Inspection on 25/08/05 for Stanley Burn Care Centre

This inspection was carried out on 25th August 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

Stanley Burn Care Centre 03/05/07

Stanley Burn Care Centre 18/10/06

Stanley Burn Care Centre 30/05/06

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 Stanley Burn Care Centre Station Road Wylam Northumberland NE41 8JA Lead Inspector Mary Blake Unannounced 25 August 2005 9:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Stanley Burn Care Centre B53-BO3 S63750 Stanley Burn Care Centre V240105 250805 Stage4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Stanley Burn Care Centre Address Station Road Wylam Northumberland NE41 8JA 01661 853298 01661 854293 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) European Care (England) Limited Ms Andrea Selby CRH 40 Category(ies) of DE(E) - Dementia - Over 65 (22) registration, with number OP - Old Age (18) of places Stanley Burn Care Centre B53-BO3 S63750 Stanley Burn Care Centre V240105 250805 Stage4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 11th & 12th April 2005 Brief Description of the Service: Stanley Burn Care Centre cares for 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 service users to move freely around their part of the home. All of the bedrooms are single, with twenty one having en-suite 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. Stanley Burn Care Centre B53-BO3 S63750 Stanley Burn Care Centre V240105 250805 Stage4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The ownership of the home changed on the 4th May 2005 and this is the first inspection under new ownership. Twenty three outstanding requirements from previous owners were examined and fourteen had been met, five were being progressed and four were outstanding. Due to the concerns raised at previous inspection the home has received additional monitoring visits on the following dates, 19th April, 6th and 20th May, 6th June and 3rd August 2005. An additional visit to discuss issues with the proprietor’s representative was undertaken on 20th June 2005. The inspection was unannounced and the second of this inspection year and took place over one day. Residents care records, staff rota plus additional statutory records were examined. The manager, four staff, eight residents and two relatives were spoken to. What the service does well: It was seen and residents commented that staff were kind and considerate when helping them. Residents spoke of a gradual introduction to the home and there was a detailed pre-admission process. Residents, where able, described good relationships with the staff and said they were all polite and helpful. Staff were friendly and relaxed with the inspector and were keen to discuss their work and the residents care needs. Stanley Burn Care Centre B53-BO3 S63750 Stanley Burn Care Centre V240105 250805 Stage4.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better: Residents must have up to date information about the home and contracts between themselves and the new owners. There remain insufficient social and leisure activities for residents. Staff must be supervised within the recommended timescales of six times per year. There is insufficient overview by the proprietor who does not complete statutory visits or complete supervisions/appraisals of the Registered Manager. Stanley Burn Care Centre B53-BO3 S63750 Stanley Burn Care Centre V240105 250805 Stage4.doc Version 1.40 Page 7 Review and improve the quality assurance system within the home. Provide evidence that the electrical wiring system and portable electrical appliances are tested and are safe. 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. Stanley Burn Care Centre B53-BO3 S63750 Stanley Burn Care Centre V240105 250805 Stage4.doc Version 1.40 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Stanley Burn Care Centre B53-BO3 S63750 Stanley Burn Care Centre V240105 250805 Stage4.doc Version 1.40 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2 Prospective residents have the information they need to make and informed choice about where to live. Each resident does not have a written contract/statement of terms and conditions with the new owners of the home. EVIDENCE: The statement of purpose and service user guide was examined and these had been updated and reviewed to reflect the change in ownership. Residents and their families expressed their concern about not having up to date contract. Contracts examined related to the previous owners only. Residents and relatives can visit the home prior to admission. Stanley Burn Care Centre B53-BO3 S63750 Stanley Burn Care Centre V240105 250805 Stage4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8 & 10 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 not addressed. Residents feel that they are treated with respect and their right to privacy respected. EVIDENCE: Individual plans of care are available and have shown some progression. They had been appropriately reviewed and updated. There remains insufficient information in relation to individual social needs. The manager now audits six of these plans per week and a new care plan format is currently being introduced, this will be reviewed at the next inspection. Residents’ nutritional needs are now adequately addressed. There was sufficient evidence of assessment, staff actions and recording in relation to individuals requiring nutritional support. Stanley Burn Care Centre B53-BO3 S63750 Stanley Burn Care Centre V240105 250805 Stage4.doc Version 1.40 Page 11 During a number of visits it was observed and the residents spoke of staff giving them privacy but also supporting their independence and that staff were respectful in their dealings with them. Stanley Burn Care Centre B53-BO3 S63750 Stanley Burn Care Centre V240105 250805 Stage4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,14 & 15 Social care needs, recreation and stimulation remain inadequate. The menu, food choices and quality of food on offer were sufficient to meet the needs of residents and residents were now supported to exercise choice in relation to mealtimes. EVIDENCE: The social care co-ordinator role has been under review and steps are being taken to develop the range and type of activities for residents. This will be reviewed further at the next inspection. A number of people living in the home were spoken to and everyone commented on the lack of social and stimulating activities, all stated that they would prefer to have activities on a regular basis as well as more social opportunities. During the monitoring visits and at inspection the residents commented on the great improvement in the quality and choice of the food served. The cook spoke knowledgably about the changes implemented and the nutritional needs of older people. She and her staff, with the residents, had reviewed the four weekly rotational menus. This indicated significant improvement of meals, Stanley Burn Care Centre B53-BO3 S63750 Stanley Burn Care Centre V240105 250805 Stage4.doc Version 1.40 Page 13 particularly at teatime, with adequate alternatives and choice and improved nutritional content. Records of the actual food provided at all meals are now kept. There is no longer significant use of frozen food and the Registered Manager stated that the night staff no longer prepares the vegetables and potatoes. The cook and staff were seen preparing fresh vegetables and making cakes including the use of eggs, butter and full milk. Meals are taken in pleasant, well-lit dining rooms with good staff attendance and supervision. Stanley Burn Care Centre B53-BO3 S63750 Stanley Burn Care Centre V240105 250805 Stage4.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were previously inspected. EVIDENCE: Stanley Burn Care Centre B53-BO3 S63750 Stanley Burn Care Centre V240105 250805 Stage4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,21,26 Improvements had been made with the décor and maintenance of the home. Outstanding issues do not provide the residents with safe surroundings or appropriate bathing facilities. The home is clean, pleasant and hygienic. EVIDENCE: Stanley Burn Care Centre B53-BO3 S63750 Stanley Burn Care Centre V240105 250805 Stage4.doc Version 1.40 Page 16 Stanley Burn Care Centre B53-BO3 S63750 Stanley Burn Care Centre V240105 250805 Stage4.doc Version 1.40 Page 17 Since the last inspection the home have continued with their redecoration programme A number of other areas have been addressed • • • • • • • Five radiators accessible to residents have been guarded. The temperature in the residential wing is now comfortable and the metal radiator guards surface temperature no longer exceeds safe levels. Two of the four bathrooms are used and a third is in the process of being updated. Door wedges are no longer used and dorguards are fitted to doors as necessary. The laundry has had its hand-washing facilities reinstated. The external drive adjacent to the entrance of the home had been made safe. However, an Electrical Wiring Installation Certificate was not available. Portable electrical appliance testing had not been carried out since May 2003. The kitchen was clean and the cleaning records were being reviewed and updated. Care staff practices in relation to hand washing, cleaning of commodes and the use of the sluicing facilities were now adequate. • • Stanley Burn Care Centre B53-BO3 S63750 Stanley Burn Care Centre V240105 250805 Stage4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 Resident’s needs are met by the number and skill mix of staff. Residents are supported and protected by the homes recruitment policy and practices. EVIDENCE: Since the previous inspection the staffing shortages have been addressed and the deployment and number of staff on duty has been sufficient to meet the needs of the services users. There have been changes to the staffing roles and management. Discussion with the Registered Manager it was agreed that due to the low dependency of the current residents the following staffing would be provided 6 care staff from 8am to 5pm 5 care staff from 5pm to 8pm 4 care staff from 8pm to 10pm 3 care staff from 10pm to 8am Night staff reduced due to the changes in duties and needs of residents. This must be kept under review. All residents spoken to said that staff at the home were kind and considerate and expressed their satisfaction with the availability of staff and that staff now Stanley Burn Care Centre B53-BO3 S63750 Stanley Burn Care Centre V240105 250805 Stage4.doc Version 1.40 Page 19 have time to meet their needs and they were no longer left alone for long periods of time. Examination of staff files indicated that the procedures for the recruitment of staff were satisfactory. Stanley Burn Care Centre B53-BO3 S63750 Stanley Burn Care Centre V240105 250805 Stage4.doc Version 1.40 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,33,36,37,38 The Registered Manager’s leadership has now been consistent and has ensured that residents receive consistent quality care. Quality assurance systems are inadequate. Staff are not appropriately supervised. The health, safety and welfare of service users and staff are not always promoted or protected. EVIDENCE: 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. Stanley Burn Care Centre B53-BO3 S63750 Stanley Burn Care Centre V240105 250805 Stage4.doc Version 1.40 Page 21 The Registered Manager had implemented training and overviewed the infection control practices of care staff and appointed a new cook to over the nutritional standards and the cleanliness within the kitchen. The absence of carver dining chairs in the dining rooms on the mental illness units should be urgently reviewed following risk assessment. Fire Prevention services undertook two visits to the home and are now satisfied with the fire prevention and safety within the home. However, it was again identified that annual safety testing of the portable electric items was over a year overdue and an electrical wiring certificate for the building was not available. The monthly visits required to be undertaken by the proprietor had not taken place since May 2005 when the proprietor acquired ownership of the home, this is concerning as a meeting was held with the proprietors representative outlining the health and safety concerns from the previous inspection. Stanley Burn Care Centre B53-BO3 S63750 Stanley Burn Care Centre V240105 250805 Stage4.doc Version 1.40 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 1 x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 3 15 3 COMPLAINTS AND PROTECTION 2 x 2 x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 3 x 1 x x 2 2 2 Stanley Burn Care Centre B53-BO3 S63750 Stanley Burn Care Centre V240105 250805 Stage4.doc Version 1.40 Page 23 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 7,11,37 Regulation 15 &17 Requirement Review and update service users care plans to detail the action that needs to be taken to ensure that all aspects of their personal and social care needs are met. Outstanding (previous timescale of 1st June 2005 not met but progress being made). Consult with service users about the program of activities and provide suitable social care and recreation on a daily basis. Outstanding (previous timescale of 1st May 2005 not met but progress being made). Care staff must receive formal supervision at least six times a year. Outstanding (previous timescale of 1st June 2005 not met but progress being made) Review the number of operational bathrooms and provide detail of this review to CSCI. Outstanding (previous timescale of 1st May 2005 not met but progress being made) Night staff must attend a fire drill every three months and day staff every six months and keep suitable records.Outstanding (previous timescale of April 2005 Timescale for action 1st December 2005 2. 12 16(2)(m) 1st December 2005 3. 36,37 18(2) 1st December 2005 1st December 2005 4. 21 23(2)(j) 5. 19,38 23(4)(a) 1st October 2005 Stanley Burn Care Centre B53-BO3 S63750 Stanley Burn Care Centre V240105 250805 Stage4.doc Version 1.40 Page 24 not met) 6. 31 18(2) The manager’s performance must be supported and monitored through effective supervision and appraisal Outstanding (previous timescale of 1st May 2005 not met) Provide evidence to CSCI of the electrical wiring certificate for the whole home and the testing of all portable electrical appliances.Outstanding (previous timescale of 1st May 2005 not met) Review and improve the quality assurance system at the home Outstanding (previous timescale of 1st June 2005 not met) Visits by the registered provider to the home must be carried out on a monthly basis. Outstanding (previous timescale of 1st June 2005 not met) 1st October 2005 7. 19,38 13(4)a 1st October 2005 8. 33,37 24 1st October 2005 1st October 2005 9. 31,37 26 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. Refer to Standard 38 Good Practice Recommendations The provide dining chairs with arms and skids in the dining rooms on the mental illness unit. Stanley Burn Care Centre B53-BO3 S63750 Stanley Burn Care Centre V240105 250805 Stage4.doc Version 1.40 Page 25 Commission for Social Care Inspection Northumbria House Manor Walks, Cramlington Northumberland NE23 6UR 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. 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