Inspection on 08/08/05 for Stanmore Residential Home

This inspection was carried out on 8th 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 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 19/07/06

Stanmore Residential Home 18/01/06

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 2-4 Jersey Avenue Stanmore Middlesex HA7 2JQ Lead Inspector Sue Mitchell Unannounced 8 August 2005 11:00am 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. Stanmore Residential G62-G11 S17560 Stanmore Resi v212177 080805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Stanmore Residential Address 2-4 Jersey Avenue Stanmore Middlesex HA7 2JQ 020 8907 4636 020 8933 2051 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) Mr Nalin Joshi Ms Carol Sweeney CRH - Care Home 18 Category(ies) of OP 17, DE(E) 1 registration, with number of places Stanmore Residential G62-G11 S17560 Stanmore Resi v212177 080805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 17 Places for older people both genders, 1 Demetia care female Date of last inspection 19.10.04 Brief Description of the Service: Stanmore Residential Home is a care home providing care and accommodation for 17 older persons and one named person who has dementia and is over 65 years old. Mr and Mrs Joshi own the care home. The home is located in a quiet residential road, within a few minutes drive from Stanmore, within the residential area of Belmont. The home is close to a variety of local shops and amenities, such as 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. The home is located on a quiet residential road.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 Stanmore Residential G62-G11 S17560 Stanmore Resi v212177 080805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place during the late morning until late afternoon. The inspectors toured the home and met with and spoke to a number of residents during the course of the visit. There were three care staff on duty with the manager. The proprietor also visited the home and spoke with the inspectors. The inspectors spoke to the care staff on duty during the afternoon. The residents were involved in a singsong and a game of Bingo during the afternoon. The inspection focussed on following up the previous requirements, care plans and assessments of new clients, medication, health and safety matters. What the service does well: What has improved since the last inspection? What they could do better: No requirements were made at this inspection, which is commendable. Three requirements were outstanding from the last inspection, one of which had not been assessed on this occasion. The manager and proprietor must ensure the Statement of Purpose is updated and advice is sought from the fire officer as to the use of mechanisms to hold open bedroom doors safely. Three Stanmore Residential G62-G11 S17560 Stanmore Resi v212177 080805 Stage 4.doc Version 1.40 Page 6 recommendations were made in respect of improvement to health care recording, archiving old fire records and collating all the information on residents into one care folder. 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 G62-G11 S17560 Stanmore Resi v212177 080805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Stanmore Residential G62-G11 S17560 Stanmore Resi v212177 080805 Stage 4.doc Version 1.40 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 standard(s) 1,3 Residents and their relatives are given appropriate information to assist them in making their choice of home. Residents are fully assessed prior to admission and are involved in their care plans and ongoing assessments. EVIDENCE: The home had been required to update its Statement of Purpose. This had been partially completed. It must be further amended to reflect the variation to the home’s registration to accommodate one person with dementia care needs, room sizes and change the references from NCSC to CSCI. Two new resident’s files were inspected. The written assessments were found to be comprehensive and covered physical and psychological health and social care needs. There was evidence that families, where possible, were asked to give written information concerning their relative’s needs and requirements. This was then added to the care plans. The resident’s individual daily routines were documented as a result of these assessments. Stanmore Residential G62-G11 S17560 Stanmore Resi v212177 080805 Stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9 Residents care plans are written to reflect their assessed needs and wishes. The residents receive regular health care support from the local community health services EVIDENCE: Two care plans and associated documents were assessed. The care plans contained documented evidence of residents’ likes, dislikes and personal wishes. Information on theirs, and their families’ wishes after death is also now being recorded on the care plans. Each person had risk assessments in place with particular attention being paid to falls assessments. Care plans were noted to be reviewed monthly with relevant changes recorded. Information on the residents was being kept in a number of files in the office. It was recommended that the manager should put all current information on each person in one working care plan folder for ease of access and inspection. There was recorded evidence of appointments and outcomes made with the dentist, optician, chiropodist and audiologist. It is recommended that particular care is taken in making sure all areas of the care plan are checked and a degree of detail recorded for all items i.e. vision, hearing following appointments with health care professionals Stanmore Residential G62-G11 S17560 Stanmore Resi v212177 080805 Stage 4.doc Version 1.40 Page 10 The inspector was informed that the residents could stay with their own GP if they remain in the same catchment area. The manager stated that the GPs visit as and when required. The manager of the home is responsible for ongoing physical assessments of residents. Intervention due to pressure areas or prevention of pressure areas is documented. The inspectors were informed that there were no residents with pressure sores at the time of this inspection. There is support from the district nursing service as required. The district nurse visited the home during the inspection to check on one resident. It was found that particular attention is paid to the residents psychological health, and methods are devised and documented of distraction techniques and managing behaviours of residents who are confused or restless. There was one person in the home with a diagnosis of dementia. Staff were observed to provide one to one support to this person. Residents have a nutritional needs assessment on admission. The home encourages the residents to participate in a daily exercise routine. The medication and records were inspected on this occasion and found to be in order. The home has regular visits from the local pharmacist to check the stock and records. Stanmore Residential G62-G11 S17560 Stanmore Resi v212177 080805 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 The resident’s hobbies and interests are recorded and they are encouraged to participate in activities of their choice. EVIDENCE: The residents’ spoke to the inspectors about the activities they did in the home. They gave positive feedback about what was provided and what they enjoyed. The home provides a range of activities both morning and afternoon. A record of activities and who participated in them was made available for inspection. The staff also write the days activities on the blackboard in the lounge. On the day of the inspection the residents had had an exercise session in the morning and a singsong and Bingo in the afternoon. One resident said she went out shopping with the proprietor, which she enjoyed. The manager stated that the residents are taken to the seaside each year. The residents care plans indicated their preferred activities and routines. Staff were observed to spend time with the residents, running activities and sitting and chatting to them. Staff said that they enjoyed doing activities with the residents. Stanmore Residential G62-G11 S17560 Stanmore Resi v212177 080805 Stage 4.doc Version 1.40 Page 12 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) 16 Residents are encouraged to voice their concerns and complaints in the knowledge that they will be listened to. EVIDENCE: The home has a clear complaints policy and procedure in place. There had been five complaints made by four residents and one relative since the last inspection. These related to minor but important issues for the residents such as relationships, meals and getting up times. These complaints were noted to be dealt with appropriately and were clearly documented. The residents who spoke to the inspectors said they had no concerns or complaints and spoke positively about the staff, care provided and the meals. Stanmore Residential G62-G11 S17560 Stanmore Resi v212177 080805 Stage 4.doc Version 1.40 Page 13 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) 19,26 The residents live in a well maintained and homely environment, which is free from odours. EVIDENCE: The inspectors toured the premises with the manager. She stated that there were some minor repairs being undertaken by the handy person. The residents’ rooms were viewed and were seen to be comfortably furnished with residents having personal possessions in their rooms. The home has two communal areas and the residents were seen to spend the majority of their time there with each other and staff. The home was free from odours. There had been two requirements relating to Standard 26, which were noted to have been met on this inspection. Stanmore Residential G62-G11 S17560 Stanmore Resi v212177 080805 Stage 4.doc Version 1.40 Page 14 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) 27,29,30 The residents are cared for by a stable and competent staff team, that have had regular training to carry out their work with the residents. EVIDENCE: The rota was made available for inspection. The manager works alongside care staff on the morning shift. She stated that she generally works with the new residents to get to know them, as she is responsible for writing the care plans. There were three carers on each shift and one domestic who were working in the morning of the inspection. Staff take it in turns to cook the meals. The proprietor stated that due to the increased dependency needs of some residents who need one to one support at lunchtime, she had provided an extra staff member to work over this period. The manager and proprietor stated that there had been little staff turnover and there were no staff vacancies. The home had been required to ensure staff records were up to date and be in place for inspection. The manager showed the inspector two staff files, which contained the information required. The inspectors spoke to the three afternoon staff. They had all worked in the home for some time and spoke positively about the manager and proprietor and the support they received from them. They were also very enthusiastic about the training opportunities provided by the home. One person said that she was being sent on an English as a Second Language course to assist her in her studies for NVQ2, which she really appreciated. The staff also spoke knowledgably about the residents needs and activities they helped them with. Stanmore Residential G62-G11 S17560 Stanmore Resi v212177 080805 Stage 4.doc Version 1.40 Page 15 Training records and certificates were kept on site for all staff. All the staff had undertaken a range of training over the past year: fire training, dementia, safe handling of medication, protection of vulnerable adults, food safety, social care, introduction to working in care and management development. The home has links with Learn Direct training organisation. Both the manager and proprietor have recently completed their NVQ4 and the manager was on a mentoring course. They have also booked staff to attend training on dementia care. They were also about to start a more intensive course on dementia care. It was evident from discussion with staff and management that training is a high priority with the proprietor which us commendable. Stanmore Residential G62-G11 S17560 Stanmore Resi v212177 080805 Stage 4.doc Version 1.40 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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) 38 The resident’s health, safety and welfare are protected by regular health and safety checks within the home and through staff training. EVIDENCE: All certificates relating to the equipment and appliances used in the home were made available for inspection. These were noted to be in order and up to date. The lift was due to have its six monthly inspection. Staff training records indicated that they receive regular health and safety training. A fire risk assessment was in place and the weekly call bell tests are recorded. It was recommended that the fire record folder be reviewed and old information archived. The home had been required to seek advice from the fire officer as to the purchase of appropriate and safe mechanisms, which allow bedroom doors to be kept open without risk to residents. This had not been achieved. One resident who prefers to remain in her room all the time had her door propped open so she could see what was going on and people could pop in for chat. The manager stated that the bedroom doors are all kept shut at night. Stanmore Residential G62-G11 S17560 Stanmore Resi v212177 080805 Stage 4.doc Version 1.40 Page 17 Risk assessments had been carried out as required on residents who used the stairs. The home is prompt in reporting all Regulation 37 events to the CSCI office. The manager is now auditing the accident records on a monthly basis to assess any patterns in incidents. Stanmore Residential G62-G11 S17560 Stanmore Resi v212177 080805 Stage 4.doc Version 1.40 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 x COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x 2 x x x x 2 Stanmore Residential G62-G11 S17560 Stanmore Resi v212177 080805 Stage 4.doc Version 1.40 Page 19 No 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 1 Regulation 4 Requirement The Statmentof Purpose must be further amended to reflect the variation to the home’s registration to accommodate one person with dementia care needs, room sizes and change the references from NCSC to CSCI The registered person shall establish and maintain a system for reviewing, (with the service user and their representatives involvement) the service at appropriate intervals, and improving the quality of care provided at the care home. The registered person shall supply the Commission a report in regard to quality assurance i.e. an annual development plan for the home. (Not assessed on this occasion new timescale issued) Advice needs to be sought from the local fire service in regard to appropriate and safe methods/mechanisms, which allow doors to be open without risk to individuals.· Appropriate safe mechanisms Stanmore Residential G62-G11 S17560 Stanmore Resi v212177 080805 Stage 4.doc Version 1.40 Page 20 Timescale for action 30.9.05 2. 33 24(1)(2)( 3) 31.10.05 3. 38 13(4)23(4 ) 30.9.05 need to be in place if doors are kept open. Doors must not be propped open (Previous timescale of1.12.04 not met). 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. Refer to Standard 7 8 Good Practice Recommendations It was recommended that the manager should put all current information on each person in one working care plan folder for ease of access and inspection It is recommended that particular care is taken in making sure all areas of the care plan are checked and a degree of detail recorded for all items i.e. vision, hearing following appointments with health care professionals It was recommended that the fire record folder be reviewed and old information archived. 3. 38 Stanmore Residential G62-G11 S17560 Stanmore Resi v212177 080805 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection 4th 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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