one said they had been out with staff anywhere recently either for a run out or to shop or attend entertainments. The visitors’ book showed that residents did have visits from family and friends. There was not a lot of evidence of residents being involved in community activities. A requirement was made about asking residents their preferences and finding ways to prevent people feeling restless and bored. The inspector felt that there was an underlying theme in residents discussions that might point to them not being encouraged to be as in control of their lives as might be expected. Residents did say they had choice in where they spent their time and when they got up and went to bed but several comments were made about ‘staff knowing best’ or their wishes not being met because of the Stanbeck F58 F10 s22615 stanbeck v235956 090805 ui stage 4.doc Version 1.40 Page 13 arrangements in the home. The quality assurance in the home did have ways of ascertaining residents’ opinions but there was a problem in how options and choices were supported. The inspector judged that this was best addressed by trying to look at individual needs and this is addressed above under the Standard on care planning. Stanbeck F58 F10 s22615 stanbeck v235956 090805 ui stage 4.doc Version 1.40 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 standard(s) 16,18 Both of these matters are managed in a satisfactory way allowing for residents to be protected from abuse and to have a way of having serious complaints listen to and dealt with. EVIDENCE: The residents said that they could make complaints and ‘have their say’. One or two people did have some issues on the day and these are addressed in other parts of this report. There were copies of the complaints procedure around the home and evidence that residents could use this. Some residents felt that although serious complaints would be listened to and dealt with, dayto-day suggestions and concerns were often not dealt with properly. These matters are dealt with earlier in the report. Residents said there was nothing concerning them about the way staff treated them and they thought that they were protected from abuse. Staff were spoken to about protecting people and they had a fairly sound understanding of what was abusive and how to deal with it. Stanbeck F58 F10 s22615 stanbeck v235956 090805 ui stage 4.doc Version 1.40 Page 15 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 standard(s) 19,20,21,26 There were a number of things that needed to be improved about the environment so that residents can live in comfortable surroundings. EVIDENCE: The inspector toured the building and all areas were reasonably clean. The spacious lounge is on the ground floor with double patio doors leading out into an attractive and well-tended garden. This lounge had been recently redecorated to a good standard. The dining room was quite well furnished and staff said that there were new tables on order for this room. Individual accommodation is in good-sized single rooms with toilet and wash hand basin ensuite. One or two rooms had been redecorated and a number of rooms had good quality ‘rise and fall’ height adjustable beds. The home still has a couple of older metal-framed beds that the person in charge said were going to be replaced. One or two rooms were looking a little shabby and could do with redecoration and some new furniture and again the person in charge said this was in hand. Stanbeck F58 F10 s22615 stanbeck v235956 090805 ui stage 4.doc Version 1.40 Page 16 There was a problem with the hall carpet which needed stretching and repairing to stop it becoming a trip hazard for residents. A requirement was made that this was dealt with. The home has two bathrooms and a communal toilet. One or two residents said they would like it if the home had a shower and a good practice recommendation was made about this as the inspector thought this would be a good improvement to the facilities. Residents said they used their ensuite facilities but it was obvious that residents do use the communal toilet near the lounge and the toilets in the bathrooms. None of these facilities had toilet roll holders and on at least two occasions there was no toilet paper in two of these areas. All three of these facilities had piles of hand and bath towels that seemed to be stored in these rooms. These towels were being used by anyone in the bathrooms but there were no paper towels. These things mean that there is a possibility for cross infection especially if staff are using these baled towels and other people have already used them. There were several packets of incontinence pads in the bathrooms; some were lying open near the lavatory. These personal things really ought to be stored out of sight in individuals’ rooms. Open storage might lead to residents using each other’s pads and expose the products to potential contamination. The inspector judged that the home was not as precise about infection control in these areas and a requirement was made about tidying and improving hygiene in these areas. Stanbeck F58 F10 s22615 stanbeck v235956 090805 ui stage 4.doc Version 1.40 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29,30 Staffing levels in the home are adequate and staff receive good levels of training. The recruitment procedures had not been followed correctly and this could have implications for the safety and wellbeing of residents. EVIDENCE: Staff rosters were seen for the five weeks leading up to the inspection. There were two staff on duty during the day and one waking night carer. The provider and her two daughters also work in the home for at least forty hours per week each. Care staff deliver care and clean the home. The inspector judged that the staffing was adequate to deliver care and services but that sometimes this meant there was not a lot of scope for additional activities unless the management team created time for them to arrange these. Residents said that staff worked hard and knew their jobs but that sometimes they had to wait for attention and that there wasn’t a lot of time for staff to do activities with them. Staffing arrangements need to be considered as part of the review of personal care delivery and arrangements for activities that are two of the things the home must do as outcomes of this inspection. The staff files showed that the procedures for recruitment were very good and that potentially these would protect residents from harm. One of the files did however show a major problem. This person had started to work with only one written reference and incomplete background checks. A requirement was made that residents are not cared for by staff until all the background checks are completed. This is so that residents are not exposed to people with criminal records or to staff who have been dismissed from any other care service. Stanbeck F58 F10 s22615 stanbeck v235956 090805 ui stage 4.doc Version 1.40 Page 18 Staff were happy with training in the home and there is a training programme that staff are encouraged to participate in. Residents thought staff had plenty of training and knew ‘what they are about…’. Stanbeck F58 F10 s22615 stanbeck v235956 090805 ui stage 4.doc Version 1.40 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 36,38 The home manages health and safety and supervision of staff fairly well and this allows residents to be reasonably well protected from harm. EVIDENCE: The staff said they were given the opportunity to sit down and talk with senior staff about their job role and how they were progressing. They said that notes were taken of these meetings and that they were also observed in the way they worked. The inspector checked on these ‘supervision’ files and these showed that senior staff did check on individual team members. It was recommended that the files do need to show a few more details of how staff work with individual residents. This might be done in conjunction with starting a ‘key-worker’ system that would help to individualise care. Staff were aware of health and safety matters and said they had received training on these matters. The inspector saw the maintenance file and the fire Stanbeck F58 F10 s22615 stanbeck v235956 090805 ui stage 4.doc Version 1.40 Page 20 log book and these were in order. There were no hazards seen apart from the matters mentioned in the section on the environment above. Stanbeck F58 F10 s22615 stanbeck v235956 090805 ui stage 4.doc Version 1.40 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 2 15 3 COMPLAINTS AND PROTECTION 2 3 2 x x x x 2 STAFFING Standard No Score 27 3 28 x 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x 2 x 3 Stanbeck F58 F10 s22615 stanbeck v235956 090805 ui stage 4.doc Version 1.40 Page 22 NO Are there any outstanding requirements from the last inspection? 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 7 Regulation 15 (1) Requirement Timescale for action 30/09/05 2. 8 3. 12 4. 19 5. 26 6. 29 It is required that residents (or their represtatives if necessary) are consulted and involved in devising their care plans and should sign that they are in agreeement with the content. 12 (1) (b) It is required that residents are and 15(1) offered and encouraged to have daily personal care. Residents must be offered the opportunity to bathe as frequently as they wish. 16 (2) It is required that residents are (m) and consulted about outings and (n) and activities and that a range of (3) options are provided that will suit individual needs 16 (2) (c ) It is required that the hall carpet is repaired or replaced in order to prevent the carpet becoming a trip hazard. 13(3) it is required that the communal and16 (2) toilet and bathrooms are tidied (j) and 23 and a review of hygiene (2) (d) arrangements are made. and (m) 19 The registered person must not employ new staff until two written references and appropriate checks have been made F58 F10 s22615 stanbeck v235956 090805 ui stage 4.doc 30/09/05 30/09/05 30/09/05 30/09/05 30/09/05 Stanbeck Version 1.40 Page 23 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 21 36 Good Practice Recommendations It is recommended that the registered provider conside whether it would be possible to install a shower in the home. it is recommended that supervision notes give a litle more detail of the content of the discussion in relation to working with individual residents. Stanbeck F58 F10 s22615 stanbeck v235956 090805 ui stage 4.doc Version 1.40 Page 24 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 © 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 Stanbeck F58 F10 s22615 stanbeck v235956 090805 ui stage 4.doc Version 1.40 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!