Inspection on 04/11/05 for Stanfield House

This inspection was carried out on 4th November 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Stanfield House 08/08/06

Stanfield House 14/02/06

Stanfield House 18/01/05

Stanfield House 23/06/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Stanfield House Stanfield House Joicey Square Stanley Co Durham DH9 0PG Lead Inspector Kathy Bell Unannounced Inspection 4th November 2005 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.V254318.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.V254318.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.V254318.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th January 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. One wing of the building is currently used by the Health Authority as a separate unit but this shares the homes catering and domestic services.. Stanfield House DS0000031245.V254318.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 November 2005. The inspector, Kathy Bell, spoke to 10 residents, two relatives and two staff as well as the manager. She also looked at records and looked around the building. Many of the residents made the comment that they cant fault the home. Residents and relatives particularly praised the staff describing them as caring, helpful and diligent-they always have a good word for you. What the service does well: What has improved since the last inspection? There are now four electrical sockets in each bedroom although in some cases these are all together in one place. It would have been desirable to have a double socket in two different areas of the bedroom so that one was convenient wherever it was needed. Stanfield House DS0000031245.V254318.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.V254318.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.V254318.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): These standards were not assessed during this inspection. EVIDENCE: Stanfield House DS0000031245.V254318.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): Staff write a care plan which explains the care each person needs. These covered most of the important information staff needed to look after each person well but they had not recorded an assessment of the risk of each resident developing pressure sores. This could lead to residents suffering pressure sores when they could have been avoided. The arrangements for obtaining medical care for each resident and for handling medication were generally satisfactory but in one case, the home had not asked for advice on a pressure sore quickly enough. This could mean that the sore became worse when it need not have done so. Similarly, the home handled medication correctly in most ways but staff must make sure that changes or instructions are properly recorded to avoid any chance of errors. Stanfield House DS0000031245.V254318.R01.S.doc Version 5.0 Page 10 EVIDENCE: Each resident has a plan of care which explains the care staff need to give them. Staff record each month that they have reviewed the care plan. However they had not always updated the care plan when a change had taken place. Staff felt that the systems for passing on information between them at hand overs and verbally worked well so that this would not have caused problems. The care plans covered most of the important areas, such as personal care, if the person needed any help getting around or getting into the bath etc, continence needs. They also showed that staff had asked residents how they liked to live and be looked after. Care plans included risk assessments which described how an activity, for example, bathing independently, could be dangerous, how staff would make it safer and the reasons why the resident would benefit from doing that activity. These risk assessments recognised that residents had the right to make their own choices and that independence was something to be valued. Care plans did not include assessments of whether a resident was at risk of developing pressure sores. This is very important because homes need to identify who is at risk and refer them to the district nurse. The district nurse would then carry out her assessment and arrange for any equipment or advice to be provided to try and prevent sores developing. In one case, staff had recorded that a sore was developing and then been instructed on how to treat it but a referral had not been made to the district nurse until six days later. This was not a satisfactory level of care. Other records showed that staff had obtained medical advice when necessary and relatives felt that the staff did keep a close eye on residents and asked the GP to visit for the least thing. There are established systems for handling medication and all the staff who administer medication have received external training. In most ways the records were satisfactory but in some cases there was a difference between the instructions on the medication sheet provided by the pharmacy, which is based on the directions from the doctor, and how staff were actually administering the medication. These cases were when the directions instructed medication to be taken and staff were actually giving it to residents only when the residents felt they needed it. The doctor who prescribed the medication may agree that this is all right but the home must check with them to make sure. Stanfield House DS0000031245.V254318.R01.S.doc Version 5.0 Page 11 Also, the medication sheet gave general instructions on the use of creams, such as apply thinly but the care plan did not explain where it was to be applied. Staff described how fuller instructions are written on the container for the medication so that staff do know what to do. However it is safest if information is also recorded in the care plan. Staff were recording checks of the temperature of the fridge used for medication and had often recorded temperatures of 6°C. The instructions on the fridge recommended a maximum temperature of 5°C. The dial on the fridge showed an increase up to 6° even though the door had not been opened. No action had been taken to put this right. Stanfield House DS0000031245.V254318.R01.S.doc Version 5.0 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 the following standard(s): 12, 13, & 14 Residents can take part in the range of activities provided in the home or pursue their individual interests. Relatives are able to visit at any reasonable time. Residents are able to make choices about how they wish to live. EVIDENCE: The home has its own small day centre and residents can join in the activities there. These include bingo, videos, quizzes, craft activities and pamper sessions. In the evenings staff also use this area for recreational activities and entertainments. Trips out, for example, to the Metrocentre are arranged and entertainers, ministers of religion and a Pat dog visit the home. Some residents prefer to watch television or listen to music in their rooms. Care plans considered residents social needs and mentioned their previous interests or hobbies to guide staff in meeting their needs for recreation or stimulation. Residents can receive visits from friends and families at any reasonable time. Residents confirmed that they could choose whether they wanted to stay in their rooms or join in activities. Discussions with residents and staff showed that residents were choosing how they wanted to live, even if this was not fully approved of by staff. Stanfield House DS0000031245.V254318.R01.S.doc Version 5.0 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 Residents feel able to make complaints and expect that these will be responded to properly. There are satisfactory arrangements to protect residents from abuse. EVIDENCE: The book for recording compliments, comments and complaints showed that residents felt free to comment on the meals and occasionally on other matters. This book recorded the action staff had taken in response to the comments. Staff have received training to increase their awareness of the risks of abuse of vulnerable adults. The home had a copy of the local multi-agency procedures for responding to allegations of abuse. The home follows correct procedures for the recruitment of staff to make sure that, as far as possible, only people suitable for work with vulnerable adults are employed. Stanfield House DS0000031245.V254318.R01.S.doc Version 5.0 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 The home is a safe and comfortable place to live. The building is well maintained and appeared clean on the day of inspection. EVIDENCE: All areas of the home which were looked at seemed pleasant and comfortable. The building seemed to be well maintained. The home seemed clean on the day of inspection and relatives confirmed that it was always kept this way. Stanfield House DS0000031245.V254318.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: Stanfield House DS0000031245.V254318.R01.S.doc Version 5.0 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The manager of the home is suitably qualified and experienced to be in charge. There are systems to make sure that residents financial affairs are looked after safely. Regular safety checks are carried out on all aspects of the home to make sure that residents health and safety are protected. EVIDENCE: The manager is a qualified nurse with many years experience in residential care for older people. There are established systems for looking after money for residents which include two staff signing to confirm any transactions and the records are independently audited. Stanfield House DS0000031245.V254318.R01.S.doc Version 5.0 Page 17 Comprehensive checks are carried out to make sure the building is kept safe. These include checks of water temperatures, visual checks of portable electrical appliances and checks of the fire safety system. Stanfield House DS0000031245.V254318.R01.S.doc Version 5.0 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 x X X X X X 3 STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X x X 3 X X 3 Stanfield House DS0000031245.V254318.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? yes 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 OP7 Regulation 15 Requirement Care plans must always be kept up-to-date and must include detailed information about any treatment to be given. The home must assess the risk of pressure sores for each resident, refer for specialist assessment if necessary and refer for treatment promptly if sores develop. The home must administer medication as directed by the prescribing doctor. If the information provided by the pharmacistappears incorrect, they must check this with the doctor. They must take action if the fridge for medication is not cool enough. Timescale for action 11/11/05 2 OP8 13 11/11/05 3 OP9 13 11/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Stanfield House DS0000031245.V254318.R01.S.doc Version 5.0 Page 20 No. Refer to Standard Good Practice Recommendations Stanfield House DS0000031245.V254318.R01.S.doc Version 5.0 Page 21 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.V254318.R01.S.doc Version 5.0 Page 22 - 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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