Inspection on 25/03/08 for Stanwell Rest Home

This inspection was carried out on 25th March 2008.

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.

Other inspections for this house

Stanwell Rest Home 27/09/07

Stanwell Rest Home 18/04/07

Stanwell Rest Home 31/08/06

Stanwell Rest Home 25/01/06

Stanwell Rest Home 26/01/05

Stanwell Rest Home 07/07/04

Stanwell Rest Home 09/03/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Stanwell Rest Home 72/76 Shirley Avenue Southampton Hampshire SO15 5NJ Lead Inspector Chris Johnson Unannounced Inspection 11:10 25 March 2008 th X10015.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 Stanwell Rest Home DS0000012167.V359462.R01.S.doc Version 5.2 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. 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. Stanwell Rest Home DS0000012167.V359462.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stanwell Rest Home Address 72/76 Shirley Avenue Southampton Hampshire SO15 5NJ 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) 023 8077 5942 stanwellcarehome@btinternet.com Stanwell Rest Home Limited Mrs Margaret Haug Care Home 34 Category(ies) of Dementia - over 65 years of age (26), Mental registration, with number disorder, excluding learning disability or of places dementia (26), Mental Disorder, excluding learning disability or dementia - over 65 years of age (26), Old age, not falling within any other category (34) Stanwell Rest Home DS0000012167.V359462.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service Users in category MD not to be admitted under 55 years of age. The eight service users to be accommodated in the separate apartments must be in the category of OP and in need of personal care only. The apartments may only be used by service users whose assessed needs can be met within that environment. 27th September 2007 Date of last inspection Brief Description of the Service: Stanwell Rest Home is a care home that is registered to provide personal care and accommodation for a maximum of thirty-four older people. The home is situated in a residential area of Southampton close to Shirley shopping centre and within easy access of public transport. Accommodation is split between two buildings. Twenty-six residents can be accommodated within the main building. This building consists of three former residential properties that are linked internally. Accommodation is spread over two floors. Eight further residents who only require assistance with personal care needs can be accommodated in self-contained apartments situated at the rear of the main property. The cost of living at the home ranges from £335 to £440 per week. Additional costs are charged for newspapers, hairdressing and chiropody. Stanwell Rest Home DS0000012167.V359462.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This home is subject to enforcement action. A notice of proposal to cancel the registration of the provider of the home was issued on 5th March 2008. As the home is subject to enforcement action we have not made any judgements or quality ratings under any of the headings for any of the standards. Neither have we made an overall quality rating. Since the last key inspection of the home the previous registered manager (as named on page 4 of this report) has stood down and at present the home is without a registered manager. An acting manager was recruited and has now been in post for several months. The purpose of this inspection was to assess how well the home is doing in the meeting of all key National Minimum Standards, compliance with regulations, previous requirements and to assess what the outcomes are for people who live at his home. The findings of this report are based on a number of different sources of evidence. These included: An unannounced visit to the home, which was carried out on 25th March 2008 whereby we looked at all key standards. We also carried out random inspections of the home on 17th December 2007 and 8th January 2008. All regulatory activity since the last inspection was reviewed and taken into account including any notifications sent to the Commission for Social Care Inspection. Following the last key inspection of the home on 27th September 2007 two statutory requirement notices were issued. Compliance with these notices was assessed during the random inspections of the home. The acting manager completed an Annual Quality Assurance Assessment (AQAA) prior to the visit. Surveys were sent to sixteen members of staff, eight of the people who live at the home, three GP’s, other health professionals and four care managers. Relative surveys were sent to the acting manager for her to distribute to the relatives of named individuals. At the time of writing this report we had received completed surveys from three health professionals, four care managers, five relatives, two people living at the home and one staff member. During this visit we looked at the physical environment including, people’s bedrooms and all communal areas of the home. Staff and care records were inspected. Some members of staff were spoken with and others were observed during their day-to-day interactions with those living at the home. We examined records, policies and procedures. We spoke with several people living at the home. Stanwell Rest Home DS0000012167.V359462.R01.S.doc Version 5.2 Page 6 The acting manager and the provider were present throughout the visit to answer questions and discuss issues. Verbal feedback was provided at the end of the inspection. The history of the registration of the home shows that there has been insufficient understanding of the need to meet requirements and to sustain lasting improvements. Compliance with regulations has not been as a result of a robust system for ensuring quality care and good outcomes for service users. As a consequence the Commission has served a Notice of Proposal to Cancel the registration of the provider. What the service does well: What has improved since the last inspection? We found an improvement in the assessment process in so much as nobody had moved into the home without being first assessed as to their suitability and whether the home was right for them. The quality of care planning has started to improve and a new format of written care plan has been introduced. The frequency that peoples’ care and support needs are reviewed has been attended to and new procedures have been introduced to monitor and report changes in peoples’ needs. The procedures for the recording and administration of medication have been improved and the medication system is now being audited on a regular basis. All communal areas in the main house have been re-carpeted with plainer style carpeting. Carpeting has been replaced in all bedrooms as necessary. All toilet and bathroom doorframes have been painted red to aid with recognition. Signage has been put in place on all toilet and bathroom doors. Bedroom doors all show the room number, name of occupant and a photo of the occupant. These measures are intended to assist people with support needs associated with dementia, making the environment less confusing and to aid with orientation. Stanwell Rest Home DS0000012167.V359462.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Stanwell Rest Home DS0000012167.V359462.R01.S.doc Version 5.2 Page 8 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 Outcomes Statutory Requirements Identified During the Inspection Stanwell Rest Home DS0000012167.V359462.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 This home is subject to enforcement action EVIDENCE: At the last key inspection of the home in September 2007 we found that the assessment process used within the home was lacking and requirements were made. At the random inspection of the home on 17th December we looked at the assessment documentation of two people who had moved into the home since the September inspection. On that occasion we established that the previous requirement had not been met and we found that this area was still lacking. During the most recent visit to the home (25th March 2008) we looked at pre admission assessments and care notes for people who had moved into the home since our last visit. These demonstrated that people had been assessed prior to admission to determine whether the home could meet their needs. For both people there were copies of the home’s own assessment carried out by the manager. We saw that people had been given the opportunity to visit the Stanwell Rest Home DS0000012167.V359462.R01.S.doc Version 5.2 Page 10 home beforehand and that they could move in on a trial basis. Evidence was seen to demonstrate that the placement had been reviewed after a period of six weeks. Recordings of one person’s review showed that a range of people had been involved. As well as the person, the review had been attended by; a relative, the homes’ acting manager, a night staff carer and the persons’ key worker. It was not possible to assess whether the home had improved on obtaining care management assessments before admitting someone due to the fact that those most recent admitted to the home were privately funded. The provider of the home has however told us that they will no longer admit people funded by a local authority unless they have received a copy of the care management assessment. In discussion with the acting manager she said that she intended to revise the current assessment documentation to make it more comprehensive. One person spoken with said that they had looked around a few homes prior to choosing to move in to Stanwell. They said, “I chose this one as it was bright and I liked it”. The home does not provide intermediate care. This standard is therefore not applicable and was not assessed. Stanwell Rest Home DS0000012167.V359462.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,and 10 This home is subject to enforcement action EVIDENCE: The September 2007 inspection identified several areas of concern regarding peoples’ health and personal care needs. Three requirements were made for this outcome area, two of which had not been met from previous inspections. At the random inspection of the home on 17th December we looked at peoples’ care plans and saw that there were still serious shortcomings in the regularity that care needs and care plans were kept under review, the accuracy of recorded information, contradictions between peoples’ assessed needs and care plans, lack of risk assessments and poor medication procedures. The AQAA told us that care plans were being redesigned. The care plans of three people were looked at during the site visit. This included two people who had recently moved in and one person who had lived at the home for some time. The acting manager explained that some peoples’ files had been transferred to the new format and others were in the process of being transferred. Examples of both types of care plans were examined during the visit to the home. Two of the three care plans examined were in the new Stanwell Rest Home DS0000012167.V359462.R01.S.doc Version 5.2 Page 12 format and the third was mainly in the old format. There was evidence that all three peoples’ plans had been reviewed. In discussion with one staff member they said that they had recently completed a review of a care plan and found the new style care plans easier to use. The new care plan format covered peoples’ support needs to a greater extent, were more individual and person centred than previously found and demonstrated that attempts had been made to promote peoples’ independence. Those seen gave a clear description of the level of need and assistance that people required with their daily care needs. Care plans provided clear guidelines as to how staff should assist people with their care needs and what if any risks were present. All risk assessments had been reviewed since the last visit to the home and risk management plans were in place to address any identified risks. Nutritional risk assessments had been introduced and we saw that systems had been put in place to monitor and report any concerns that staff may have with people’s nutritional needs. This included regular weight checks; records of food intake and we saw that where there were concerns these had been referred to the relevant healthcare professionals. Moving and handling assessments had been completed for each of the three peoples files looked at. A ‘psychological profile’ detailing peoples’ mental health support needs had been introduced since our last visit. These provided a description of their need; any identified risks, the signs, symptoms and possible ways of dealing with. Staff told us that they had full access to care plans. The manager explained that they had revised the way staff record and report on people’s day-to-day lives. We saw that for each person there is now written guidance for staff providing them with prompts as to which things are pertinent to record for each person in the ‘daily notes’. These were individual and relevant to the persons support needs. From examination of the daily notes they agreed with what was recorded in care plan and evidenced that care was being provided as per the care plan. Records were available to demonstrate that people have access to a range of services such as GP’s, Dentists, Chiropodists and District nurses. Changes in the recording of health care records were seen and those seen demonstrated that the home had monitored and taken action to address health care concerns with records kept of appointments, telephone calls and the outcome of any medical intervention. A GP commented, “On the whole I am happy with the level of care in the home”. Relatives reported that they considered that the home met the needs of their relative and provided the support and care that they expected. The results of care manager surveys were that two people responded that the home ‘always’ monitored and attended to individuals’ healthcare needs and two people responded ‘usually’. Stanwell Rest Home DS0000012167.V359462.R01.S.doc Version 5.2 Page 13 The medication administration records were examined for three people. No gaps were found in the recording sheets on this occasion. Coding had been used correctly to identify and any issues such as a medication being missed or refused and the reasons for this were clearly recorded on the back of the medication administration-recording sheet. We also looked at the storage and recording of one person’s stocks of Temazepam. These had been appropriately recorded and stored. At the last key inspection on 27th September 2007 and at the random inspection of 17th December we found that the home was not storing creams appropriately and found out of date creams in communal bathrooms. During this visit to the home we did not find any medicines inappropriately stored. All of the medication records were checked against stock held and all were found to tally. The manager had recently attended a medication management course and the home’s medication policy had recently been updated. A medication audit had been introduced and we saw that stocks and records are now being audited regularly. The home has also introduced a medication communication book for staff to document any changes in a persons’ prescribed medication. All people spoken with were in agreement that staff respected their privacy and dignity. They confirmed that staff knocked on doors before entering. We observed this to the case during our visit. In discussion with staff they said that screens were available in all shared rooms to provide privacy when assisting someone with their personal care needs. They demonstrated an understanding of the importance of maintaining people’s dignity. One person commented that they had covered this during their induction. Stanwell Rest Home DS0000012167.V359462.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 This home is subject to enforcement action EVIDENCE: When we inspected the home in September 2007 an activities co-ordinator had recently been employed. At the time of this visit they had been in post for several months. The activities person spoke very enthusiastically about their role. They explained that they were employed to work for four hours a day five days a week. Although they said that this was flexible and could be adjusted according to what people wanted to do. A file was seen to show that an individual activities log is kept for each person living at the home. This provided evidence that a variety of individual and group activities had taken place on a regular basis. This included regular trips out in the homes’ minibus. We also saw evidence that trips and activities had been organised around to fit in with peoples’ individual routines, preferences and likes and dislikes. Future plans included afternoon teas, and a garden party. In discussion with people living at the home they all confirmed that they had met the activities co-ordinator and that they had been consulted about the type of activities that they liked to do. People commented on the minibus trips and told us that they enjoyed these. Further evidence of the range of activities offered was seen from examination of the ‘daily notes’. Stanwell Rest Home DS0000012167.V359462.R01.S.doc Version 5.2 Page 15 During the visit to the home people were observed to be free to choose whether or not to engage in activities, how to spend their time and had the freedom to access all areas of the home as well as their own bedrooms as they so chose. One person commented, You can do what you like within reason”. Information recorded in the new style care plans showed that people are consulted and supported to make their own choices. People told us that they are able to have visitors to the home and to keep in touch with their friends and family. Feedback from surveys would support this. In discussion with people living at the home the following comments were made regarding the standard and choice of food. “It is good has got taste”, “So far I have has not disliked anything”. “ Some I like some I don’t. Normally I can have something different” and “Excellent”. In discussion with the cook we saw that a kitchen records book had been introduced. The cook explained that the homes’ procedure had been revised to include the recording of the consumption of meals and food intake for each person. The new procedure stated that staff must record what each person has eaten throughout the day. Whilst people have a right to refuse a meal if someone refuses a meal on two occasions this has to be reported to the manager. This enables the home to monitor peoples’ nutritional intake and is intended to address the concerns raised in previous reports about the lack of nutritional assessments and the lack of appropriate action to address weight loss / lack of appetite. A recommendation was made following the inspection of the home in September 2007 that ‘All residents should be given a choice at lunchtime’. Whilst people said that they could have an alternative meal if requested there is not generally a second option available at lunchtime unless this is due to dietary requirements. One care manager has commented that this is something that the home could improve. Stanwell Rest Home DS0000012167.V359462.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 This home is subject to enforcement action EVIDENCE: The home has a complaints procedure and a copy this is on display in the home. A record of complaints received is maintained alongside details of any action taken to address the issue. Results from surveys were that people knew how to make a complaint and that these are responded to appropriately. In discussion with people living at the home most knew how to raise a concern or complaint and said that they would take any concerns to the acting manager. The home has an adult protection policy, which guides the procedure should there be allegations of abuse. The home has told us that they intend to rewrite the in–house adult protection procedure. We were told that staff received training in abuse awareness this was confirmed through examination of staff records and in discussion with individual members of staff. Staff spoken with demonstrated that they were aware of the issues and their responsibilities towards safeguarding people. We saw that the home had procedures for safeguarding people’s finances and that visitors to the home are required to sign in on arrival. Stanwell Rest Home DS0000012167.V359462.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,24 and 26 This home is subject to enforcement action EVIDENCE: Following the last key inspection of the home on 27th September 2007 a statutory requirement notice was issued regarding the failure to comply with requirements made on previous occasions with regard to the physical environment. Compliance with this notice was assessed during the random inspection of the home on the 8th January 2008. At the random inspection it was found that the home had made several improvements to the environment. All communal areas in the main house had been re-carpeted with plainer style carpeting. Carpeting had been replaced in all bedrooms as necessary. Carpeting had also been replaced in the downstairs office. All toilet and bathroom doorframes had been painted red to aid with recognition. Signage was in place on all toilet and bathroom doors. Bedroom doors all showed the room number, name of occupant and a photo of the occupant. The doors to the separate lounges all had different pictures on. Stanwell Rest Home DS0000012167.V359462.R01.S.doc Version 5.2 Page 18 Some communal areas of the home had been redecorated. During this visit to the home we looked around the communal areas of the home both in the main building and in the self-contained flats. This included bathrooms, toilets, lounges as well as peoples’ bedrooms in the main house and the flats. The home was clean throughout and there were not any adverse odours present. Toilets and bathrooms were all found to be clean. Infection control procedures were observed to be in place. The home employs two domestic staff to clean and both were on duty at the time of the visit. We saw that people had been able to personalise their own rooms with personal items. People told us that they were happy with the environment and cleanliness of the home. People living in the flats said that where possible they kept their own rooms clean and that staff supported them to do this and did additional cleaning as necessary. In several bathrooms and toilets within the main home there is room for further improvement to the décor and some floorings would benefit from being replaced. Also the hallway of the part of the home known as number 76 would benefit from being redecorated. This was discussed with the provider and acting manager whereby the importance of continuing with the redecoration programme was emphasised. The acting manager said that she wanted to establish a rolling programme. As regards the requirement to safeguard people from the risk of scalding from hot water. We were informed that work had commenced on installing thermostatic controls on all water outlets. The provider said that thermostatic controls had been installed on all basins in the part of the home known as number 76 and that work had commenced to install these to all of the basins in the rest of the home. We saw that the temperature of bathwater continues to be monitored. Stanwell Rest Home DS0000012167.V359462.R01.S.doc Version 5.2 Page 19 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 This home is subject to enforcement action EVIDENCE: At the last key inspection carried out on 27th September 2008 requirements were made regarding staffing levels and staff training. We looked at staffing levels at the random inspection of 8th January 2008 and found that on that occasion staffing levels were sufficient for peoples’ needs. Evidence from this visit showed that this had been maintained. We examined the home’s rota and this proved to be a true reflection of the actual staff on shift. In the area referred to as the flats provision had been made for one member of staff to be on duty. The current needs of people living in the flats in relation to staffing levels were discussed. It was reported that the people living there had low support needs and this was confirmed through discussion with staff members. It was demonstrated that on the day of the visit staffing levels within the flats were sufficient to meet peoples’ needs. It will be necessary to keep the staffing of the flats under review and to increase as necessary. Examination of the rota demonstrated that shifts and cover are planned in advance. Staff members spoken with reported that in their opinion they were sufficiently staffed and that replacement cover was brought in to cover leave as necessary. Although we did not find any evidence that this was not the case a comment received from a staff survey suggested that at times the home was short staffed. The recruitment records of two members of staff who had been employed by the home since the last key inspection were examined. These demonstrated Stanwell Rest Home DS0000012167.V359462.R01.S.doc Version 5.2 Page 20 that the home follows procedures and carries out all relevant checks on staff prior to recruitment. We saw that the home had recently interviewed a candidate for the role of assistant manager. The acting manager had involved and sought the opinion of those living at the home as to the candidate’s suitability. People living at the home were asked their opinion as to whether applicant chatted to them, communicated clearly, whether they were comfortable talking to them and their suitability. The acting manager said that this was something that they planned to do with all future applicants. At the random inspection of 8th January 2008 and this inspection we saw evidence that staff had had undertaken a variety of different training. These included; a medication distance learning course, fire, first aid, COSHH, risk assessment and nutrition. On the day of this most recent inspection time an outside assessor was at the home reviewing each staff members training needs and we were informed that this would inform and determine the future training programme. The acting manager reported that she had now completed a ‘train the trainer course in moving and handling. A training schedule was seen to demonstrate that all staff would be attending moving and handling training during the last week of March and the first week of April. We also saw that new staff receive induction training at the onset of their employment pertinent to the home and are enrolled on induction training that falls within the Skills for Care guidelines and that this is completed within the accepted timescale. We saw evidence that staff were supervised and supported through this process. People living at the home all expressed their satisfaction with the help and assistance that they received from staff and the staffs’ attitude. Comments included, The staff are exceptionally good, The carers are very friendly there is nothing they wouldn’t do for you and “ very good if you want anything they get it”. Stanwell Rest Home DS0000012167.V359462.R01.S.doc Version 5.2 Page 21 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 This home is subject to enforcement action EVIDENCE: Following the last key inspection of the home on the 27th September 2007 the provider of this service was required to submit an improvement plan detailing their plans to address all the outstanding requirements. When we carried out the random inspections we found that not all issues had been addressed as described in the improvement plan. Subsequently during the random inspection of 17th December 2007 it was brought to the provider’s attention that statutory powers under sections 31 and 32 of the Care standards Act 2000 were in use and notices were left identifying failures that led us to believe that an offence may have been committed. Following a management review it was decided to issue a notice of proposal to cancel the registration of the home and this was issued on 5th March 2008. Stanwell Rest Home DS0000012167.V359462.R01.S.doc Version 5.2 Page 22 Since the last key inspection of the home the previous registered manager has stood down and at present the home is without a registered manager. An acting manager was recruited and has now been in post for several months. At this inspection we noted that there has been an improvement in many areas and the provider attributes this to the present manager. However the homes’ history shows that they have not been proactive in the past at undertaking monitoring of the service or developing a good quality assurance model or taking remedial action from their own audit of the service and that most changes and improvement have been as a result of issues raised by the Commission for Social Care Inspection. The provider said that they were waiting to appoint an assistant manager and they would be taking up the post once all pre employment checks had been completed. The provider said that this new post would provide additional management support and that they would spend 50 of their time involved in providing care and the other 50 undertaking management responsibilities. The provider also said that the intention was to provide management cover on the rota seven days a week so that a manager was on duty everyday of the week. In discussion with people living at the home they told us that they do have the opportunity to attend resident meetings and that these are held frequently. One person said, “we can talk about issues and the manager has said if we don’t want to talk at the meeting we can talk to her in private”. In discussion with another person when asked whether they were asked their views they replied, “It would be good to be asked questions like you have asked”. The home will look after small amounts of peoples’ money if they so wish. We checked three peoples’ records and found that accurate records had been kept of all money kept and spent. A regular audit of the money and records had been completed. The AQAA indicated that equipment had been regularly serviced. Examination of a sample of service contracts substantiated this. The home has several stair lifts and these had all been serviced in February 2008. The report from the contractor who carried out the service stated that some of the stair lifts are now obsolete and intermittent faults were occurring in one of the lifts. The provider said that eventually these would need to be replaced, as spare parts are no longer available. A certificate demonstrating that the home’s electrical system was checked in January 2008 was seen. This did however highlight that some issues needed urgent attention. The provider said that he had requested a quote and that the work would be carried out. Examination of the fire log showed that regular fire drills had been carried out and that regular and thorough testing of the home’s fire detection and firefighting equipment was being done. Stanwell Rest Home DS0000012167.V359462.R01.S.doc Version 5.2 Page 23 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 2 Stanwell Rest Home DS0000012167.V359462.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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 OP15 Good Practice Recommendations All residents should be given a choice at lunchtime. Stanwell Rest Home DS0000012167.V359462.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Stanwell Rest Home DS0000012167.V359462.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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