CARE HOMES FOR OLDER PEOPLE
Stanley Burn Care Centre Station Road Wylam Northumberland NE41 8JA Lead Inspector
Mary Blake Key Unannounced Inspection 18th October 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Stanley Burn Care Centre DS0000063750.V320646.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. Stanley Burn Care Centre DS0000063750.V320646.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Stanley Burn Care Centre Address Station Road Wylam Northumberland NE41 8JA 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) 01661 - 853298 01661 - 854293 www.europeancare.co.uk European Care (England) Ltd Ms Andrea Selby Care Home 40 Category(ies) of Dementia - over 65 years of age (22), Old age, registration, with number not falling within any other category (18) of places Stanley Burn Care Centre DS0000063750.V320646.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 30th May 2006 Brief Description of the Service: Stanley Burn Care Centre accommodates 40 people in a two storey detached property. It is set in a quiet residential area on the outskirts of the village of Wylam. The home is on two floors with a passenger lift to all levels. There are a variety of aids and adaptations to allow residents to move freely around their part of the home. All of the bedrooms are single, with twenty one having ensuite facilities and communal bathing and toilet facilities are situated around the home. There is sufficient communal lounge and dining space. The home is close to local amenities and transport networks. Stanley Burn Care Centre is registered to provide residential care for frail older people and older people with dementia. The statement of purpose and resident guide, this includes the last inspection report, is available at the front entrance and individual copies are provided to residents The fees range from £360 to £500 per week. Stanley Burn Care Centre DS0000063750.V320646.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was a key unannounced inspection, second of the year and took place over two days. A general tour of the premises was carried out. Case tracking was carried out. Residents care records; pre-admission documentation, medication systems, staff and maintenance records were examined. The manager, deputy, four care staff, three ancillary staff, the administrator, fourteen residents and three relatives were spoken to. What the service does well: What has improved since the last inspection?
There had been good progress made on the majority of requirements from the previous inspection, eleven have been met, three are progressing and two are outstanding. Individual care plans have continued to improve. Staff were more involved in planning and evaluating care and the plans this helps staff give residents the care they need. The management overviews these plans and this helps to provide a consistent staff approach. Medication systems and staff awareness had been reviewed to ensure that confusion over administration of medications does not occur. The social and leisure activities for residents have greatly improved giving residents more choice of a range of things to do and helping relieve boredom. Meals are varied, well balanced and nicely presented offering good choice and nutritious food at all meals. All of the residents spoken to were pleased with the improvements to the quality and choice available. Stanley Burn Care Centre DS0000063750.V320646.R01.S.doc Version 5.2 Page 6 Residents commented that there has been improvement to the number and consistency of staffing available to them ensuring that residents have assistance when needed. Staff recruitment records were clear and concise and contained all relevant information. The vetting process helps protect residents. Staff training was well organised with specialised dementia training being undertaken this improves staff skills to meet these needs. The management/senior care staff supervises staff and this gives an overview of staffs ability to provide satisfactory care for residents. The Registered Manager, Andrea Selby, has reviewed the differences in the quality of provision between the residential and dementia units and made good progress to ensure that all residents receive quality care. 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. The summary of this inspection report can be made available in other formats on request.
Stanley Burn Care Centre DS0000063750.V320646.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 Stanley Burn Care Centre DS0000063750.V320646.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have theirs need fully assessed by care staff before admission to the home. Intermediate care is not provided. EVIDENCE: Pre-admission assessments are undertaken and accurately reflect the needs of the residents. Residents commented upon the admission process and of being able to visit the home, to meet other residents and staff “I was able to tell Andrea what I needed”. Stanley Burn Care Centre DS0000063750.V320646.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal needs of residents were met. Individual care plans continue to show improvements. Staff use care plans to meet personal needs and are involved in completing them. Social care needs are now addressed. The residents receive their prescribed medication in line with safe working practices. Residents feel that they are treated with respect and their right to privacy respected. The residents are having their needs met by the staff in the home. The staff are skilled in providing the care in a sensitive and dignified manner. EVIDENCE: Stanley Burn Care Centre DS0000063750.V320646.R01.S.doc Version 5.2 Page 10 Four care plans were examined and were of a satisfactory standard. Relevant risk assessments for the prevention of falls, nutrition, moving and assisting and continence promotion were in place. The plans are regularly reviewed and updated. The care plans showed that the residents have access to all NHS services and facilities. A number of assessment tools are in use they were reviewed monthly and were dated and signed. Daily reporting of residents care was generally satisfactory. The changing health care and mental health care of residents was reviewed and up dated. The medicines in the home are well managed and safely disposed. The medicines were stored safely. Two residents medication was examined as part of the case tracking both were satisfactory. The controlled drugs procedures were satisfactory. Staff were treating residents with respect and dignity. Personal care was given in privacy. Staff used residents preferred name at all times. Residents, where able, were complimentary about the staff in the home and felt able to have privacy in their own rooms. Stanley Burn Care Centre DS0000063750.V320646.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are satisfied with the flexibility of their routines for daily living and activities. Arrangements for residents to maintain contact with their family and friends and the local community are suited to each individual’s needs and vary accordingly. There is a social programme in place and assessments completed for each individual resident. The food served is good and the residents are happy with the quality and the quantity. EVIDENCE: The social care co-ordinator role has been under review. Staff hours are now being provided, this is an interim measure to provide interesting opportunities and relieve boredom for all residents. Positive steps are being taken to develop the range and type of activities for residents. A number of people living in the
Stanley Burn Care Centre DS0000063750.V320646.R01.S.doc Version 5.2 Page 12 home were spoken to and commented on the improvement of the social activities. Residents were generally happy and enjoyed being able to move freely around the home. The majority of the residents were moving around the home and were being encouraged to do so even when they were at some risk of falling. The residents are encouraged to go to places in the local area and families are encouraged and supported to take residents out and about. Residents take control of their daily routines in simple but important ways including the time they get up, what and when they eat and how they spend their time. All residents, who could, said that they are able to make choices about how they spend their day. The residents’ bedrooms were personalised reflecting individual choices and preferences. Residents said they were happy with the decoration. Residents have visitors at any time and are able to use their own rooms, the small lounges or the larger, busier lounges to receive them. The meals served were good and all of the residents enjoyed the food, which was well cooked. Staff support was on hand. The reorganisation of dining rooms provided a more quiet and social occasion. The tables were nicely set and lunch was seen as a social occasion. Comments heard during the lunch time was “this is tasty” and “the food is always so good” “its good because you get a choice”. Staff provided residents with individual portions and choice, which gave encouragement to residents with poor appetites and several residents took up the offer of second helpings. Several residents were using the dining chairs, which have arms/slides, increasing their independence. Stanley Burn Care Centre DS0000063750.V320646.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home ensures residents and relatives aware of the complaints policy by making it available in a variety of places. Complaints are managed satisfactorily and the necessary action taken. Staff had completed training in the Protection of Vulnerable adults and this is necessary to ensure that residents are protected. EVIDENCE: The complaints procedure is displayed in the home and within each resident’s bedroom. The records of the complaints made to the home was examined and was satisfactory. Four of the residents said that they knew problems were dealt with and how this would be done. A relative visiting the home was aware of the complaints procedure but had not needed to use it. The Registered Manager stated that all staff were aware of the whistle blowing policy and informing the Manager of any incidents or issues of which there are concern. Staff confirmed this during interview. Staff had completed Protection of Vulnerable Adults training. Stanley Burn Care Centre DS0000063750.V320646.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The residents do not live in a safe environment. There are good communal areas. The bedroom areas are personalised and comfortable. The home is clean and pleasant but does not have satisfactory hygiene systems. Improvements had been made with the décor and maintenance of the home, but outstanding issues do not provide the residents with safe surroundings. EVIDENCE: The location and layout is suitable for the residents who live here. There are lounges and dining rooms that are pleasantly decorated and furnished. Residents were able to use a range of lounges and there was a range of television and audio equipment available for their use.
Stanley Burn Care Centre DS0000063750.V320646.R01.S.doc Version 5.2 Page 15 The residents have been encouraged and supported to bring personal items with them resulting in individualised rooms reflecting personal taste and previous lifestyles. The home was clean with no offensive odours. The standards of cleanliness in the building areas occupied by residents were satisfactory. Care staff practices in relation to hand washing and the use of the sluicing facilities were not adequate. The laundry was dirty and difficult to clean. The sluice is not easily accessible, was dirty and in need of refurbishment with evidence of soiled laundry not appropriately bagged. The kitchen was generally clean but had not undergone the planned refurbishment, tiles and flooring were damaged and difficult to clean, the cleaning records had not been completed. Staff food hygiene practices were unsatisfactory, fridge/freezer temperatures were not taken or recorded since 26/09/06, they were also dirty with pools of blood stained water. Food was not stored or dated correctly and the cook appeared unclear on food hygiene practices. An Electrical Wiring Installation Certificate was still not available. Following the issue of an immediate requirement notice the manager had ensured that an electrical contractor had carried out an assessment of the building and systems(240806). This assessment had identified a high number of safety issues and unsatisfactory emergency lights and alarm systems, no remedial work had been undertaken. The Registered Person and Manager of the home had overlooked this. A large number of door wedges were being used, the stairwell was used for storage and furniture had been placed unsafely within an upstairs landing area restricting means of escape. All of these were removed and made safe before the end of the first visit. Stanley Burn Care Centre DS0000063750.V320646.R01.S.doc Version 5.2 Page 16 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager ensures there are adequate numbers of staff on duty that have appropriate skills and experience to care for the residents. Resident’s needs are met by the number and skill mix of staff. The recruitment processes in place protect residents. External and internal training takes place. EVIDENCE: Staffing rotas showed that there are enough staff are on duty to meet the necessary staffing levels. When sickness and staff holidays occur home staff usually cover. The home currently operates 6 care staff 8am to 5pm 5 care staff 5pm to 10pm 3 care staff 10pm to 8am Additional management and ancillary staff are in place. Stanley Burn Care Centre DS0000063750.V320646.R01.S.doc Version 5.2 Page 17 There is an in house training programme in place and the Manager continues to work toward 50 of the staff having National Vocational Qualification in Care level 2 or above, with 10 of the staff having completed this. Staff said that they are undertaking or had completed NVQ in Care level 2 or over and the home has an induction and training programme for all staff working in the home. Staff were very positive about the in-house dementia training taking place. Staff spoke knowledgably about the individual needs of residents. There had been no new staff recruited since the previous inspection, two staff recruitment files were examined and were satisfactory. Stanley Burn Care Centre DS0000063750.V320646.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36,37 & 38 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents live in a home, which is run and managed by an experienced person. Quality systems are being established and developed. Resident’s financial interests are safeguarded. Staff are appropriately supervised The health, safety and welfare of residents and staff are not always promoted or protected. Stanley Burn Care Centre DS0000063750.V320646.R01.S.doc Version 5.2 Page 19 EVIDENCE: The manager has many years experience in a caring and managerial role. The Registered Manager has addressed the majority of the outstanding requirements and is working towards the others within her remit. It was notable that she immediately addressed the requirements that would promote the health, safety and well being on the residents. Accidents are recorded effectively with accident analyses being completed. The system for checking resident’s monies was satisfactory. Records of staff supervision records showed that the timescales of six per year were being met. The Registered Manager had previously implemented training and overviewed the infection control practices of care staff and of food safety within the kitchen but once again these practices are poor. The monthly proprietor visits have taken place with some quality assurance systems being implemented. Resident/customers surveys take place six monthly with issues being addressed. There is a well detailed action plan for the home with actions planned for three months, yearly and three yearly and audit tools covering all of the standards. However, there are inadequacies in these systems as neither, the home manager nor proprietor, was aware that the urgent remedial work to make the building safe for residents, staff and visitors had not been done. Health and safety issues have not been adequately met and had been outstanding over a period of time this presents a serious risk to residents therefore an immediate requirement notice was issued to the registered person. Stanley Burn Care Centre DS0000063750.V320646.R01.S.doc Version 5.2 Page 20 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 1 X X X X X X 1 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 3 2 1 Stanley Burn Care Centre DS0000063750.V320646.R01.S.doc Version 5.2 Page 21 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 OP19 Regulation 13(4) (a) Requirement The Registered person must provide evidence to CSCI of the electrical wiring certificate for the whole home. Outstanding (previous timescale of 1st May 2005, 1st October 2005 and 14th June 2006 not met) 2nd Immediate requirement notice issued 2. OP33 24 The Registered person must review and improve the quality assurance system at the home Outstanding (previous timescale of 1st June 2005, 1st October 005 and 1st August 2006 not met but some progress being made) 3. OP19 13 (4)(a) The Registered person must replace damaged carpet in the lounge of the dementia unit. Outstanding previous timescale of 1st September 2006 not met but good progress being made with
Stanley Burn Care Centre DS0000063750.V320646.R01.S.doc Version 5.2 Page 22 Timescale for action 20/10/06 01/11/06 01/12/06 fitment due November 2006 4. OP22 23(2)(n) The Registered person must provide dining armchairs with arms and slides for residents within the dementia unit Outstanding as of 1st October 2006 but good progress being made 5. OP38 23 (4) (c)(iv) The Registered person must provide evidence of annual maintenance of fire alarm and emergency lights systems Outstanding as of 14th June 2006 2nd Immediate requirement notice issued 6 OP19 13(4)(c) 16(2)(g) The Registered person must repair and refurbish damaged 01/04/07 tiles and flooring in the kitchen and meet the recommendation of the Food Safety Agency. The Registered person must 01/11/06 address the shortfalls in the food hygiene practices a) Freezer and fridge temperatures must be taken and recorded. b) All equipment must be cleaned and in working order. c) All food must be dated and stored safely d) Cleaning schedules must be followed Outstanding previous timescale of 14th June 2006 not met e) Kitchen Staff must be trained in food safety and practices must be improved The Registered Person must 01/12/06 review the laundry and sluice facilities so that they are suitable
DS0000063750.V320646.R01.S.doc Version 5.2 Page 23 01/03/07 20/10/06 7 OP38 16(2)(i) 13(3) 13(4)(c) 8 OP26 13(3) 23(2)(k) 16(2)(k) Stanley Burn Care Centre 9 OP26 13(3) 16(2)(j) 18 10 OP28 for purpose and enable safe practices The Registered Manager must undertake a review of all staff hygiene and hand washing practices. The Registered Person must provide evidence of how 50 of staff will obtain NVQ level 2 in Care or above. 01/11/06 01/12/06 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 Stanley Burn Care Centre DS0000063750.V320646.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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