Inspection on 21/10/08 for Stanmore Residential Home

This inspection was carried out on 21st October 2008.

CSCI found this care home to be providing an Excellent service.

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 19/07/06

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 30/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Stanmore Residential Home 2-4 Jersey Avenue Stanmore Middlesex HA7 2JQ     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Tony Lawrence     Date: 2 1 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Stanmore Residential Home 2-4 Jersey Avenue Stanmore Middlesex HA7 2JQ 02089074636 02089332051 nalinjoshi24@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Nalin Joshi,Mrs Anila Joshi care home 18 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 18 The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Date of last inspection Brief description of the care home 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 Care Homes for Older People Page 4 of 26 Over 65 18 0 Brief description of the care home that is easily accessible The range of fees is available from the owner 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. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 3 stars. This means people using the service experience Excellent quality outcomes. This unannounced key inspection took place on Tuesday 21st October 2008 from 09:15 - 16:00. During this visit we reviewed the homes performance against all of the key National Minimum Standards for care homes for older people. We did this by talking to residents, their relatives, staff working in the home, the homes owner and manager. We also looked at care records kept in the home, saw all communal areas and some residents bedroom. Care Homes for Older People Page 6 of 26 Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who may want to move into the home and their represetatives are given enough information about the services provided. People are encouraged to visit before moving in and their care needs are assessed and recorded. Evidence: This was the first home we looked at for mum and we didnt look at any others - this was perfect. Comment from a relative I couldnt visit but my son came and he said Id like it here - he was right! Comment from a resident During this visit we checked the homes Statement of Purpose and Service User Guide. Following a requirement we made after our last key inspection in July 2006, we saw that the manager had reviewed and updated both documents to include details of all Care Homes for Older People Page 10 of 26 Evidence: services provided in the home, including respite care. Arrangements were also in place to make sure that information about the home was updated every three months. The home now provides good information for potential residents and their representatives. The manager told us that the local authorities responsible for placing people in the home usually provided some information about individuals care needs. The manager or a senior member of staff also visited people before they moved into the home to complete the homes own care needs assessment. During this visit we checked the care plan files for four people living in the home and saw that all the required assessments had been completed. People moving into the home could be sure that their care needs would be assessed and met. People living in the home and their relatives told us that, wherever possible, people were encouraged to visit the home before deciding whether or not to move in. Relatives told us that the owner, manager and staff had been very welcoming then they visited. The owner and manager confirmed that the home did not provide intermediate care and Standard 6 did not apply. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents personal and health care needs are well assessed and recorded. The home works well with other agencies to meet health care needs. Residents medication is managed safely. Evidence: The staff are very good, they do the things I need and leave me alone when I want them to! Comment from a resident. Mum has always had help with her health care. The staff and manager are very attentive and if any help is needed, they make sure Mum gets it. Comment from a relative. During this visit we checked the care plan files of four people living in the home, including one person who was staying for a period of respite care. We saw that the care plans were based on the homes own care needs assessments and information provided by peoples relatives, local authorities and other agencies. The care plans Care Homes for Older People Page 12 of 26 Evidence: covered peoples health, personal and social care needs and included goals to make sure that identified needs were met. All of the care plans we checked had been reviewed at least twice each year, and more frequently if the persons needs changed in between planned reviews. We saw evidence that, wherever possible, residents and their relatives were involved in writing and reviewing peoples care plans. People living in the home and their relatives can be confident that peoples needs will be assessed, recorded and met in the home. The manager told us that the home used a local pharmacist to provide residents prescribed medication. During this visit we saw that all medication was securely stored in a lockable cupboard in the homes lounge. We checked the Medication Administration Record sheets for all 16 people living in the home and we saw that these were well completed, with no errors or omissions. We also saw that staff had easy access to the homes medication policy and residents files included clear information about medication prescribed for individuals. Residents can be confident they will receive the medication they need, but staff should make sure that they record the opening date on bottles of residents eye drops, to make sure that these are not used beyond the use by date. Residents care plan files included evidence of good joint work with health care services, including peoples GPs and the District Nursing Service. Residents and their relatives told us that they felt peoples health care needs were met well in the home. People also told us that they felt staff treated residents with respect and we saw that this happened consistently during this visit. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home have access to appropriate activities and are supported to keep in contact with relatives, friends and other significant people. The home provides a varied and nutritious diet that residents enjoy. Evidence: I enjoy mixing with other people living here, but if I want some private time I can always go to my room. Comment from a resident. The food is very tasteful and there is always plenty of it. Comment from a resident. If I dont want whats on the menu, the staff will always make something else for me. Comment from a resident. During this visit we saw that residents social, cultural, religious and leisure interests and needs were recorded well as part of their care plans. We also saw that the homes initial assessment of peoples needs included their culture and religion and details of how any identified needs would be met in the home. The manager told us that none of the current residents went to local places of worship, but a visitor came to the home Care Homes for Older People Page 14 of 26 Evidence: every week from a local church to talk with some residents. We saw that residents were asked about their leisure interests as part of the homes initial care needs assessment. These were recorded as part of their care plan and the home arranged a programme of activities in the home and the local community. Residents told us that they enjoyed the activities each afternoon, but were able to choose whether or not they joined in. We saw that peoples care plans included details of their relatives, friends and other significant people, together with arrangements for contacting them. Residents and their relatives told us that staff were very good at making sure that people living in the home stayed in contact with other people. The manager told us that peoples relatives usually managed their personal finances but the home did administer small sums for personal spending. We checked the record of expenditure for residents personal finances and saw that these records were up to date and well maintained. Residents can be confident that their personal money will be well managed by staff, if this support is needed. The residents and relatives we spoke with during this visit were very positive about the food provided in the home. We saw from the homes menus that a varied and nutritious diet was provided. On the day of this visit, residents had chicken casserole, potatoes and brussel sprouts for lunch with chocolate gateau for dessert. Vegetarian and Asian options were also available. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are cared for safely and people can be confident their complaints will be investigated by the provider. Evidence: Ive never had to complain about anything, but Id speak to the manager and Im sure shed sort it out. Comment from a resident. Weve never needed it, but we were given a copy of the complaints procedure when Mum moved in. Comment from a relative. During this visit we saw that the homes complaints procedure was displayed in each residents bedroom. The homes complaints record showed us that there had been five formal complaints from residents or their relatives since our last inspection in July 2006. All of the complaints were very well recorded and the record included details of actions taken by the owner and manager and the outcomes for people making the complaints. We saw that the homes whistle blowing policy and procedures were displayed in the homes office, together with information about the local authoritys safeguarding adults policy. The owner told us that she had obtained a copy of the local authoritys safeguarding procedures for staff reference. The manager confirmed there had been no safeguarding issues or investigations since our last inspection. Care Homes for Older People Page 16 of 26 Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides good standards of private and communal accommodation. Residents bedrooms are comfortable, individualised and well furnished. Evidence: I am very happy with my bedroom, its comfortable and I have brought some of my own things with me. Comment from a resident. Im very comfortable here. I like company in the conservatory but my room is quite satisfactory. Comment from a resident. Stanmore Residential Home is a detached, 2 storey property in a residential area, close to shops and transport links. There are four shared and ten single bedrooms on the ground and first floors. There is level access to the ground floor and a passenger list to the first floor. On the ground floor there is a large lounge / dining room, laundry, kitchen and office. There is a sufficient number of bath / shower rooms and toilets on both floors, close to residents bedrooms and communal areas. There is a large, attractive garden to the rear that is accessible to residents with mobility difficulties. During this visit we saw all communal parts of the home and some residents bedrooms. Communal areas were well decorated and comfortably furnished. Bedrooms were comfortable, well decorated and well furnished. Five residents told us that they Care Homes for Older People Page 18 of 26 Evidence: had brought some of their own possessions with them and all said they were happy with their bedrooms. All parts of the home we saw during this unannounced visit were clean and hygienic. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well staffed during at all times of the day and night to provide care and support to residents. Staff are well supervised and have access to relevant training opportunities. Evidence: I enjoy everything about my job. I enjoy the team work and the relationships with my colleagues and service users. Comment from a member of staff. The staff are very good, they care about the residents and are good at their job. Comment from a relative. During this visit we checked the staff files for four people working in the home. Three of the files included all of the information and pre-employment checks needed to meet these Standards, including Criminal Record Bureau checks. The fourth file had most of the required information, but the owner must make sure that the employee provides evidence of leave to remain and work in the UK. We saw that the manager had completed an annual appraisal with each member of staff working in the home in August 2008. We also saw that each member of staff had a minimum of four formal supervision sessions with the manager during 2008. This was evidence that staff were well supported to make sure they work effectively to Care Homes for Older People Page 20 of 26 Evidence: meet residents care needs. We checked the staff rotas and these showed that there were three staff on duty during the morning and afternoon shifts. There were two waking night staff on each night to provide care to residents. During our visit, staff we saw that staff worked well together to respond to residents requests for care and support. Personnel and staff training files showed that all staff had completed a range of training, including core skills training and refresher training. The manager also told us that all but two of the staff working in the home had completed their National Vocational Qualification (NVQ) Level 2 training. Some staff had also gone on to complete their NVQ Level 3. Residents and relatives who spoke to us during this inspection were very positive about the quality of care staff employed in the home. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and is run in the best interests of residents. One improvement to fire safety standards in the home is needed. Evidence: The owner and manager are very, very good, they will do anything for the people living here. Comment from a relative. I have regular supervision with the manager. It is very helpful. Comment from a member of staff. The homes owner told us that she was a qualified general and mental health nurse and had opened the home in 1988. The current manager was appointed in 2001. She has more than 20 years experience of social care and ran her own care home for four years before coming to Stanmore Residential Home. We have registered the owner and manager as fit persons to own and manage a care home for older people. The Care Homes for Older People Page 22 of 26 Evidence: owner and manager both demonstrated an excellent awareness of current best practise and developments in social care and residential services. The owner told us that residents and their relatives were given a quality assurance questionnaire each year to enable them to comment on the services provided in the home. Results from the survey were collated by the owner and used to develop an annual action plan to further improve services. Relatives who spoke with us during this visit said that they had received surveys each year. They told us they felt this helped to improve communication between the home and relatives and had resulted in improved services for residents. The manager told us that relatives or the local authority usually managed residents finances but the home did administer small amounts of personal spending money for individuals. We checked the finances records for three residents and saw that peoples personal money was well managed and records were up to date and well maintained. We saw evidence that all people working in the home were well supervised by the manager. Each person had received formal supervision at least 4 times during 2008 and a written record was kept of each session. Staff told us that they found the supervision and support helpful. During this visit we checked a selection of records kept in the home, including residents care plans, care needs and risk assessments, finance, medication, health and safety and staff records. We saw that all of these records were well maintained and up to date. This was evidence that the care and support provided in the home was well recorded, showing that residents were receiving the care and support they needed. During this visit we saw that required health and safety checks were carried out and accurate records were kept. During this visit we discussed one health and safety issue with the owner and manager. The owner and manager must make sure that fire doors in the home are not propped open. This is especially important in high risk areas such as the kitchen. Where fire doors need to be kept open, they must be fitted with a selfclosing device that is activated by the homes fire alarm system. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action 1 29 19 The owner must make sure that, where required, staff provide evidence of leave to remain and work in the UK. This will make sure that all staff working in the home are eligible to care for vulnerable adults. 31/12/2008 2 38 23 Fire doors in the home must not be wedged open at any time. This will reduce risks to residents, staff and visitors in the event of a fire. 05/12/2008 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 9 Staff should make sure that they record the opening dates on bottles of eye drops. Care Homes for Older People Page 25 of 26 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!