CARE HOMES FOR OLDER PEOPLE
Stanfield House Stanfield House Joicey Square Stanley Co Durham DH9 0PG Lead Inspector
Kathy Bell Unannounced Inspection 14th January 2006 10:00 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 Stanfield House DS0000031245.V267597.R01.S.doc Version 5.0 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. Stanfield House DS0000031245.V267597.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Stanfield House Address Stanfield House Joicey Square Stanley Co Durham DH9 0PG 01207 232 546 01207 232 546 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) Durham County Council Mrs Florence Anne Bennett Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Stanfield House DS0000031245.V267597.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 4th November 2005 Brief Description of the Service: Stanfield House is registered to provide care (but not nursing care) for 21 older people . It is a long established local authority care home near the centre of the town of Stanley. The building has two floors with a lift to the first-floor. All the bedrooms are singles. There are three lounges and a separate dining room on the ground floor and a lounge/dining room on the first floor. The building is furnished and decorated to a good, domestic style, standard and there is a pleasant garden in front of the building. Stanfield House DS0000031245.V267597.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place during one day in February 2006. The inspector, Kathy Bell, spoke to seven residents, two relatives and two staff as well as the manager and looked at some records. Residents and relatives spoke highly of the home, described it like a five-star hotel and said they couldnt fault it. They said the staff were excellent. What the service does well: What has improved since the last inspection?
Care plans looked at on this inspection showed that staff looked at all areas of need, including the risk of pressure sores. They have responded to the requirements from the last inspection about the temperature of the medication fridge and making sure that the information on the record of medication given to residents tallies with the instructions given by the doctor. Stanfield House DS0000031245.V267597.R01.S.doc Version 5.0 Page 6 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. Stanfield House DS0000031245.V267597.R01.S.doc Version 5.0 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 Stanfield House DS0000031245.V267597.R01.S.doc Version 5.0 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 makes sure it receives full information about residents before admitting them, so it can be sure it will be able to meet their needs. EVIDENCE: Residents files included a copy of an assessment made by a care manager, which set out each persons needs and how these were to be met. Stanfield House DS0000031245.V267597.R01.S.doc Version 5.0 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): 10 Residents feel that they are treated with respect and their privacy is also respected. EVIDENCE: All the residents spoken with said that they were treated with respect. They described how the staff knock on their bedroom doors, say who it is and ask if they can come in. Staff were heard talking to residents with a pleasant manner. A resident explained how staff make sure that they respect the wishes of each resident about whether they have someone of the same sex helping them with personal care. Stanfield House DS0000031245.V267597.R01.S.doc Version 5.0 Page 10 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): 15 Residents enjoy their food and the home make sure it meets their nutritional needs. EVIDENCE: The residents all said that the meals were good and they were offered choices. The home records what each person chooses each day. This record is linked to the main menu which is kept, and as a quick way of recording, staff tick if someone is choosing the main choice for that meal. This is satisfactory but they must make sure that the record shows which menu was available that day. During the inspection the cook came up to the lounge to check what one group of residents might like for their tea, knowing that the planned meal was the meal they had eaten as an alternative the day before. This showed that she was aware of what they had eaten and was making sure they had a satisfactory variety. Residents care plans included assessments of nutritional needs and residents individual likes and dislikes were also recorded. One care plan also showed that staff had obtained equipment to help someone eat independently. Stanfield House DS0000031245.V267597.R01.S.doc Version 5.0 Page 11 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): These standards were not assessed during this inspection. EVIDENCE: Stanfield House DS0000031245.V267597.R01.S.doc Version 5.0 Page 12 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): These standards were not assessed during this inspection. EVIDENCE: Stanfield House DS0000031245.V267597.R01.S.doc Version 5.0 Page 13 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 Staffing levels seem satisfactory at present to meet physical care needs but the manager must keep under review how dependent the current group of residents is and whether staff are able to meet their social and emotional needs and offer them choices in their daily lives. Over threequarters of the care staff have achieved the recommended qualification for care workers and the home has good systems to make sure that only suitable people are recruited to work in the home. Staff receive the training they need to provide good care. EVIDENCE: During each daytime shift, there is a residential supervisor and two care assistants on duty. There is also a care assistant employed to work in the day centre. There are two staff on duty awake at night. These staffing levels would generally be seen as satisfactory for the numbers of residents (19 at present). However the manager and staff described residents as needing a great deal of help in their daily lives, with for example, 15 of the 19 needing to be washed and dressed each morning. A number of residents also suffer from confusion. Staff felt that they were continuing to provide satisfactory personal care but felt there was not enough time for talking with residents and providing one-to-one attention when people needed it. A particular concern was that staff said the night staff, who finish at 7:15 a.m. were helping some residents to get up, washed and dressed, because too many people needed help at the beginning of the day. The inspector was told this could start at 5:30 a.m. The inspector asked the manager to carry out early morning visits to see if this was the case. Following the inspection she confirmed that night staff do get some people up early but only if they are
Stanfield House DS0000031245.V267597.R01.S.doc Version 5.0 Page 14 obviously restless and ready to get up. She described people who could be at risk if they tried to get up unaided. Obviously staff should respond to residents wishes, even if they cannot express these in words but residents should never be woken early to make the workload manageable. The manager must continue to monitor this. The more able residents who were able to speak to the inspector and relatives did not mention staffing levels as a problem. Threequarters of the care staff have the recommended qualification for care assistants which is NVQ 2 in care. The recommended minimum is that half the staff achieve this so this is a good achievement. The home uses the County Councils recruitment procedures which include obtaining CRB/POVA check and two references. All of these were not available for inspection in the home for new staff but the manager confirmed that she had seen them. The system for recording training does not provide a complete record for each worker but the manager is putting in place a record which will enable her to see easily who requires which training and when refreshers are needed. Records seen showed that staff receive training in key areas such as food hygiene and fire safety and there are regular refreshers on moving and handling. Staff have received valuable in-house training on areas such as promoting continence and independence, and dementia. Stanfield House DS0000031245.V267597.R01.S.doc Version 5.0 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): 33 & 35 The home has a number of ways of finding out whether it is providing the care which residents want and need but it should develop a more formal way of finding out the views of residents and relatives. When the home looks after residents money for them there is a system to make sure that they account for all the money and that it is kept safely so that residents are protected from abuse. EVIDENCE: The home has a book in which residents or relatives can record compliments or comments and information is available on how to complain. Monthly residents meetings are held and the records show that staff ask whether people are satisfied with meals etc. . While these are valuable,unavoidably it is the more able residents who take part in these meetings which means they do not give staff feedback on the views of less able residents. In the past, staff have asked residents to fill in survey forms after we have received respite care but
Stanfield House DS0000031245.V267597.R01.S.doc Version 5.0 Page 16 few were completed. It is recommended that the home develops a system to actively obtain the views of residents and relatives, rather than relying on them raising any issues. Each month, the manager provides information on the running of the home for her line manager to assess how well the home is operating. The home keeps full records of any money they look after for residents and keeps receipts for money spent. Stanfield House DS0000031245.V267597.R01.S.doc Version 5.0 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 X 8 X 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X 3 X X X Stanfield House DS0000031245.V267597.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP27 Regulation 18 Requirement The manager must continue to check whether staffing levels are adequate for the dependency levels of current residents. She must continue to make sure that staffing arrangements do not restrict residentschoices in daily routines. Full records of staff training must be kept,ideally in a way which helps the manager keeps track of training received and needed by each person and when refreshers are due. Timescale for action 31/03/06 2 OP37 17 30/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP15 OP33 Good Practice Recommendations The record of the choices residents make at mealtimes should show what the main meal choice was for each day. The home should develop a way of surveying the views of residents and relatives about the running of the home.
DS0000031245.V267597.R01.S.doc Version 5.0 Page 19 Stanfield House Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 Stanfield House DS0000031245.V267597.R01.S.doc Version 5.0 Page 20 - 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!
