Inspection on 13/06/06 for Stanton Lodge Nursing & Residential Home

This inspection was carried out on 13th June 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Stanton Lodge Nursing &... 21/04/10

Stanton Lodge Nursing &... 26/01/10

Stanton Lodge Nursing &... 10/06/09

Stanton Lodge Nursing &... 06/08/08

Stanton Lodge Nursing &... 04/06/07

Stanton Lodge Nursing &... 14/11/05

Stanton Lodge Nursing &... 02/06/05

Stanton Lodge Nursing &... 07/12/04

Stanton Lodge Nursing &... 26/05/04

Similar services:

The Highlands

Turret Villa Retirement Home

Moor House

Blenheim House

1 Lanark Close

Mendip House

Beaconsfield Court Care Home

Ann Charlton Lodge

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

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Stanton Lodge Nursing & Residential Home Millfield Avenue Shiremoor Tyne & Wear NE27 0LE Lead Inspector Mrs Irene Bowater Key Unannounced Inspection 08:30 13th June 2006 X10029.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 Stanton Lodge Nursing & Residential Home DS0000029001.V289888.R01.S.doc Version 5.1 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 and Care Homes for Adults 18 – 65*. 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. Stanton Lodge Nursing & Residential Home DS0000029001.V289888.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Stanton Lodge Nursing & Residential Home Address Millfield Avenue Shiremoor Tyne & Wear NE27 0LE 0191 2522919 0191 2535017 stanton.lodge@fshc.co.uk 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) Laudcare Ltd (a wholly owned subsidiary of Four Seasons Health Care Ltd) Mrs Veronica Bernadette Cairns Care Home 72 Category(ies) of Old age, not falling within any other category registration, with number (51), Physical disability (21) of places Stanton Lodge Nursing & Residential Home DS0000029001.V289888.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Three named service users are under pensionable age. No further admissions of under pensionable age service users must take place without prior agreement of the Commission for Social Care Inspection 14th November 2005 Date of last inspection Brief Description of the Service: Stanton Lodge is a purpose built 72 bed care home. All the accommodation is on ground floor level and all the bedrooms have en-suite facilities. The home is situated in a residential area and is close to local amenities and public transport. There are three units within the home each offering a different category of care, personal care, personal care with nursing and a unit for young physically disabled people. Qualified nurses are employed in the two nursing units and senior care and care staff, staff the third unit. There are lounges and dining rooms on each unit and there is a smoking lounge. All units have specialist baths, showers and disabled toilets. There are enclosed garden areas, which are wheelchair accessible, and there are car-parking facilities. Fee rates vary from £356 to £490.This includes the nursing care element without specialist equipment. Stanton Lodge Nursing & Residential Home DS0000029001.V289888.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key unannounced inspection that took place over eight hours and was carried out by two inspectors. Following the last unannounced inspection the home was subject to a Warning Letter being issued in December 2005. Letters and other correspondence in relation to this are available at the CSCI office. The Company have responded to the issues raised and are complying with the requirements within timescales. They continue to work with CSCI and other Agencies. Over the course of the day a tour of the premises took place and residents, relatives and staff were spoken to. Care records and other home records were also inspected. Surveys of residents were also carried out. What the service does well: The staff have all the necessary information before any resident moves into the home to ensure they can meet their needs. Contracts are available and they set out what the residents can expect to receive for the fees and their terms and conditions of occupancy. The care plans are detailed regarding the health and personal care needs of individual residents. There is good communication with other professionals to ensure residents health care needs are met. Staff make particular attention to make sure residents maintain their dignity and right to privacy when delivering personal care. Resident’s rights and preferences about who assists them is taken into account at all times. Visitors are made welcome and there are good links with the local community. Residents on the Younger Persons unit said they regularly went to the pub or on outings with friends, family or alone. One resident said the staff supported him as much as they could to go out, as he liked his independence too much. Surveys that were returned said the following: “The nursing home is 100 on its care and everything else.” “They gave me all the support I needed and the information I wanted.” “I am very happy living here, I get everything I need.” “The staff are friendly and the rooms are cosy.” Five visitors said: Stanton Lodge Nursing & Residential Home DS0000029001.V289888.R01.S.doc Version 5.1 Page 6 “We are happy with the care”, “We have no complaints” “I can’t fault the care” “The home is nice” “The staff are excellent” Residents spoken with said they knew who to complain to should if they were unhappy. The staff are confident about using the “Whistle Blowing” policy to protect the residents as far as possible. What has improved since the last inspection? What they could do better: Although there have been improvements made to the care plans, work is still needed to ensure they are clear and detailed about the social care provided. Improvements are needed to the medicine charts. The menus need to be reviewed to enable more varied and nutritious meals to be available. Comments from residents on the three units about the food said: “The portion size is small”, Stanton Lodge Nursing & Residential Home DS0000029001.V289888.R01.S.doc Version 5.1 Page 7 “There’s not a lot of variety”. “Sometimes the food is not so good”. Further training for staff is needed so that they can continue to improve the lives of the residents living in the home. The consultation with residents and their representatives needs to improve to ensure the home continues to develop and provide a good service. The home needs to develop the activities and flexible lifestyles for residents, which develops individual choices and independence. The systems to enable residents receive interest on their money need to be resolved. Health and Safety issues, in regard to the kitchen, must be reviewed to keep residents, staff and visitors as safe as possible. The domestic appliances need to be replaced. The refurbishment of the home must be completed within timescales. All of the requirements from this report need to be met within the timescales. 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. Stanton Lodge Nursing & Residential Home DS0000029001.V289888.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) Stanton Lodge Nursing & Residential Home DS0000029001.V289888.R01.S.doc Version 5.1 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3,OP, YA 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The Statement of Terms and Conditions (Contract) sets out the rights and obligations of both the resident and provider. The admission assessments ensure the residents care needs will be met. Stanton Lodge Nursing & Residential Home DS0000029001.V289888.R01.S.doc Version 5.1 Page 10 EVIDENCE: All of the residents have detailed contracts. These set out the terms and conditions including fee rates for people living in the home. Residents who are funded by a Local Authority have a contract with the home, which in turn, contracts with Authority. The care plans showed that there are comprehensive preadmission and admission assessments, which are completed by care managers and the home’s senior staff. Residents who are self-funding and without a care management assessment have a comprehensive assessment carried out by the senior qualified nursing staff. Stanton Lodge Nursing & Residential Home DS0000029001.V289888.R01.S.doc Version 5.1 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards to be inspected at least once during a 12 month period JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 OP, YA 6,9,16,18,19,20 Quality in this outcome is adequate. This judgement has been made using available evidence including a visit to the service. The care planning system need further improvement to provide staff with the information they need to meet resident’s social care needs. The health needs of residents are currently being met. There is interagency working. The lack of two signatures for hand written directions on medicine charts has the potential to place residents at risk. Personal support is currently promoting residents right to privacy and dignity. Stanton Lodge Nursing & Residential Home DS0000029001.V289888.R01.S.doc Version 5.1 Page 12 EVIDENCE: Three resident’s spoken to said that they regularly went to the local pub or on outings with friends or family and alone. Several people have electric wheelchairs and can use the nearby metro station. One person said that he enjoyed getting out as much as possible and that the staff supported him to do so he felt that he could not cope with being stuck indoors all the time, as he likes his independence too much. One person maintains contacts with her community and day care support service whilst in Stanton Lodge on respite. People are encouraged to maintain interests and to get involved in activities organised within the home. Care plans examined contain risk assessments for people to enable them to engage in independent activities. Care plans contain information regarding personal preferences and personal care. Resident’s spoken to said that they could choose whether to have a bath or shower and how often. One person said that in the main the support he received within the home was to enable him to have a shower and that the staff were very good and helped him when he asked. One care plan contained clear instructions that personal care should be provided by female staff only to a female service user with high dependency needs in order to preserve her dignity. Another care plan contained information regarding prompts to personal hygiene for someone to whom personal grooming and independence were highly significant. One care plan for a respite resident did not contain a photograph, any personal or social information. Four care plans were detailed about all aspects of personal and health care needs. There was evidence that specialist referrals are made when necessary including psychiatric and tissue viability nurses, physiotherapists, occupational therapists and consultants. The care plans lacked detail about residents social care needs and assessments were incomplete. Care plans contain risk assessments, which enable residents to take responsibility for their personal safety and to exercise choice in some aspects of their daily lives. Some people on the YPD unit are independent and require input for specific personal care tasks. Others are more dependant and may have limited communication and the challenge for the staff team is to develop effective strategies to enable people to exercise choice and to maximise independence. Stanton Lodge Nursing & Residential Home DS0000029001.V289888.R01.S.doc Version 5.1 Page 13 The home has detailed procedures to make sure medicines are administered safely. The home is undergoing major refurbishment and the treatment room has been relocated to another area of the home. It was confirmed that a new controlled drug cupboard was on order and the flooring was to be replaced. An audit of Controlled Drugs was correct and there were no gaps on the Medicine Administration Records. Not all hand written entries had been double signed. Stanton Lodge Nursing & Residential Home DS0000029001.V289888.R01.S.doc Version 5.1 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 OP, 12,13,15,17,YA Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the service. Further improvements in social activities will provide stimulation and interest for residents living in the home. Support from relatives and representatives provide residents with opportunities to maintain their previous lifestyles. Residents are not fully supported to make choices and take control over their lives. The choices and presentation of meals is not satisfactory to meet residents’ individual needs. Stanton Lodge Nursing & Residential Home DS0000029001.V289888.R01.S.doc Version 5.1 Page 15 EVIDENCE: Many resident’s spoke of choices and decisions they were supported to make including activities and where to sit. Many were unaware of the impact of building work and where they would be moving to when the YPD Unit is relocated. One person said that his belongings had been moved from his room to a temporary room whilst he was out. He did not know how long he would be in the temporary room for or where he would be moving to in the new YPD Unit. Staff spoken to said that the manager had had a couple of meetings with residents and families and told them about the building work. Residents are given limited choice in choosing meals and the way that choices are made is ineffective for those with memory impairment and communication problems. There is no menu displayed in the home and menus are not made available in pictorial format to assist choice and decision-making. People who are independent are given limited choices; those who are dependent are not enabled to make effective decisions. Bed times and rising times are flexible for those who are independent but for those who require assistance care is provided as part of a daily routine. Meal times follow a pattern of routine and there are no alternatives available as a matter of course. Observation at lunchtime did not indicate that choice and decision making was actively promoted. Meal choices are made the day before from a written tick list, which staff discuss with residents. There is no menu displayed in the dining room. Lunch on the day of inspection was liver or cheese pasties with mashed potatoes and carrots and gravy. In addition people can request something else, one person had scrambled egg and a number of people had booked baked potatoes and cheese. The staff on the YPD unit were stretched to provide assistance to two people who require help and to provide more independent residents with their meals. A new staff member was assisting a resident with their meal .She had no previous experience and one person had to wait until the qualified nurse intervened on his behalf to ensure he received his lunch as the care worker assigned to the task was redirected by a colleague. One person had made a choice the previous day and wished to change his mind however there were not enough baked potatoes and he was given liver as previously ordered. He chose to leave the dining room and to refuse the lunch provided. Dessert was semolina, which none of the residents on the YPD unit wanted but one person had. Yoghurts were brought to the dining room from the kitchen Stanton Lodge Nursing & Residential Home DS0000029001.V289888.R01.S.doc Version 5.1 Page 16 however not everybody wanted yoghurt either. The main cooked meal and tea is included on the staff tick list however dessert is not indicated. The meal time routine on the residential and nursing unit was satisfactory and several of the residents chose to have the meal served in their bedrooms. Menus were not available and the residents were unsure what was for lunch. Six residents said the “food is fine,” three said, “it’s all the same”; four said “it’s awful”. One relative said the “food portion size is small and there is not a lot of variety”. The toasters, kettles and microwave ovens on the units were generally dirty with old food spillages and food crumbs. One person said that the staff were very good and friendly and that they just let him get on with his life. There was evidence on the activities wall of local community involvement and people come and go from the building using the local shops and the nearby metro station to venture further afield. There is a new activities coordinator working full time who spends a lot of time with residents in the YPD Unit. Resident’s spoke of the barbecue, which was held for the first England football match of the world cup. Trips have been organised recently to St Mary’s Island, a picnic and to the Red Lion for lunch, a trip is planned to the Air Show in Sunderland. A visit to the area where one resident grew up has been arranged and outings now take place on individual basis. More work could be done to engage less vocal independent service users in meaningful activities. Three residents have holidays arranged this year and have had holidays in previous years. One person was offered a holiday but as a smoker made the decision to use his money for cigarettes rather than contribute toward the cost of a holiday. There is no evidence that other service users have access to holidays. Stanton Lodge Nursing & Residential Home DS0000029001.V289888.R01.S.doc Version 5.1 Page 17 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The complaints procedures are clear. Relatives and residents are confident that their views are always listened to or acted upon. Arrangements for the Protection of Vulnerable Adults are satisfactory and protect residents from harm. EVIDENCE: The home has policies and procedures in place for dealing with complaints. The records show that two complaints have been received at the home since the last inspection. These were thoroughly investigated with action and outcomes documented. Nine residents and three relatives said they knew who to talk to should they have any concerns. The policies and procedures for the Protection of Vulnerable Adults is in place which links into the Local Authority Procedural framework. The home is clear when incidents need external input and who to refer incidents to. The staff were able to discuss what action to take should there be any allegation of abuse. Stanton Lodge Nursing & Residential Home DS0000029001.V289888.R01.S.doc Version 5.1 Page 18 Currently there are no allegations of abuse being investigated. The registered manager has attended a two-day training course and training is regularly arranged with records kept. Stanton Lodge Nursing & Residential Home DS0000029001.V289888.R01.S.doc Version 5.1 Page 19 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,24,25,26,OP. 23,25,26,27,28,30 YA. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the service. There is now major investment in the home, which is improving the conditions for people who live there. There are still some outstanding requirements that have the potential to place residents at risk. Stanton Lodge Nursing & Residential Home DS0000029001.V289888.R01.S.doc Version 5.1 Page 20 EVIDENCE: The home is a single storey purpose build care home. A Warning letter was issued in December 2005 about the poor standard of the environment and the home is currently undergoing a vast refurbishment and redecoration programme. Each unit has access to enclosed courtyards and garden areas. The areas are generally tidy and the younger residents were enjoying sitting in the warm sunshine. The communal areas are also undergoing refurbishment and the refurbishment programme will address the poor standard of carpets, décor and furnishings. There is currently refurbishment of the bathing facilities .The problems with the mould and mildew on shower tiles, “bubbling of the ceiling paint” in the shower room, missing tiles and tiles bevelling, pooling of water, missing drains and an odour in one shower room should be resolved with the refurbishment programme. There are plans to adapt bedrooms to enable full en-suite facilities with overhead tracking. Bedrooms are also undergoing refurbishment and carpets, fittings and redecoration is now underway in these areas. The residents have been encouraged to bring small personal items into the home making the bedrooms highly personalised. All of the bedrooms are single en-suite. Given the extensive refurbishment the staff are working extremely hard to keep the home clean, tidy and fresh. There were no odours in the home on the day of inspection. The laundry remains small especially for the number of residents it caters for. Since the last inspection the flooring has been replaced, new machines have been provided and the staff have access to the sink for effective hand washing. The sluices were generally clean, with working disinfectors. Staff had access to liquid soap and paper towels in all areas. Stanton Lodge Nursing & Residential Home DS0000029001.V289888.R01.S.doc Version 5.1 Page 21 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 OP.32, 33,34,35 YA Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The home has made progress with staff recruitment. Currently the home is adequately staffed. The lack of a consistent, fully trained staff team has had a detrimental impact on the quality of care provision in the home. The recruitment and selection procedures ensure residents are protected. Stanton Lodge Nursing & Residential Home DS0000029001.V289888.R01.S.doc Version 5.1 Page 22 EVIDENCE: There were 3 care staff on duty on the Younger Persons Unit during the course of this inspection one of whom was a new staff member working with more experienced colleagues. In addition there was a qualified nurse on duty in the YPD Unit and a domestic. The staff team comprises a large number of Eastern European staff that have been recruited by the company from Poland to bring care skills to Four Seasons. Staff spoken to during the inspection were clear about their jobs and demonstrated an awareness of the needs of service users. It was clear that staff have developed a rapport with service users and despite some language difficulties communication seems to be improving. Staff on duty during the inspection said that the attitude of the new workforce was much improved and resident’s said that staff “will do anything for you” and that “they are very helpful”. Staff files contain job descriptions and staff and residents are clear about who does what. Staff wear different coloured tunics and follow their own tasks. Residents spoken to knew who was on duty that day and that the activities coordinator was not in on that day. Residents say that staff are cheerful and helpful. Staff files were checked for seven members of staff and training documents are available, which indicate that induction training has been provided and that mandatory training has been provided in part to two staff. Three of the staff files examined did not contain any evidence of specialist training in working with people with specific disabilities or with younger people. Four files showed that training in Dementia care, care planning, tissue viability and infection control was taking place. It was confirmed that 50 of staff do not have NVQ level 2 training. A new staff member was on duty and was working with experienced staff to develop her experience and to ensure that safeguards are in place until CRB & POVA First checks are returned. Staff files checked contained confirmation of identity, CRB or equivalent checks, work permits, qualified nurses registration, and written references. Files also contain interview records and application forms. Each unit is staffed separately: Younger Persons Unit 1 qualified nurse over 24 hours 3 carers during the day Nursing Unit 1 qualified nurse over 24 hours 3 carers during the day Stanton Lodge Nursing & Residential Home DS0000029001.V289888.R01.S.doc Version 5.1 Page 23 Residential Unit 1 Senior carer and 1 carer during the day In addition to the 2 qualified nurses there are 4 care staff on duty overnight. The staffing levels have been reduced since the last inspection due to the decrease in occupancy due to the refurbishment of the home. The home currently does not use agency staff. Stanton Lodge Nursing & Residential Home DS0000029001.V289888.R01.S.doc Version 5.1 Page 24 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35, 36, 38 OP. 8, 23,37,39, 42 YA. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the service. The home has a manager who shows guidance and direction to staff, which should promote quality care. Stanton Lodge Nursing & Residential Home DS0000029001.V289888.R01.S.doc Version 5.1 Page 25 The systems for consultation and quality monitoring are available, although residents do not always have their views taken into account. Residents personal accounts are not managed to ensure their best interests are protected. There are health and safety practices, which pose potential risks to residents, staff and visitors. EVIDENCE: The registered manager has been in post since October 2004. She is a first level registered nurse with many years experience. She continues to work hard to develop both the quality of life for the residents and improve the overall service provision. A resident meeting took place in April about the planned refurbishment of the home however residents spoken to during the inspection were aware that building work was taking place and that the YPD Unit would be relocated but they had not been involved in discussions about the relocation of the YPD Unit nor had they been invited to visit the new unit as it takes shape or had any input to colour schemes or design and layout. The quality monitoring systems are in place with monthly visits and reports available from the Company representative. The manager has systems in place to monitor the practice and developments in the home. Staff meetings are held regularly with records kept. Residents’ personal allowances are held in a central non-interest bearing account. The Company is planning to change the system to enable residents to get interest on their own money. This has not yet happened. The home maintains detailed records of all transactions with cross-referenced receipts. Two people sign the transactions. The arrangements for formal staff supervision are available with records kept. It was confirmed that supervision was not carried out six times a year. There is a full range of Health and Safety policies available in the home. There is a new cooker in the kitchen and the extractor fans have been cleaned. The waste pipe from the dishwasher is dirty and held up from the floor with a block of wood. Both the hot trolleys need the door catches repaired and both need to be cleaned. Outside the kitchen door the household waste bins were not secure, waste was piled on top of the bins and food debris littered the ground. Stanton Lodge Nursing & Residential Home DS0000029001.V289888.R01.S.doc Version 5.1 Page 26 The management of the refurbishment and redecoration of the home is satisfactory. The staff have received training in safe working practices. Accident recording was satisfactory and monthly audits are carried out. Maintenance records were clear, up to date and signed. Fire records and risk assessments were available and up to date. Stanton Lodge Nursing & Residential Home DS0000029001.V289888.R01.S.doc Version 5.1 Page 27 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 X 2 3 3 3 4 X 5 X 6 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 ENVIRONMENT Standard No Score 19 2 20 2 21 2 22 2 23 X 24 2 25 2 26 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No Score 31 3 32 X 33 3 34 X 35 2 36 2 37 X 38 2 Stanton Lodge Nursing & Residential Home DS0000029001.V289888.R01.S.doc Version 5.1 Page 28 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 Requirement The registered persons must ensure that the care plans are detailed in regard to social care. The registered persons must ensure that the care plans are detailed in regard to social care. The registered persons must ensure that resident’s choices and decision-making is actively promoted and recorded in the care plans. The registered persons must ensure that resident’s choices and decision-making is actively promoted and recorded in the care plans. The registered persons must ensure that all handwritten directions on the Medicine Administration Records have two signatures. The registered persons must ensure that all handwritten directions on the Medicine Administration Records have two signatures. The registered persons must DS0000029001.V289888.R01.S.doc Timescale for action 07/08/06 2 YA9 15 07/08/06 3 OP14 12 07/08/06 4 YA7 12 07/08/06 5 OP15 13 07/08/06 6 YA20 13 07/08/06 7 OP15 12,16 07/08/06 Page 29 Stanton Lodge Nursing & Residential Home Version 5.1 8 YA17 12,16 9 OP15 12,16 10 YA17 12,16 11 OP19 13,23 12 YA24 13,23 13 OP20 16,23 14 YA28 16,23 review the menus to ensure they are suited to individual assessed and recorded need. All meals and snacks must be varied, appealing and nutritious. The menus must be in formats that are easily read and understood. Outstanding 31/08/04 Timescale of 31/01/06 not met. The registered persons must review the menus to ensure they are suited to individual assessed and recorded need. All meals and snacks must be varied, appealing and nutritious. The menus must be in formats that are easily read and understood. Outstanding 31/08/04 Timescale of 31/01/06 not met. The registered persons must ensure that the toasters are replaced and the microwaves are cleaned after use. The registered persons must ensure that the toasters are replaced and the microwaves are cleaned after use. The registered persons must ensure that the renewal and refurbishment of the premises continues within timescales. The registered persons must ensure that the renewal and refurbishment of the premises continues within timescales. The registered persons must ensure that the furnishings and fittings in all communal areas are domestic in style and of good quality for the ranges of interests and activities preferred by residents. The registered persons must DS0000029001.V289888.R01.S.doc 07/08/06 31/07/06 31/07/06 31/07/06 31/07/06 31/07/06 31/07/06 Page 30 Stanton Lodge Nursing & Residential Home Version 5.1 15 OP21 23 16 YA27 23 17 OP21 23 18 YA27 23 19 OP24 13, 16,23 20 YA26 13,16,23 21 22 23 OP28 YA32 OP30 18 18 12(1) 13(4) ensure that the furnishings and fittings in all communal areas are domestic in style and of good quality for the ranges of interests and activities preferred by residents. The registered persons must ensure that repairs are carried out to en-suite areas and ensure there is no pooling of water in shower rooms. Outstanding from 02/06/05 The registered persons must ensure that repairs are carried out to en-suite areas and ensure there is no pooling of water in shower rooms. Outstanding from 02/06/05 The registered persons must ensure that bathrooms and shower rooms are repaired and refurbished to ensure there are sufficient bathing facilities to meet residents assessed needs. The registered persons must ensure that bathrooms and shower rooms are repaired and refurbished to ensure there are sufficient bathing facilities to meet residents assessed needs. The registered persons must ensure that bedrooms are redecorated and furniture replaced as part of the refurbishment programme. The registered persons must ensure that bedrooms are redecorated and furniture replaced as part of the refurbishment programme. The registered persons must ensure that 50 of care staff are trained to NVQ level 2. The registered persons must ensure that 50 of care staff are trained to NVQ level 2. The registered persons must DS0000029001.V289888.R01.S.doc 31/07/06 31/07/06 31/07/06 31/07/06 31/07/06 31/07/06 31/10/06 31/10/06 31/10/06 Page 31 Stanton Lodge Nursing & Residential Home Version 5.1 18 24 YA35 12(1) 13(4) 18 25 OP35 12,20 26 OP36 18 27 YA36 18 28 29 30 OP38 YA42 OP38 13 13 13,16,23 ensure that specialist training is provided for all staff to ensure they can meet the residents’ needs. Outstanding 02/06/05. Timescale of 31/01/06 not met. The registered persons must ensure that specialist training is provided for all staff to ensure they can meet the residents’ needs. Outstanding 02/06/05. Timescale of 31/01/06 not met. The registered persons must ensure that where they hold personal allowances for individual residents any interest accrued is paid into their account. Timescale 31/01/06 not met. The registered persons must ensure that staff receive formal supervision 6 times a year. Timescale of 31/01/06 not met. The registered persons must ensure that staff receive formal supervision 6 times a year. Timescale of 31/01/06 not met. The registered persons must ensure the hot trolley’s are repaired or replaced. The registered persons must ensure the hot trolley’s are repaired or replaced. The registered persons must ensure that the kitchen is regularly cleaned and the household waste is stored appropriately and the area kept free from spillages. 31/10/06 01/09/06 07/08/06 07/08/06 31/07/06 31/07/06 07/08/06 Stanton Lodge Nursing & Residential Home DS0000029001.V289888.R01.S.doc Version 5.1 Page 32 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 YA8 YA14 Good Practice Recommendations The residents should be given the opportunity to become more actively involved in the day-to-day running of the home. Holidays should be considered for the younger residents as part of the contract price. Consideration should be given to providing a designated activities organiser for the younger persons unit. Consideration should be given to providing the complaints procedure and care plans in alternative formats. 3. YA22 Stanton Lodge Nursing & Residential Home DS0000029001.V289888.R01.S.doc Version 5.1 Page 33 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI. Stanton Lodge Nursing & Residential Home DS0000029001.V289888.R01.S.doc Version 5.1 Page 34 - 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!