Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 02/06/05 for Stanton Lodge Nursing & Residential Home

Also see our care home review for Stanton Lodge Nursing & Residential Home for more information

This inspection was carried out on 2nd June 2005.

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

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

All residents have a full assessment by the care management team and the home before deciding to live in the home. The staff has a good understanding of the residents needs and the relationships were friendly and professional. The staff are keen to raise standards and are eager to develop the home. The residents spoken with said how hard the staff work and that they always try to improve their lives. The residents said they felt safe and knew how to complain if they were unhappy about anything.

What has improved since the last inspection?

The manager has now been in post for eight months and has a good understanding of the pressing and outstanding issues in the home. She has reduced the amount of agency staff in the home and has recruited senior carers, a deputy manager and qualified nurses. This means that the staff are now beginning to work as a team. The manager has also actioned some of the outstanding requirements from previous inspections in regard to redecoration and replacing specialist bathrooms. The manager now has a training and development plan for the year, which should ensure that staff receive the training they need to care for the residents.

What the care home could do better:

The contracts for residents who are self funding must be introduced and the contracts for the younger persons reviewed. The care planning must improve to ensure that the staff know how to care for each resident. Advice from other specialists must be sought about dietary needs and their advice put into practice with records kept. Risk assessments must be updated at least monthly, and dated and signed by the author. The recording of medication must be clear and the Controlled Drug cupboard light repaired. The treatment room needs to be clean and well organised at all times. The social and recreational activities must improve for all residents and detailed information obtained so that their preferences and choices of events are taken into account. The menus and content of the meals must improve, as the residents are still dissatisfied with the food provision. The specialist training for staff must be progressed so that the residents` needs are met and they are protected from harm. The geography of the building, dependency of residents and the skill of the staff must be taken into account when staffing the home. Further consideration should be given to providing a full time activities organiser. CSCI must be informed when there are staffing shortages. To ensure the home is safe and comfortable, the repairs, refurbishment andredecoration must continue without delay. Policies and procedures for the control of infection must be followed and all equipment must be in safe working order. Progress must continue to meet the outstanding requirements from previous inspections. The staff must ensure that they follow policies and procedures to ensure the health, safety and welfare of residents`, all staff and visitors to the home. The manager must progress with her application to become the registered manager of the home.

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Stanton Lodge Nursing & Residential Home Millfield Avenue Shiremoor Tyne & Wear NE27 0LE Lead Inspector Irene Bowater Unannounced 02 June 2005 09:30 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 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 B53-B03 S29001 Stanton Lodge V221626 020605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Stanton Lodge Nursing & Residential Home Address Millfield Avenue Shiremoor Tyne & Wear NE27 0LE 0191 2522919 0191 2535017 None Laudcare Ltd 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) Vacant CRH 72 Category(ies) of OP Old age (51) registration, with number PD Physical disability (21) of places Stanton Lodge Nursing & Residential Home B53-B03 S29001 Stanton Lodge V221626 020605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection 7th December 2004 Brief Description of the Service: Stanton Lodge is a purpose built 72 bed care home. All the accomodation is on ground floor level and all the bedrooms have ensuite 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 eash offering a different category of care,personal care,personal care with nirsing 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 accesible and there is ample car parking facilities. Stanton Lodge Nursing & Residential Home B53-B03 S29001 Stanton Lodge V221626 020605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place over eight and a half hours. There have been a number of outstanding and ongoing issues in the home in regard to the premises, staffing and care practices. The manager has now been in post for eight months and the inspection focused on the requirements from the last inspection and the quality of life for all the residents in the home. The manager was not available for the first part of the inspection, assistance was given from the newly appointed deputy manager. A tour of the building took place, a range of records were inspected and staff and residents on all units spoken to. What the service does well: What has improved since the last inspection? Stanton Lodge Nursing & Residential Home B53-B03 S29001 Stanton Lodge V221626 020605 Stage 4.doc Version 1.30 Page 6 The manager has now been in post for eight months and has a good understanding of the pressing and outstanding issues in the home. She has reduced the amount of agency staff in the home and has recruited senior carers, a deputy manager and qualified nurses. This means that the staff are now beginning to work as a team. The manager has also actioned some of the outstanding requirements from previous inspections in regard to redecoration and replacing specialist bathrooms. The manager now has a training and development plan for the year, which should ensure that staff receive the training they need to care for the residents. What they could do better: The contracts for residents who are self funding must be introduced and the contracts for the younger persons reviewed. The care planning must improve to ensure that the staff know how to care for each resident. Advice from other specialists must be sought about dietary needs and their advice put into practice with records kept. Risk assessments must be updated at least monthly, and dated and signed by the author. The recording of medication must be clear and the Controlled Drug cupboard light repaired. The treatment room needs to be clean and well organised at all times. The social and recreational activities must improve for all residents and detailed information obtained so that their preferences and choices of events are taken into account. The menus and content of the meals must improve, as the residents are still dissatisfied with the food provision. The specialist training for staff must be progressed so that the residents’ needs are met and they are protected from harm. The geography of the building, dependency of residents and the skill of the staff must be taken into account when staffing the home. Further consideration should be given to providing a full time activities organiser. CSCI must be informed when there are staffing shortages. To ensure the home is safe and comfortable, the repairs, refurbishment and Stanton Lodge Nursing & Residential Home B53-B03 S29001 Stanton Lodge V221626 020605 Stage 4.doc Version 1.30 Page 7 redecoration must continue without delay. Policies and procedures for the control of infection must be followed and all equipment must be in safe working order. Progress must continue to meet the outstanding requirements from previous inspections. The staff must ensure that they follow policies and procedures to ensure the health, safety and welfare of residents’, all staff and visitors to the home. The manager must progress with her application to become the registered manager of the home. 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 B53-B03 S29001 Stanton Lodge V221626 020605 Stage 4.doc Version 1.30 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 Standards 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 6-10 and 18–21) (Standards 11–17) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37–43) Stanton Lodge Nursing & Residential Home B53-B03 S29001 Stanton Lodge V221626 020605 Stage 4.doc Version 1.30 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. 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. Prospective service users have an opportunity to “test drive” the home. 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 standard(s) 2,5,YA,2,3,5 OP The home has not yet produced a Statement of Terms and Conditions of Residency; therefore the rights and obligations of residents and the provider are not clear. The admission procedures are available and completed, which enables staff to meet residents assessed needs. Preadmission visits allow residents and their representatives an opportunity to assess all aspects of the service. EVIDENCE: The home has not produced a Statement of Terms and Conditions (or contract) for any of the residents who are self funding. Residents who are funded by a Local Authority have a contract with the Authority who in turn contracts with the home. Stanton Lodge Nursing & Residential Home B53-B03 S29001 Stanton Lodge V221626 020605 Stage 4.doc Version 1.30 Page 10 All residents have a preadmission assessment and care plan from the Care Managers. The senior staff carry out their own assessments prior to admission. The staff confirmed that residents are encouraged to visit the home before moving in and that all residents have a review before deciding to stay on a permanent basis. Stanton Lodge Nursing & Residential Home B53-B03 S29001 Stanton Lodge V221626 020605 Stage 4.doc Version 1.30 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6-10 and 18 –21 (Adults 18-65) 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. Including their physical and emotional health needs. 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. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. Service users receive personal support in the way they prefer and require. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 7, 9, 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 standard(s) 6,18,19, YA,7,8,9,OP The care planning is not clear or consistent to provide staff with the detailed information they need to meet residents assessed needs. The lack of up to date documentation and detailed assessments have the potential to place residents at risk. All staff are not following medication policies which could place residents at risk. Stanton Lodge Nursing & Residential Home B53-B03 S29001 Stanton Lodge V221626 020605 Stage 4.doc Version 1.30 Page 12 EVIDENCE: All of the residents have individual care plans. Several of the care plans were not detailed in regard to the individual’s health, social and mental health needs. Risk assessments had not been completed, updated or signed. The social care assessments and care plans were brief and in some cases not completed. The moving and handling assessments were incomplete and not up to date. There was evidence from the plans that the changing needs of residents had not been identified and recorded in the care plan in regard to weight loss and it was difficult to find what specialist advice had been sought from the dietician. Some of the diet, fluid, turn and hygiene records showed gaps, however the care plans state that these areas of care needed detail monitoring. There was some evidence that the lack of comprehensive care planning and updating was being addressed. Some of the care plans were impressive and showed that staff had comprehensive knowledge of residents assessed needs. All residents have access to all NHS services and facilities. Specialist nurses, physiotherapists, occupational therapists and consultants are sourced for advice as necessary. The district nursing service supports the residents who live on the personal care unit. The treatment room was generally tidy, however would benefit from a deep clean and further organisation. A random review of the Medicine Administration Records (MAR charts) showed that not all handwritten entries had been double signed and some handwritten directions were abbreviated. The home record all medicines in and out of the home and the staff have sight of the prescriptions to ensure they are correct. An audit of the Controlled Drugs was found to be correct. The Controlled Drug cupboard external warning light still has not been repaired. Stanton Lodge Nursing & Residential Home B53-B03 S29001 Stanton Lodge V221626 020605 Stage 4.doc Version 1.30 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 11 – 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. Including opportunities for personal development. Service users engage in appropriate leisure activities. Service users maintain contact with family/ friends/ representatives and the local community as they wish. And have appropriate personal, family and sexual relationships. 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. 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15, 16 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 standard(s) 12,13,15,16 YA,12,13,15 OP Limited progress has been made to ensure all residents social and leisure preferences are met. Links with family, friends and the local community are maintained. The home has only made limited progress to improve the provision of a varied menu, which meets residents taste and preferences. The residents are not able to exercise choice and control over their diet and what they eat. EVIDENCE: The residents on the younger persons unit do not have the facilities to develop their independent living skills, or find employment as the placements are normally long term and their health needs would exempt them from employment. They are enabled to maintain their previous activities as far as possible. Four of the residents were attending day centres on the day of inspection and one Stanton Lodge Nursing & Residential Home B53-B03 S29001 Stanton Lodge V221626 020605 Stage 4.doc Version 1.30 Page 14 resident was out with her family. The activity coordinator is stretched considering the resident population and their diverse needs. The activities are generally open to all the residents and not specific to one group, which causes some problems with the older and younger residents and how their interests are met. Several of the residents stated that there needed to be more choices of things to do. They said there was hardly any entertainment being brought into the home and there were not many opportunities to get out. One resident explained that the bus had been off the road for several weeks and the requests from to be taken out are met with a lot of “can’t do that” from staff. Some one said that there is no one even available to go along the road to the local shops. Another said that there is nothing going on in the home. The manager demonstrated an awareness of how residents felt and was trying to resolve some of the immediate issues especially in the repair of the bus. Some of the residents attend local day centres and other residents said that their relatives are always welcome at any time. The home offers a four-week menu with the main meal being in the evening. The menu does not always offer a variety of meals .In one week the variety of potato for the evening meal alternated with mashed and boiled potato and chips were on the menu three times. The alternative for the lunchtime meal on four occasions was soup and sandwiches. At the last inspection there was criticisms about the food provided and the residents were again asked for their views regarding the variety and content of the meals. One resident said there had been a little improvement, one said tea times were too predicable and another said there could be more variety. Other residents said the food is still poor and one said it is awful. The inspector joined the residents on the younger persons unit for lunch. The residents offered no complaints regarding the meal. One of the younger residents said the meals were lovely and one said he had only had one bad meal since he had been in the home. The meals were hot and plentiful and staff assisted in a discreet manner. Residents were offered hot and cold drinks throughout the day. The tea trolley was stained and grimy with spillages. The manager confirmed that she was fully aware of these matters and it was part of her weekly management agenda. The kitchen was reasonably clean and organised. There was not much evidence of fresh vegetables, but there was a good stock of frozen produce in one freezer. There was some fresh fruit but it appeared to Stanton Lodge Nursing & Residential Home B53-B03 S29001 Stanton Lodge V221626 020605 Stage 4.doc Version 1.30 Page 15 be over ripe. Some of the sauces such as tomato ketchup and mayonnaise were stored on the shelves instead of the fridge. Stanton Lodge Nursing & Residential Home B53-B03 S29001 Stanton Lodge V221626 020605 Stage 4.doc Version 1.30 Page 16 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’ legal rights are protected. Service users are protected from abuse. Including neglect and selfharm. 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 standard(s) 22,23 YA,16,18 OP. The home has a satisfactory complaints system with evidence that some residents feel that their views are listened to and acted upon. There are detailed policies and procedures for the Protection of Vulnerable Adults. Formal training for staff in Abuse has not been undertaken therefore proper responses may not be followed to protect residents from harm. EVIDENCE: The home has suitable policies and procedures in place for dealing with complaints. The records showed that all complaints are investigated, recorded with outcomes recorded. A recent concern regarding medication, personal care and staffing has been completed with an appropriate action plan to be put in place. The residents spoken with still have concerns about the food and staffing especially at the weekends. The registered manager is fully aware of the problems with the food. Each unit in the home have their own designated staff and the numbers are regularly monitored. A Protection of Vulnerable Adults policy and procedure is in lace and this links in with the Local Authority Adult Protection policy. The staff within the home have had some training, however they have not had Stanton Lodge Nursing & Residential Home B53-B03 S29001 Stanton Lodge V221626 020605 Stage 4.doc Version 1.30 Page 17 the opportunity to attend Local Authority training, which would ensure that they would know what steps to take should there be any allegation or suspicion of abuse. Stanton Lodge Nursing & Residential Home B53-B03 S29001 Stanton Lodge V221626 020605 Stage 4.doc Version 1.30 Page 18 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 have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. Service users have sufficient and suitable lavatories and washing facilities. Provide sufficient privacy and meet their individual needs. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. And lifestyles. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. 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 standard(s) 24,26,27,30 YA .19,20,21,24,26 OP Some improvements to the decoration and fittings in the home have been made. The standard of the environment currently does not provide a clean, odour free living place. The bedrooms do not provide appropriate ventilation or furnishings to meet individual needs and lifestyles. There are a number of matters, which put people at risk of harm and do not provide residents with a safe and comfortable place in which to live. EVIDENCE: Stanton Lodge Nursing & Residential Home B53-B03 S29001 Stanton Lodge V221626 020605 Stage 4.doc Version 1.30 Page 19 The home is a single storey, purpose built care home situated in a residential area, close to local shops and transport links. The home is accessible to all residents and there are enclosed garden areas, which are accessible to wheelchair users. The home has three separate units but there is little to distinguish between the younger and older persons units in the home, as the decoration, furniture fittings and layout being generally the same. The younger persons unit is currently not arranged in separate groups of ten and there are no separate facilities for residents who need a short period of respite care. There are lounges and dining rooms on each unit. The decoration, furniture and fittings are satisfactory although there is wheelchair damage to walls and paintwork. The carpet in the smoking room is full of cigarette burns and was dirty. The lounge chairs were also grubby and stained. Each resident on all units have a single room with en-suite facility. Several of the bedrooms were showing signs of wear and tear in regard to damaged, worn bedroom furniture. The wardrobes were not fixed to the walls and the tops of wardrobes were used to store quite large personal items, which is a potential safety risk. A number of windows in bedrooms do not have natural ventilation, however the manager confirmed this ongoing problem was now being addressed. A number of bedrooms had an odour problem and were generally dusty and untidy. Several of the carpets were stained and dirty. In one bedroom the vinyl in the en-suite was rippling, the toilet seat needs replacing in another and a runner was missing in between the carpet and corridor carpet. All of the residents have brought personal items with them making their rooms very individual and reflecting their lifestyles. Two of the bathrooms are being refitted and there are suitable bathing and showers in each of the units. Bathroom 1 and 2 were used a store rooms and was full of general rubbish, televisions, wheelchairs, boxes used catheter bags empty stained urinal, mattresses, bedrails and a fluid balance chart for a named resident. Bathroom 2 smelt stale, as there was no room to get to the bath or sink to Stanton Lodge Nursing & Residential Home B53-B03 S29001 Stanton Lodge V221626 020605 Stage 4.doc Version 1.30 Page 20 flush the water on regular intervals. There has been ongoing problems with the drainage from the shower rooms, which has been addressed, however there is still some pooling of water in one of the rooms. Refurbishment of bathrooms is being undertaken to provide suitable bathing facilities for residents with disabilities. The home was generally clean and tidy, however there were “pockets” of odours is some areas. The hairdressing room was particularly untidy and had not been cleaned since the hairdressers visit earlier in the week. Hair cutting were all over the floor, stale beakers of drinks had been left, and the vinyl flooring was lifting under the sink and the wooden shelving was damaged and split. The reception area has been redecorated to a good standard. The sluices were not secure. There was no liquid soap or hand towels for staff to wash their hands after dealing with soiled continence aids or body fluids. The inside of the disinfector was rusty and not in use. The laundry was untidy, disorganised and dirty. The washing machines were leaking dirty water on to the floor, which the laundress was constantly attempting to mop up with little success. The vinyl flooring was stained lifting and was not easily cleaned. The hand wash sink was practically inaccessible due to the amount of dirty washing. There was also a vast amount of unclaimed clothing left in the laundry area. Stanton Lodge Nursing & Residential Home B53-B03 S29001 Stanton Lodge V221626 020605 Stage 4.doc Version 1.30 Page 21 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 36 (Adults 18-65) are: 27. 28. 29. 30. • • • Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. 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. Service users benefit from clarity of staff roles and responsibilities. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers standards 27, 29 and 30 (Older People) and Standards 34 and 35 (Adults 18-65) the key standards to be inspected at leat once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,34,35 YA 27,29,30 OP Some progress has been made to address staffing shortages, however residents do not always receive holistic care. The recruitment and selection of staff ensures residents are protected and supported. The provision of specialist training and staff supervision is not adequate to ensure that the residents’ needs are met. EVIDENCE: The registered manager transferred from another home within the group and has been in post for eight months. There has been difficulties with recruitment of staff and short notice staffing has been particularly problematic .The manager is trying to resolve the problem, however the residents said the staff are “run off their feet” and “there are not enough of them.” Stanton Lodge Nursing & Residential Home B53-B03 S29001 Stanton Lodge V221626 020605 Stage 4.doc Version 1.30 Page 22 Each unit is staffed separately: Younger Persons Unit 1 qualified nurse 8am to 8pm, 4 carers 8am to 2pm, and 3 carers 2pm to 8pm. Nursing Unit: 1 qualified nurse 8am to 8pm, 4 carers 8am to 2pm, 3carers 2pm to 8pm Residential Unit: 1 senior carer and 1 carer 8am to 8pm. Overnight there are 2 qualified nurses and 5 care staff on duty for the whole home. There are adequate domestic, laundry, kitchen, maintenance and administration staffs employed. The activities person is only employed for twelve hours a week and the lack of social and leisure activities is evident throughout the home. On the day of inspection a newly employed deputy manager and qualified nurse were undergoing induction. A random inspection of staff files showed that the recruitment and selection policies were being followed. Criminal Record Bureau checks, 2 references, proof of identity and medical checks were available. The personal identification numbers (PIN) of qualified nurses are checked to ensure they are registered to practice. The staff receive statutory training, however there was little evidence from the records and from talking to staff that specialist training was provided There has been little progress with NVQ training and the manager confirmed that this was now on hold until later in the year. The system of staff supervision is in place but has fallen behind schedule. Stanton Lodge Nursing & Residential Home B53-B03 S29001 Stanton Lodge V221626 020605 Stage 4.doc Version 1.30 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 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 and from competent and accountable management of the service. 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. Service users are confident their views underpin all self-monitoring, review and development by the home. 32. 33. 34. 35. 36. 37. 38. • The Commission considers standards 33, 35 and 38 (Older People) and Standards 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 standard(s) 39,42,YA,31,38 OP The manager showed knowledge of the service and demonstrated leadership qualities. There continue to be issues in the maintenance of the building and practices, which pose potential risks to residents’ safety. EVIDENCE: The manager transferred from another home within the company and has been in post for eight months. Her application to become registered manager of this home has not yet been completed. Stanton Lodge Nursing & Residential Home B53-B03 S29001 Stanton Lodge V221626 020605 Stage 4.doc Version 1.30 Page 24 She is an experienced first level nurse with many years experience. She is aware of the problems in the home and is currently prioritising those areas that require improvement. A full range of health and safety policies are available in the home. The maintenance records were up to date and organised. The staff receive suitable training in safe working practices. The accident records were clear, dated and signed. As stated in other parts of this report some environmental issues result in some unsafe practices, which could place residents at risk. Several of the outstanding requirements from previous inspections have not been actioned. Stanton Lodge Nursing & Residential Home B53-B03 S29001 Stanton Lodge V221626 020605 Stage 4.doc Version 1.30 Page 25 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 1 3 3 4 x 5 3 6 N/A HEALTH AND PERSONAL CARE ENVIRONMENT Standard No 19 20 21 22 23 24 25 26 STAFFING Score 3 2 2 x x 2 x 2 Score Standard No 7 8 9 10 11 Score 2 2 2 x x Standard No 27 28 29 30 2 x 3 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 2 COMPLAINTS AND PROTECTION Standard No 16 17 18 Score 3 x 2 MANAGEMENT AND ADMINISTRATION Standard No Score 31 2 32 x 33 x 34 x 35 x 36 x 37 x 38 2 Stanton Lodge Nursing & Residential Home B53-B03 S29001 Stanton Lodge V221626 020605 Stage 4.doc Version 1.30 Page 26 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 OP 2 YA 5 Regulation 5 Requirement The home must provide a Statement of Terms and conditions(or contract). PCT contracts must be developed where appropriate. OUTSTANDING SINCE 31.03.04 The care plans must set out the detail the action to be taken by staff to ensure all aspects of health,social and personal care needs are met. The care plans must be updated at least once a month to reflect changing needs and current objectives for health and social care. Detailed risk assessments must be completed. Baseline obsevations and turn,fluid and diet charts must be completed where a need is identified. The care plans must be in a format that residents can understand. OUTSTANDING SINCE 31.08.04 The home must refer to specialists regarding residents weight loss and implement the instructions and advice with detailed recordings. Timescale for action 1st August 2005. 2. OP7 YA 6,9 14,15 1st September 2005 3. OP8 YA 19 14,17 1st August 2005 Stanton Lodge Nursing & Residential Home B53-B03 S29001 Stanton Lodge V221626 020605 Stage 4.doc Version 1.30 Page 27 4. OP 9 YA 20 13,17 5. OP 12 YA14 4,9,12,16 6. OP 15 YA 17 12,16 7. 8. OP 18 YA 23 OP 20 YA 12,13 23 All handwritten directions on the MAR sheets must have a witness signature and abbreviations must not be used. The CD cupboard external light must be repaired. OUTSTANDING SINCE 30.06.04 The home must ensure that residents interests are recorded and they are given opportunities for social and leisure activities both within and outside the home with activities recorded. OUTSTANDING SINCE 7.12.04 The menus must be reviewed 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 SINCE 31.08.04 The tea trolley requires replacing. Condiments must be stored in the fridge according to directions. The home must provide Abuse training with records kept. The carpets in the communal areas must be deep cleaned to eliminate any odours. The carpet in the smoking room requires replacing The lounge chairs which are worn,stained and shabby require replacing. Doors and paintwork that are wheelchair damaged must be repainted. The hairdressing room must be cleaned after each use. The home must remove all broken,obsolete items from 1st August 2005 1st September 2005. 1st August 2005 1st September 2005 1st September 2005 9. OP 21 YA 27 23 1st September Page 28 Stanton Lodge Nursing & Residential Home B53-B03 S29001 Stanton Lodge V221626 020605 Stage 4.doc Version 1.30 10. OP24 YA 26 13,23 11. OP 26 YA 30 13.16,23 bathrooms. Ensure repairs are carried out in en-suite areas. Ensure there is no pooling of water in shower rooms. The home must ensure wardrobes are fixed to prevent toppling accidents. The storage of items on top of wardrobes must be addressed. Bedroom furniture which is worn and shabby must be replaced as part of a refurbishment progranmme. The lack of natural ventilation in the bedrooms adjacent to the Metro Line must progress. OUTSTANDING SINCE 30.04.05 The home must ensure that all carpets are deep cleaned. The home must review the cleaning schedule to ensure all areas are cleaned daily. Replace the carpets that are stained with body fluids. The washing machines must be repaired or replaced. The flooring in the laundry requires replacement. The walls must be repainted to allow easy cleaning. There must be free access to the handwash basin to allow effective handwashing. Soiled continence pads must be appropriately disposed of. The sluices must have liquid soap and paper towels. The sluice doors must be kept locked when not in use. The staffing levels in the home must be reviewed regularly to meet the changing needs of the residents. The Commission for Social Care Inspection must be informed of 2005. 1st September 2005 1st September 2005 12. OP 27 YA 33 18 2nd June 2005 Stanton Lodge Nursing & Residential Home B53-B03 S29001 Stanton Lodge V221626 020605 Stage 4.doc Version 1.30 Page 29 shortfalls. 13. OP 30 YA 35 0P 31 YA 37 OP 38 YA 30 12,18 The home must ensure that specialist training is provided for all staff to ensure they can meet the residents needs. The manager must progress with her application to become registered manager of the home The home must ensure procedures for all safe working practices are understood and followed at all times. 1st December 2005 1st September 2005 2nd June 2005. 14. 15. 9 13,23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard YA 4 YA 8 YA 14 Good Practice Recommendations The contract for younger persons should specify a three month trial period. The residents should be given the opportunity to be 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. A resuscitation policy should be developed and all staff should be trained in dealing with this type of emergency. Consideration should be given to providing the complaints procedure in alternative formats. 4. 5. YA 21 OP 11 YA 22 Stanton Lodge Nursing & Residential Home B53-B03 S29001 Stanton Lodge V221626 020605 Stage 4.doc Version 1.30 Page 30 Commission for Social Care Inspection Northumbria House Manor Walks, Cramlington Northumberland NE23 6UR National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Stanton Lodge Nursing & Residential Home B53-B03 S29001 Stanton Lodge V221626 020605 Stage 4.doc Version 1.30 Page 31 - 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!