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Inspection on 25/05/05 for Stanton Nursing Home

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

This inspection was carried out on 25th May 2005.

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

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

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

The home provides a homely and relaxed atmosphere, which is always clean and tidy. Residents are always provided with a well-balanced nutritious meal using fresh meat and vegetables a choice of menu is available which is offered at the mealtime so residents do not forget what they may have ordered if the choice was made at breakfast; the environmental health officer has recommended the home for the Somerset Award for food. The home considers the specific emotional needs of the residents; this has made it possible for one resident to keep her dog with her at the home.

What has improved since the last inspection?

The acting manager has introduced a new preadmission assessment form which gives an holistic approach to assessment of residents prior to admission, she has also introduced an audit system which looks at infection control and is also currently putting in place a falls audit to be used in the home. The cook has worked hard developing policies and procedures for good working practices in the kitchen including hygiene and preparation of raw and cooked food. One resident admitted to the home has bought her dog with her; residents appeared to enjoy the company and also enjoyed taking the dog for walks during the day.

What the care home could do better:

Arising from general observation of staff during the day of the inspection it was noted that some staff could possibly be less task orientated and spend more time talking with the residents especially during the afternoon, although more outside entertainment has been planned it was noticed that some residents did not take part in activities during the afternoon. Care records for residents who needed cot sides contained clear risk assessments but did not contain consent forms.

CARE HOMES FOR OLDER PEOPLE Stanton Nursing Home 8 Queens Road Weston Super Mare North Somerset BS23 2LQ Lead Inspector Juanita Glass Announced 25 May, 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Stanton Nursing Home D53-D02 S20288 Stanton Nursing Home V220124 250505 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Stanton Nursing Home Address 8 Queens Road, Weston Super Mare, North Somerset, BS23 2LQ 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) 01934 625640 01934 625640 Mr Charles Larkin Care Home with Nursing 26 Category(ies) of Dementia over 65 - 26 registration, with number of places Stanton Nursing Home D53-D02 S20288 Stanton Nursing Home V220124 250505 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Staffing notice dated 15/12/2000 applies 2. Manager must be registered nurse on parts 3 or 13 of the NMC register 3. Age range 65 years and over. May accommodate one named person aged 65 years. This exemption is specific to one individual and will lapse when that person attains 65 or leaves the home. Date of last inspection 10/11/2004 Brief Description of the Service: Stanton nursing home is registered with the Commission for Social Care Inspection to provide nursing care for 26 residents suffering from dementia or associated conditions aged 65 years and over, the home is situated above the town centre of Weston super Mare and not far from local amenities. The home is a converted Victorian house and accommodation is provided over three floors, access is provided to all levels via a passenger lift and a stair lift. Stanton Nursing Home D53-D02 S20288 Stanton Nursing Home V220124 250505 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place in the presence of Mrs Margaret Jones the acting manager. Outcomes for residents were assessed through examination of care records and personnel records, observation of staff and resident interactions, and general conversation with residents and visitors, comment cards were also received from two relatives which were positive. Most of the residents spoken to were unable to express an opinion on the care they received at Stanton however they appeared relaxed, happy, well groomed and clearly had a good rapport with staff. Residents were observed to make free use of all the communal areas available including walking in the garden, during the afternoon staff were observed to encourage some residents to take part in some form of activity. One visitor spoken to said, ‘this is really the place for mum they are so attentive and caring and there is always someone with the residents and mum is always clean and tidy,’ she added that the garden area was always a popular place. What the service does well: What has improved since the last inspection? The acting manager has introduced a new preadmission assessment form which gives an holistic approach to assessment of residents prior to admission, she has also introduced an audit system which looks at infection control and is Stanton Nursing Home D53-D02 S20288 Stanton Nursing Home V220124 250505 Stage 4.doc Version 1.40 Page 6 also currently putting in place a falls audit to be used in the home. The cook has worked hard developing policies and procedures for good working practices in the kitchen including hygiene and preparation of raw and cooked food. One resident admitted to the home has bought her dog with her; residents appeared to enjoy the company and also enjoyed taking the dog for walks during the day. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Stanton Nursing Home D53-D02 S20288 Stanton Nursing Home V220124 250505 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Stanton Nursing Home D53-D02 S20288 Stanton Nursing Home V220124 250505 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 3 and 5, as Stanton nursing home does not provide intermediate care standard 6 does not apply. The needs of residents are assessed before admission to the home, and relatives are provided with clear information and a chance to visit the home to assist in making an informed choice. EVIDENCE: Mrs Jones confirmed that she visits all prospective residents either at their home or in hospital to carry out a preadmission assessment this was supported by the assessments in the care records of the most recently admitted residents. Mrs Jones has also introduced a new form for recording the preadmission assessments this involves a more holistic approach to assessing the needs of the prospective resident. Care records also contained care management plans from the placing social worker. Relatives or advocates usually visit the home on the prospective residents behalf, however the home does encourage them to bring the resident if they are I able to make the journey. Stanton Nursing Home D53-D02 S20288 Stanton Nursing Home V220124 250505 Stage 4.doc Version 1.40 Page 9 The statement of purpose and service user guide provides relatives or advocates with all the information needed to make an informed choice, it has also been updated to include the new CSCI address. Stanton Nursing Home D53-D02 S20288 Stanton Nursing Home V220124 250505 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10 The health and personal care needs of the residents are well met, supported by a clear and consistent care planning system which adequately provide staff with the information they need to satisfactorily meet residents needs. Clear forms showing consent for the use of cot sides needs to be introduced. The rapport between staff and residents is informal and friendly whilst maintaining dignity and respect. EVIDENCE: Care records of seven residents were reviewed these showed very clear guidelines were in place enabling staff to meet the needs identified. All the care plans had been reviewed regularly and there was evidence to show that residents who were able accompanied by a relative or advocates, were involved in review meetings. Care records seen contained very clear risk assessments, which were specific to identify needs such as falls, pressure areas and aggressive behaviour. Mrs Jones is currently developing a falls audit to identify common times or an area that falls occur in. There was also clear evidence of involvement from multidisciplinary teams including the mental health unit, district nurses, chiropodist, dentist and optician. Most of the residents were unable to express an informed opinion however they appeared to be happy, relaxed and well groomed. Staff were observed to Stanton Nursing Home D53-D02 S20288 Stanton Nursing Home V220124 250505 Stage 4.doc Version 1.40 Page 11 respect the residents right to privacy and dignity, and appear to have a very friendly and relaxed rapport with residents. Few of the residents could hold a complete conversation, however statements such as ‘ theyre all nice girls’ and ‘they are always kind’ were frequently made. One visitor spoken to stated that the home was perfect for her mother and met all her needs, she said that her mother had not been so happy for quite a while. Following a requirement made at the last inspection the storage and administration of medication has improved, only qualified nurses administer medication the storage area was appropriate, clean and tidy and not overstocked. Stanton Nursing Home D53-D02 S20288 Stanton Nursing Home V220124 250505 Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 14 and 15 The home provides a programme of meaningful activities that are organised by the care staff in the afternoons. Residents are encouraged to exercise personal choice where possible. The meals in Stanton are good, offering both choice and variety and catering for special dietary needs. EVIDENCE: The home no longer has an activities coordinator however a range of activities are organised by the care staff, a regular dog walking routine is quite popular with those residents able to go. Records seen showed that residents take part in sessions such as music and movement, newspaper and magazine reviews and taking part in visiting entertainment; extra outside entertainers had been organised and they were advertised in the entrance hall. However during the afternoon of the inspection it was noted that some staff were more task orientated, which meant that some residents were not being included in the activities. Residents are encouraged to exercise personal choice where possible breakfast is flexible as residents can get up when they want to within reason, the quiet room enables residents to choose whether they wish to take part in activities or sit quietly. During the day residents were observed to be using all the communal areas including the secure garden. Stanton Nursing Home D53-D02 S20288 Stanton Nursing Home V220124 250505 Stage 4.doc Version 1.40 Page 13 A choice of menu is available and residents are offered a choice of meal at the appropriate mealtime rather than them being expected to remember what they have chosen in the morning for lunch. The meals provided appeared nutritious and varied with the use of fresh rather than frozen vegetables, the meal provided on the day was well presented and appetising, the mealtime was unhurried and staff were available to help when needed. Residents spoken to said they always had good food and had enjoyed their lunch, snacks and drinks are offered throughout the day. The environmental health office has recommended the home for the Somerset award for food. Stanton Nursing Home D53-D02 S20288 Stanton Nursing Home V220124 250505 Stage 4.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 The home has a satisfactory complaints system with some evidence that relatives feel their views are listened to and acted on. The home has clear guidelines for the protection of vulnerable adults. EVIDENCE: The home has a very clear complaints policy procedure, two complaints received by the CSCI had been investigated by the home a clear record of the action taken and the outcome had been kept in the home. The complaint concerned the way in which staff had welcomed an ambulance crew to the home, it was partially substantiated and guidelines have been put in place for the staff to work to. The homes policy and procedure for the protection of vulnerable adults is robust and the home followed its procedures appropriately following an incident with a member of staff in the home. The staff training in the protection of vulnerable adults has commenced and it was recommended that the home needs to continue the training so that all staff have attended. Stanton Nursing Home D53-D02 S20288 Stanton Nursing Home V220124 250505 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 22, 24 and 26. Stanton Care Home provides a comfortable and homely atmosphere, which is clean, tidy, well maintained and has access to secure gardens. EVIDENCE: It was noticed that the home is furnished in a homely fashion well decorated and ongoing maintenance is carried out when necessary. Residents were observed using all areas in the home and the quiet room is particularly popular with visitors, the secure garden area with raised flower beds was also a popular wander area for the residents. Communal space within the home is provided in a lounge, a quiet room and conservatory area the dining room is on a lower level. Suitable adaptations have been made around the home to meet the needs of the current resident group a lift enables access to all floors and residents were observed using it freely. A tour of the premises showed that all rooms are well furnished and residents had arranged personal possessions in their rooms. Double rooms are provided with screens to provide personal privacy for residents. One lady sat in her Stanton Nursing Home D53-D02 S20288 Stanton Nursing Home V220124 250505 Stage 4.doc Version 1.40 Page 16 room said she really liked the sunshine through her window, other residents were unable to express an opinion, a visitor was very pleased with the room her mother had and confirmed that it was always clean, tidy and free from offensive smells when she visited. Stanton Nursing Home D53-D02 S20288 Stanton Nursing Home V220124 250505 Stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28 and 30 Staffing levels are sufficient to meet the needs of the current resident group. All staff received training in dementia care and are being encouraged to attend NVQ training. EVIDENCE: The duty rotas confirmed that staffing levels within the home meet those agreed with the CSCI, extra staff can be arranged for hospital appointments trips or to meet extra identified needs. Visitors spoken to confirmed that there was always adequate staff on duty. Mrs Larkin arranges ongoing training, which is specific to dementia care needs. Evidence of training in the home showed that care staff are encouraged to attain their NVQ 2 In Care, and qualified staff to maintain their PREPP training. All mandatory training in the home was up-to-date and some staff had attended training in POVA issues. It was recommended as stated previously that all staff need to attend the POVA training. Stanton Nursing Home D53-D02 S20288 Stanton Nursing Home V220124 250505 Stage 4.doc Version 1.40 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 36, 37 and 38. The acting manager is qualified competent and experienced to run the home. The system for relative consultation in the home is good. All new staff are offered a full induction and formal supervision. Health and safety issues are satisfactory. EVIDENCE: Mrs Jones the acting manager is qualified as an RMN and RGN. She has many years of experience in the management of homes that have provided both general care and care of the elderly with dementia she demonstrated an awareness of the needs of the current resident group and was observed to be open and approachable, and to have a very good rapport with residents. The home carried out a quality assurance questionnaire with relatives in March this time they included GPs and they are now currently assimilating information and making plans to act on comments received, one visitor spoken Stanton Nursing Home D53-D02 S20288 Stanton Nursing Home V220124 250505 Stage 4.doc Version 1.40 Page 19 to said she appreciated her views being considered and felt they would be listened to. Residents spoken to were unable to express an opinion. All new staff receive a clear induction and work supervised until considered competent, evidence of induction forms being completed were seen in the home, staff spoken to felt they were adequately supported. The acting manager is carrying out formal supervision with all staff, records seen showed that these sessions highlighted areas of improvement and then identified courses and training that could be arranged, for example an improving English course had been arranged. The implementation of health and safety in the home was satisfactory the fire log was reviewed and found to be up-to-date and all staff had received appropriate training. All service records and generic risk assessments had been reviewed and were all up-to-date. Stanton Nursing Home D53-D02 S20288 Stanton Nursing Home V220124 250505 Stage 4.doc Version 1.40 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 4 COMPLAINTS AND PROTECTION 3 3 x 3 x 3 x 3 STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 x x x 3 3 3 Stanton Nursing Home D53-D02 S20288 Stanton Nursing Home V220124 250505 Stage 4.doc Version 1.40 Page 21 NO8 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 8 Regulation Sch3 (3q) Requirement Consent must be obtained for the use of cotsides when a need is identified through a thorough risk assessment. Timescale for action By 25/06/05 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. Refer to Standard 18 Good Practice Recommendations Need to continue to pursue the POVA training for all staff. Stanton Nursing Home D53-D02 S20288 Stanton Nursing Home V220124 250505 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Riverside Chambers Castle Street Tangier Taunton TA1 4AL 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 Nursing Home D53-D02 S20288 Stanton Nursing Home V220124 250505 Stage 4.doc Version 1.40 Page 23 - 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. 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