Inspection on 22/08/06 for Stanborough Lodge

This inspection was carried out on 22nd 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

Stanborough Lodge 21/07/08

Stanborough Lodge 26/06/07

Stanborough Lodge 12/10/05

Stanborough Lodge 13/05/05

Stanborough Lodge 26/08/04

Stanborough Lodge 13/05/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Stanborough Lodge Great North Road Welwyn Garden City Hertfordshire AL8 7TD Lead Inspector Marian Byrne Key Unannounced Inspection 31st July 2006 12:00 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 Stanborough Lodge DS0000019585.V306633.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. Stanborough Lodge DS0000019585.V306633.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stanborough Lodge Address Great North Road Welwyn Garden City Hertfordshire AL8 7TD 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) 01707 275917 01707 258405 rmd@ukgateway.net RMD Enterprises Limited Ms Sheila Pearce Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Stanborough Lodge DS0000019585.V306633.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th October 2005 Brief Description of the Service: Stanborough Lodge is a detached two storey Georgian-style property that has been converted to its present use. The building comprises of twenty-three bedrooms, each with an en-suite facility. The bedrooms are located on both floors. There are two main lounges one of which is delegated as the smoking lounge, a conservatory and dinning room. There are separate bathrooms and toilets available on each floor. All parts of the building are accessible to persons with restricted mobility. Aids and adaptations include a passenger lift; grab rails and a ramp leading from one door to aid those with restricted mobility access the garden and patio areas. There is a large, well-maintained garden with level pathways. The home is located in a quite cul-de-sac close to the A1M motorway. It is located within short distance from parkland, a local public house, local shops and amenities. They fees range from £385 - £496 per week. Stanborough Lodge DS0000019585.V306633.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out by one inspector. Service users spoke highly of the services they receive, at times good interaction was observed between staff and service users, at other times staff were observed to ignore service users when the left or entered the communal areas. The home was undergoing major refurbishments to the sittings rooms – this involved the removal of asbestos from the ceilings. This was done by a specialist organisation. The Registered Manager of the home had not completed a risk assessment of the impact of this work on the health and safety to the service users, security checks had not being carried out on the building staff nor had this Commission being informed of the work to be carried out. The residents were sitting in a small part of the dining room. On the day of the inspection they did not have access to a television or other appropriate stimulation. Most service users had stayed in their rooms. One male service users who had recently been admitted to the home had three cylinders of oxygen in his room. There was no indication except a small handwritten sign over one cylinder. The Registered Manager recognises that the service users’ needs cannot be met in full while the alterations to the sitting rooms are being carried out. Details on usual facilities available are detailed in the report of the inspection carried out on the 12th October 2005. What the service does well: What has improved since the last inspection? What they could do better: The Registered Manager must be mindful of her obligations under the Care Standard Act 2000 to inform this Commission of incidents in the home that could have a detrimental effect on the health of service users. Asbestos removal from the home would be included in this. Oxygen must be stored and labelled appropriately. Stanborough Lodge DS0000019585.V306633.R01.S.doc Version 5.2 Page 6 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. Stanborough Lodge DS0000019585.V306633.R01.S.doc Version 5.2 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 Stanborough Lodge DS0000019585.V306633.R01.S.doc Version 5.2 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. All care plans inspected contained full assessments of the service user’s needs. Quality in this outcome is good; this judgement has been made using available evidence including a visit to this service. EVIDENCE: All care plans inspected showed that a pre-admission assessment was in place. These contained good information. Service users can visit the home prior to being admitted. The inspector spoke to one service user who regularly stays for respite and is now deciding if she will stay or not. She informed the inspector that she can take as long as she needs to make her mind up. Stanborough Lodge DS0000019585.V306633.R01.S.doc Version 5.2 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. Care plans contained good information. Health care needs are fully met. Recording and administration of medication was in order. Service users were left without stimulation and assumptions were made regarding their needs. Quality in this outcome is adequate; (this would have been good had the dignity of service users being upheld) this judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans inspected were comprehensive and had all the information required including assessment of needs, risk assessment and how the needs of the service user will be met. Service users, who required heath care in-put were seen by the district nurse and all service users were registered with a local GP. Visits from health care professionals were recorded. All service users were well presented. Medicines were administered and recorded appropriately. One service user had control of her own medication this was stored and recorded appropriately. One staff member on duty was serving afternoon tea and biscuits. She handed the service users biscuits from the tin having chosen them herself and appeared to be unaware of the need to uphold the dignity of Stanborough Lodge DS0000019585.V306633.R01.S.doc Version 5.2 Page 10 the service users. She served the inspector tea with milk and sugar without asking how the inspector would like it served. Stanborough Lodge DS0000019585.V306633.R01.S.doc Version 5.2 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. Due to the alterations being carried out in the home it is not possible to judge if the service users experiences of the home meets their needs. There is no restriction on visitors. One service user who is registered blind felt that control of her life was not offered. The service users stated that the food was good. Quality in this outcome is adequate; bearing in mind the alteration being carried out at Sanborough Lodge this may change to good when the alterations have been completed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The everyday life of the home is disturbed at the moment due to the changes in the environment. This means that the sitting rooms are not available to the service users. A number of service users (six) were sitting in the corner of the dining room without stimulation. Staff were using the dining room to write up care plans and daily notes there was not interaction between them and the service users. On the day of the inspection there was a constant stream of visitors to the home. One service users spoken with was unhappy by the way a member of staff had spoken to her. Her wish was to have assistance with eating her lunch she informed the inspector that the member of staff refused to assist her. The Registered Manager stated that she would investigate this matter. All service users spoken with said the food was to their satisfaction. Stanborough Lodge DS0000019585.V306633.R01.S.doc Version 5.2 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 & 18. There is a complaints policy in place that is followed. The service users are protected from abuse. Quality in this outcome is good, this judgement has been made using available evidence including a visit to this service. EVIDENCE: A copy of the complaints procedure was available to prospective and current service users. Systems are in place to protect service users from abuse. Stanborough Lodge DS0000019585.V306633.R01.S.doc Version 5.2 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. It is difficult to assess this due to the work being carried out in the home. Other areas of the home were in need of attention. There were odours that could be associated with incontinence in three rooms. Quality in this outcome is poor; bearing in mind the alteration being carried out at Sanborough Lodge this may change to good when the alterations have been completed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: It was difficult to judge if the home was safe and well maintained. Major refurbishments were underway. The two sitting rooms in the home were undergoing redecorations. One service user was sitting in the middle of one of the rooms undergoing alterations. Three rooms had odours that could be associated with incontinence. The stair carpet was stained and dirty. Individual rooms were personalised and were decorated to reflect the taste of the service users. Many of the rooms were homely and domestic in style. Stanborough Lodge DS0000019585.V306633.R01.S.doc Version 5.2 Page 14 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 skills and experience of the staff was varied. One new member of staff did not have basic moving and handling training. The outcome of staffing on the day of the inspection for the service users was poor. The home follows robust recruitment procedures. Quality in this outcome is poor; This judgement has been made using available evidence including a visit to this service. EVIDENCE: The training record of one member of staff, who had been in post three weeks, showed that she had not undergone any training other than shadowing. She was not observed to work unsupervised, however when she served tea, coffee and biscuits she did not ask how service users would like their beverage and served biscuits by handing out two from the tin without any element of choice or hygiene. The inspector asked for a cup of tea and was given it with milk and sugar as a matter of course and handed two biscuits. This was observed by senior staff who were in the dining room. Staff entered and left the dining room without acknowledging the service users who were sitting about unstimulated. The radio station was playing music more usually associated with young people. Again the staff were unaware of this and when the inspector enquired as to why this was she was told that it was probably the builder’s choice. It was eventually changed to a more age appropriate channel. A member of staff admitted a district nurse to the home without checking her identity or escorting her to the service user. Stanborough Lodge DS0000019585.V306633.R01.S.doc Version 5.2 Page 15 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 Registered Manager must become more familiar with her responsibilities under the Care Standard Act 2000. Staff must be aware that they are working in the service users home and improve the interaction between them and the service users. The health and safety of service users must be protected through the use of risk assessments. Service user’s rooms must not be used to store oxygen. Quality in this outcome is poor; This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Registered Manager had failed to conduct a risk assessment on the work being carried out in the home. This work included the removal of asbestos from the ceilings in two sitting rooms. This could have had a detrimental effect on the health and welfare of service users, staff and visitors to the home. Stanborough Lodge DS0000019585.V306633.R01.S.doc Version 5.2 Page 16 The Registered Manager informed the inspector that specialists in the field of asbestos removal had been engaged by the home’s insurance company to complete the work. She further informed the inspector that the service users did not have access to the area, on walking through the home the inspector observed a service user sitting in his wheel chair in the middle of the work being carried out. The Registered Manager was also unable to inform the inspector if the workers carrying out the work had had security checks from the Criminal Records Bureau. This check must be carried out or the building staff must be supervised in the home at all times. The Registered Manager must ensure that the staff employed to meet the needs of service users respect the dignity of the service users by interacting with them appropriately at all times. One man recently admitted had three oxygen cylinders in his room. The door to his room did not indicate that oxygen was in use in the room. The home had recently been visited by the fire service safety officer who had made requirements. The home had reacted positively to this visit and were endeavouring to meet the requirements left by the officer. Stanborough Lodge DS0000019585.V306633.R01.S.doc Version 5.2 Page 17 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 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X X X X X X 2 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X X X X 1 Stanborough Lodge DS0000019585.V306633.R01.S.doc Version 5.2 Page 18 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 OP9 Regulation 13 (2) Requirement The registered person must ensure medicines received are recorded and audited regularly. This requirement had been met. 2. OP9 13 (2) The registered person must ensure that medicines no longer required must be returned to the service user or the pharmacy for disposal. This requirement had been met. 3 OP10 12 (4) (a) The Registered Manager must 01/09/06 ensure that staff interact with service users in a manner that upholds the service user’s dignity at all times. The Registered Manager must 31/08/06 ensure that the home is free from odours that could be associated with incontinence. The Registered Manger must 31/08/06 ensure that the staff on duty have the experience and training to meet the needs and ensure DS0000019585.V306633.R01.S.doc Version 5.2 Page 19 Timescale for action 01/09/06 01/09/06 4 OP26 16 (2) (k) 5 OP27 OP28 OP30 18 (1) (c) (i) Stanborough Lodge 6 OP31 OP33 OP38 12 (1) & (4) & 24 the safety of the service users. This must be evident in the outcomes for the service users. The Registered Provider and the Registered Manager must ensure the home is managed in a way that protects the health and safety and dignity of the service users 01/09/06 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 Stanborough Lodge DS0000019585.V306633.R01.S.doc Version 5.2 Page 20 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 Stanborough Lodge DS0000019585.V306633.R01.S.doc Version 5.2 Page 21 - 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. 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