Inspection on 19/07/06 for Stanmore Residential Home

This inspection was carried out on 19th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Stanmore Residential Home 21/10/08

Stanmore Residential Home 18/01/06

Stanmore Residential Home 08/08/05

Stanmore Residential Home 19/10/04

Stanmore Residential Home 09/06/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Stanmore Residential Home 2-4 Jersey Avenue Stanmore Middlesex HA7 2JQ Lead Inspector Judith Brindle Key Unannounced Inspection 19th July 2006 09:00 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 Stanmore Residential Home DS0000017560.V291488.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. Stanmore Residential Home DS0000017560.V291488.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stanmore Residential Home Address 2-4 Jersey Avenue Stanmore Middlesex HA7 2JQ 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) 020 8907 4636 020 8933 2051 Mr Nalin Joshi Mrs Anila Joshi Ms Carol Sweeney Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Stanmore Residential Home DS0000017560.V291488.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th January 2006 Brief Description of the Service: Stanmore Residential Home is a care home providing care, and accommodation for 18 older persons. Mr and Mrs Joshi own the care home. The home is located in a quiet residential road, a few minutes drive from Stanmore, within the residential area of Belmont. The home is close to a variety of local shops, restaurants, banks, and parks. Local public transport includes bus services. Stanmore and Harrow Wealdstone underground train stations are located within a short drive from the home. The home was opened in 1988, and consists of a detached two-story building. There is parking for several cars on the forecourt. There are four rooms that are shared, and ten bedrooms that are single. There are no bedrooms with en-suite facilities. There is a passenger lift. The home has a large enclosed, and well-maintained garden to the rear that is easily accessible The range of fees is accessible from the registered proprietor, and information in regard to additional charges is recorded in the service user guide. Information and documentation about the service is available from the care home. Stanmore Residential Home DS0000017560.V291488.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place throughout 8.5 hours during a day in July 2006. The inspector was pleased to meet, and speak with most of the residents, some relatives/visitors, and several staff on duty. The purpose of the key inspection was to spend time with the residents, and to gain their views of the service, assess key standards, and to follow up and assess as to whether previous requirements and recommendations had been met. The inspection included a tour of the premises, inspection of resident’s care plans, staff personnel records, medication storage and administration, menus and mealtimes, and inspection of a variety of other records. The inspector spent a significant part of the inspection talking with most of the residents. Resident’s communication needs were diverse, some residents could verbally communicate their views of the service others communicated by sounds and gestures, due to health needs, so observation of interaction between residents and staff formed a significant part of the inspection process. The registered manager was present during the inspection. The proprietor was present during part of the inspection. Staff kindly provided all the information, and documentation requested by the inspector during the inspection. 22 National Minimum Standards were assessed during the inspection and requirements from the previous inspection were judged as having been met. The inspector thanks all those who participated in the inspection process. What the service does well: The care home has a very welcoming and calm atmosphere. Visitors and residents spoke very highly of the care provided by the care home. The manager and staff team care for residents in a competent and respectful manner, and have a particular sensitivity in regards to meeting resident’s individual and varied needs. Residents spoke of being ‘happy’ living in the care home. The manager and provider to work hard to ensure that a quality service is provided for residents, and ensure that changes are made to improve the service when this is needed. The food provision is of good standard, meets cultural needs, and choices are available. There is an emphasis on providing appropriate staff training. The registered manager has worked particularly hard in ensuring that staff have the opportunity to complete varied and appropriate training including NVQ care courses. Stanmore Residential Home DS0000017560.V291488.R01.S.doc Version 5.2 Page 6 There are staff employed who have knowledge, understanding and can communicate in languages, which meet the particular cultural needs of residents. The home has a large well maintained garden. Residents spoke of enjoying this facility. What has improved since the last inspection? 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. Stanmore Residential Home DS0000017560.V291488.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 Stanmore Residential Home DS0000017560.V291488.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 1,3 (6 is not applicable) Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Arrangements are in place to ensure that generally residents have their needs assessed prior to moving into the care home, but this needs further development to ensure that all residents including those receiving respite care have received a recorded assessment of there needs by the care home, to ensure that the service can meet the resident’s needs. EVIDENCE: The care home has documentation in regard to the service provided by the care home, which is accessible to residents and visitors/others. This includes a statement of purpose and a service user guide. The service user guide was displayed in the communal area. The statement of purpose needs to be amended to ensure that the criteria in regard to the provision of respite care are recorded in this documentation. The care home has an admission procedure, which is included in the statement of purpose documentation. This includes information in regard to the need for all prospective residents to receive an assessment of their needs, which Stanmore Residential Home DS0000017560.V291488.R01.S.doc Version 5.2 Page 9 includes a ‘Pre- admission of Need’ assessment by a competent senior staff member. The registered manager reported that an assessment of prospective resident’s needs is also completed by the funding Local Authority and supplied to the care home by them. Completed assessments by Care Managers from purchasing authorities were available for inspection. It is recorded that self funding prospective residents receive a comprehensive needs assessment by the registered person. Four care plans were inspected. Three care plans recorded evidence of assessment of the needs of the residents, and included evidence of a recorded pre-admission assessment of these residents’ needs. These assessments included, assessment of communication needs, mental health needs, mobility needs, social needs and preferences, and healthcare needs. The documentation in regard to a service user receiving respite care did not include evidence of assessment from a purchasing authority nor from the registered person, or evidence of a comprehensive plan of care and support. There was some documentation in regard to personal details and recorded guidance in regard to medication needs. The issue of ensuring that all residents including those receiving respite care receive an assessment was discussed with the registered manager, who spoke of her plans to ensure that senior care staff have the skills and competency to complete this documentation when the manager is not on duty. The statement of purpose needs to be amended to ensure that the criteria in regard to the provision of respite care are recorded in this documentation. Stanmore Residential Home DS0000017560.V291488.R01.S.doc Version 5.2 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 the following standard(s): Standard 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements are in place to ensure that generally resident’s health social and personal care needs are set out in an individual care plan. The registered person needs to ensure that residents receiving respite care have a comprehensive plan of care in place. Medication is administered safely. Arrangements are in place to ensure that the residents are respected and their right to privacy upheld. EVIDENCE: All residents apart from a respite service user had recorded evidence of a comprehensive plan of care. The registered person needs to ensure that all service users who receive respite care have a comprehensive plan of care, which clearly records assessed needs and action to be taken by staff to meet those needs during their stay whether it is for a short time or for several weeks. Stanmore Residential Home DS0000017560.V291488.R01.S.doc Version 5.2 Page 11 The three care plans inspected recorded resident’s health, mental health needs, social, and personal care needs, and some staff guidance, to ensure that these needs are met. There should be further development in the staff guidance to meet some assessed needs. This includes development in the recorded staff action to meet the pressure area care needs of residents, particularly those at high risk of pressure sore, those who are at risk of choking, and also in regard to those with diabetic needs. This was discussed with the registered manager. There was evidence that these care plans are reviewed at least monthly and updated to record any changes in needs. Resident’s weight is monitored. Some documentation recorded in the care plans indicated resident’s involvement in their care plans. This includes information about their preferences, hobbies and interests. ‘Daily’ records are completed by staff in regard to the progress of the residents. Records confirmed that resident’s health needs are met. Appointments with the GP, optician, dentist, community nurse, chiropodist, were documented. An optician visited a resident during an inspection. Records confirmed that residents attended hospital appointments. The manager informed the inspector of examples of recent dental treatment received by several residents. A resident confirmed that she had received recent chiropody care. A visitor confirmed that their relative receives treatment and support from healthcare specialists as and when she needs, and that she was kept informed of her relative’s progress. The registered manager confirmed that pressure relieving equipment is supplied to residents as and when they require it according to their assessed needs. The medication administration and storage systems were inspected. Medication is stored securely, and medication received from the pharmacist is recorded. Medication administration record sheets confirmed that there were no gaps in recording. Records confirmed that staff have received medication training. There are photographs of residents adhered to the medication charts. Stored medication no longer prescribed for residents should be returned to the pharmacist. This was discussed with a senior care staff member. The medication policy was easily accessible to staff. The registered manager, and induction records confirmed that staff are informed of the importance of respecting resident’s privacy needs, and of confidentiality issues, during the staff induction programme. The manager confirmed that residents who share a room agree to do so and that this is recorded in their plan of care. Shared rooms all have screen facilities. It was recorded in care plans inspected that residents open their own mail, or with staff and/or relatives support depending upon assessed needs. Stanmore Residential Home DS0000017560.V291488.R01.S.doc Version 5.2 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): Standard 12,13,14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements are in place to ensure that residents have the opportunity to participate in a variety of activities. The visiting arrangements are flexible and meet the needs of visitors and residents. Residents are supported to make choices. Meals provided are varied and nutritious. EVIDENCE: Resident’s social needs are assessed during the process of assessment. Records indicated resident’s participation in this assessment. The care home has an activity programme. This programme was followed during the inspection. Residents were given the opportunity to join in an exercise session during the inspection. The manager spoke of exercise sessions being offered on a daily basis to residents. Residents were observed to enjoy dancing to some musical songs and tunes. Staff were observed to join in these activities. Residents spoke of enjoying the garden in the warm weather. A resident spoke of her enjoyment in attending a day/resource centre for four days a week. Another resident spoke of regularly going out into the community with a Stanmore Residential Home DS0000017560.V291488.R01.S.doc Version 5.2 Page 13 family member. Another resident spoke of being ‘happy’ living in the care home. Visitors spoke of visiting the care home at different times of the day. Staff were observed to offer residents choice during the inspection. Residents who kindly spoke with the inspector were very positive about the care and support that they received from staff. There was information in regard to accessing an advocate service displayed in the sitting/dining room. Residents have access to a pay phone. Residents are generally supported by their relatives or by the purchasing Local Authority in the management of their monies. The menu recorded a variety of wholesome and nutritious meals. Choice was indicated on the menu, and staff gave examples of when a different meal was provided to residents such as preferred sandwiches rather than the main meal. The lunch provided during the inspection was unhurried and residents reported that the meal was very pleasant. Asian residents received a lunch, which met their cultural needs, and spoke of enjoying the meal. The registered provider prepares these meals. A variety of frozen, dried and tinned foods and fresh foods were stored. The staff member who assisted in the preparation of the lunch confirmed that she had received certified food and hygiene training. Residents were offered frequent drinks and snacks during the inspection. Stanmore Residential Home DS0000017560.V291488.R01.S.doc Version 5.2 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 the following standard(s): Standard 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements are in place to enable residents, relatives and others to communicate a ‘concern’ or complaint. Arrangements are in place to ensure that residents are protected from abuse. EVIDENCE: The care home has a complaints policy, and procedure. This is displayed in the home. The manager reported that all residents and their relatives/significant others receive a copy of the complaints procedure. Recorded complaints indicated that appropriate action is taken by the manager to resolve complaints, and those residents are supported in making complaints, and that these are taken seriously. It is positive that residents are enabled and supported to communicate ‘concerns’ complaints freely. A resident expressed a concern/complaint during the inspection. The registered manager communicated to the complainant and relative the action taken to resolve this. The manager confirmed that this complaint/concern and the action taken to investigate it would be recorded. The care home has a protection of vulnerable adults procedure, and the Local Authority guidance. The manager reported that staff receive abuse awareness training during induction. Records and staff confirmed that some staff had received further protection of vulnerable adults training. Staff who kindly spoke with the inspector had knowledge and understanding of the reporting and recording procedures in regard to protection of vulnerable adults. Stanmore Residential Home DS0000017560.V291488.R01.S.doc Version 5.2 Page 15 It is recommended that staff receive further protection of vulnerable adults training, and that advice in regard to this is sought from the Local Authority. Stanmore Residential Home DS0000017560.V291488.R01.S.doc Version 5.2 Page 16 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): Standard 19 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The environment is very clean and generally well maintained. The décor of some areas could be improved. EVIDENCE: The inspection included a tour of the premises. The registered person should examine ways of identifying rooms in the care home, which could assist residents in maintaining their orientation skills. This was discussed with the manager. There are areas of décor in the conservatory/dining area that need maintenance. These include peeling wallpaper in several areas. The ground floor toilet/shower room needs cracked damaged tiles replacing, paint work on the radiator cover needs repainting, and the flooring in this room needs to be assessed as there are areas that indicate a bubbling effect, which could be a trip hazard. There is a light in the laundry facility that is not working. Another light in the laundry room needs to have a shade to minimise possible fire risk. The Stanmore Residential Home DS0000017560.V291488.R01.S.doc Version 5.2 Page 17 laundry extractor fan needs cleaning, and a small hole in the ceiling needs repair. Several unclean, and dusty lampshades in the communal corridors need cleaning or replacing. A resident’s bedroom (2) needs redecoration of areas of the skirting board and wallpaper repaired or replaced. Several washbasin taps in resident’s bedrooms and a bathroom were difficult to turn on and off, and need repair. The registered person should check and if necessary repair all taps in the care home to ensure that they are in working order, and easy to turn on and off. Several residents’ bedrooms and the communal areas should be redecorated to ensure that residents live in a more pleasant and attractive environment. There should be consideration in regard to providing some new fittings and furnishings to improve and ‘freshen up’ the communal areas. This was discussed with the registered manager. Spare mattresses located in two resident’s bedrooms need to be stored elsewhere. The enclosed garden is well maintained. The home is generally clean. Staff complete cleaning duties. The registered manager spoke of recently employing a bank member of staff, who was carrying out domestic cleaning duties during the inspection. Toilets/bathroom facilities were judged to be clean, and had appropriate hand washing facilities. The laundry facilities are located away from food storage and food preparation areas, and include an industrial washing machine and dryer. Clothes were being dried outside in the garden during the inspection. Disposable aprons and gloves were seen to be accessible to staff Stanmore Residential Home DS0000017560.V291488.R01.S.doc Version 5.2 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 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): Standard 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements are in place to ensure that resident’s needs are met by appropriate numbers and skill mix of staff. Arrangements are in place to ensure that residents are supported and protected by the home’s recruitment policy and practices. Staff receive appropriate training to ensure that they are competent to carry out their roles, and responsibilities in meeting the varied needs of residents. EVIDENCE: The staff rota was available for inspection. There are generally three care staff on duty during the day, and two care staff on duty at night. The registered manager works weekdays and provides practical support and assistance to residents in regard to meeting their personal care (and other needs, including cooking duties) needs whilst on duty. Staff who kindly spoke to the inspector confirmed that there were suitable numbers of staff on duty. The registered manager confirmed that staffing needs are regularly reviewed in regards to meeting changing needs of residents. Most staff have knowledge and understanding of a variety of Asian languages, (as well as English), which meets the communication needs of several residents. Staff spoke of their key working role. Stanmore Residential Home DS0000017560.V291488.R01.S.doc Version 5.2 Page 19 The registered manager reported that most staff had completed NVQ care level 2 courses, and that there were two staff planning to start or have already commenced an NVQ level 3 care course. Staff personnel files were available for inspection. Three staff files were inspected. These included required information including, application form, references and enhanced Criminal Record Bureau check. One staff file contained a Criminal Record Bureau check from another Organisation. The manager reported that at present this staff member was not assisting residents with their personal care needs, but the registered person needs to ensure that an enhanced Criminal Record Bureau check with a Protection of Vulnerable Adults check is carried out by this employer due to the nonportability of these checks. This was discussed withy the registered manager. The home has a training plan. This should be developed to include individual staff training needs and goals. The manager and staff spoke of the variety of appropriate training courses that staff had undertaken. Records confirmed that staff had received manual handling training, risk assessment training, food and hygiene training; communication training, fire training and dementia care training. A ‘skin and wound care’ course was planned. The manager spoke of a planned comprehensive dementia care training course, which all staff would undertake. It was evident from discussion with staff and management and from inspection of records that staff training is a high priority within the care home. Records informed the inspector that staff complete an induction programme. Stanmore Residential Home DS0000017560.V291488.R01.S.doc Version 5.2 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 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): Standard 31,33,35 and 38 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. The resident’s benefit from an experienced and competent management approach to the care home. There are systems in place to monitor and improve the quality of the service for residents. Resident’s financial interests are safeguarded, and the health, safety and welfare of residents and staff are promoted and protected. EVIDENCE: The registered manager has managed the care home for several years and is very knowledgeable of the service user group. She has a very much ‘hands on approach’ and a very caring and sensitive manner, which was demonstrated during the inspection. It was evident that she knew all the residents very well and had a good understanding of their individual needs, and closely monitors Stanmore Residential Home DS0000017560.V291488.R01.S.doc Version 5.2 Page 21 the care provided to residents. The registered manager undertakes periodic training to up date her skills and knowledge whist managing the care home. The manager has completed an NVQ 4 course in management. The manager spoke of plans to complete the NVQ 4 in care, and of having completed a ‘mentoring in the workforce’ course. There are clear lines of accountability within the home. The registered provider visits the home most days. Staff confirmed that the manager was very approachable. Residents spoke highly of the manager. A recorded audit completed in May 2006 in regard to completed questionnaires about views of the service from twenty three relatives/significant others and visitors was available for inspection. A recent annual development plan of the care home had been completed. Records confirmed that the care home has systems in place to review care plans, health and safety issues, policies/procedures and staff training needs. The care home has a financial policy/procedure in regard to resident’s monies. Relatives/significant others generally manage resident’s finances. Small amounts of monies for the purchase of toiletries and for hairdressing needs are managed by the home. A sample of two residents records were inspected. These were well recorded, up to date, and the money balanced correctly. Certificates of worthiness in regard to electrical checks were up to date. A service check for Legionella in the water systems, and required service checks of the passenger lift had been recently carried out. The care home has a fire risk assessment, which had been reviewed this year. Fire equipment had received appropriate service checks. Fire action guidelines were displayed. There was some evidence of staff fire training. The registered manager reported that a fire drill, which had included residents and staff, had taken place in July 2006. The manager should ensure that any issues/concerns in regard to the evacuation of individual residents should be recorded in the fire risk assessment if not already recorded i.e. mobility needs and/or behaviour needs. There were some doors in the care home ‘propped’ open with wedges. The registered person needs to ensure that there are appropriate safe systems in place (following advice from the Local Authority Fire service) to enable doors to be left open. If these systems are not in place the doors need to be kept closed. The registered person should ensure that she regularly reviews the issue of doors possibly being ‘propped’ open within the care home. The home has an accident policy and procedure. Accidents/incidents are appropriately recorded. Health and safety monitoring systems in regard to the environment are in place. Fridge/freezer temperatures are monitored. The call bell system is in working order. Stanmore Residential Home DS0000017560.V291488.R01.S.doc Version 5.2 Page 22 The water from a washbasin tap was very hot to the touch. The provider was spoken to during the inspection and confirmed that the temperature gauge would be adjusted on the day of the inspection. The registered person needs to inform the Commission of Social Care Inspection when this is completed, and all the hot water taps in the home need testing. Hot water testing should be monitored regularly in the care home. The employer’s liability insurance certificate was displayed and up to date. Stanmore Residential Home DS0000017560.V291488.R01.S.doc Version 5.2 Page 23 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 2 X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Stanmore Residential Home DS0000017560.V291488.R01.S.doc Version 5.2 Page 24 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 OP1 Regulation 4(10(c) Requirement Timescale for action 01/10/06 2 OP3 14(1) 3 OP7 15 4 OP19 23(2) The statement of purpose needs to be amended to ensure that the criteria in regard to the provision of respite care are recorded in this documentation. There needs to be evidence that 01/09/06 all residents have received a recorded initial assessment of their needs. The registered person needs to 01/09/06 ensure that all service users who receive respite care have a comprehensive plan of care which clearly records assessed needs and action to be taken by staff to meet those needs • Peeling wallpaper in the 01/11/06 conservatory/dining area needs repair. • The ground floor toilet/shower room needs cracked damaged tiles replacing, paint work on the radiator cover needs repainting, and the flooring in this room needs to be assessed as there are areas that indicate a bubbling effect, which DS0000017560.V291488.R01.S.doc Version 5.2 Stanmore Residential Home Page 25 5 6 OP19 OP29 23 7,9,13 (6) 19 7 OP38 12,13(4) 23(4) 8 OP38 12,13(4) 23 could be a trip hazard. A light in the laundry needs repair, and the second light facility needs a lampshade. • The laundry room extractor fan needs cleaning, and a small hole in the ceiling needs repair. • Several unclean lampshades in the communal corridors need cleaning or replacing. • Several washbasin taps in resident’s bedrooms need repair. Spare mattresses located in two resident’s bedrooms need to be stored elsewhere. The registered person needs to ensure that an enhanced Criminal Record Bureau check with a Protection of Vulnerable Adults check is carried out for a new staff member. • The registered person needs to ensure that there are appropriate safe systems in place (following advice from the Local Authority Fire service) to enable doors to be left open. • If these systems are not in place the doors need to be kept closed. • The hot water tap temperature in a ground floor bathroom needs adjusting to ensure that there is no risk of harm. • The registered person needs to supply the Commission of Social Care Inspection with evidence that this has been completed. • and all the hot water taps • DS0000017560.V291488.R01.S.doc 01/09/06 01/10/06 01/10/06 01/09/06 Stanmore Residential Home Version 5.2 Page 26 in the home need testing. 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 3 Refer to Standard OP7 OP9 OP19 Good Practice Recommendations There should be further development in the staff guidance to meet some assessed needs Stored medication no longer prescribed for residents should be returned to the pharmacist. • Several resident’s bedrooms and the communal areas should be redecorated. • Communal areas should be redecorated to ensure that residents live in a more pleasant and attractive environment. • There should be consideration by the registered person in the provision of some new fittings and furnishings to improve and ‘freshen up’ the communal areas. • The registered person should check and if necessary repair all taps in the care home to ensure that they are in working order. The registered person should examine ways of identifying rooms in the care home, which assist residents in maintaining orientation skills. The training plan should be developed to include individual staff training needs and goals. The manager should ensure that any issues/concerns in regard to the evacuation of individual residents should be recorded in the fire risk assessment i.e. mobility needs and/or behaviour needs. Hot water testing should be monitored regularly in the care home. The registered person should ensure that she regularly reviews the issue of doors possibly being ‘propped’ open within the care home. 4 5 6 OP19 OP30 OP38 7 8 OP38 OP38 Stanmore Residential Home DS0000017560.V291488.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH 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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