Inspection on 11/12/07 for Star Residential Home Ltd

This inspection was carried out on 11th December 2007.

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

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

Other inspections for this house

Star Residential Home Ltd 30/04/09

Star Residential Home Ltd 15/05/08

Similar services:

Claremont House

Chesham House

Oak Ridge

Argyll House

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

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

CARE HOMES FOR OLDER PEOPLE Star Residential Home Ltd 56-64 Star Road Peterborough PE1 5HT Lead Inspector Janie Buchanan Unannounced Inspection 11th December 2007 10:00 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 Star Residential Home Ltd DS0000069558.V356071.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. Star Residential Home Ltd DS0000069558.V356071.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Star Residential Home Ltd Address 56-64 Star Road Peterborough PE1 5HT 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) 01733 777670 01733 552311 Star Residential Home Limited Mrs Dawn Bent Care Home 30 Category(ies) of Dementia - over 65 years of age (4), Mental registration, with number disorder, excluding learning disability or of places dementia (3), Old age, not falling within any other category (30) Star Residential Home Ltd DS0000069558.V356071.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Category MD is for named service users for the duration of their residency. 9th August 2007 Date of last inspection Brief Description of the Service: The Star is situated in a residential area close to Peterborough town centre. The home consists of former terrace houses that have been adapted to provide accommodation for 30 older people. All rooms are for single occupancy. The home has 10 WCS, 5 Bathrooms, 3 showers and a shaft lift. Eleven bedrooms have en-suite facilities. The weekly fee’s range from £372 to £416. The inspection report is available on the resident’s notice board in the home. Star Residential Home Ltd DS0000069558.V356071.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. For this key inspection we (CSCI) looked at all the information that we have received, or asked for, since the last key inspection. This included: • The annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. Surveys returned to us by people using the service and from other people with an interest in the service. What the service has told us about things that have happened in the home, these are called ‘notifications’ and are a legal requirement. • • We also visited the home and talked with five people living there and three members of staff. A tour of the premises was undertaken and a range of policies and documents were viewed. We also observed a lunchtime meal at the home. An expert by experience (ex by ex) was part of our inspection: an ex by ex is someone who has direct experience of using social care services. During this inspection the ex by ex looked at the quality of activties,and food and mealtimes for residents. Her feedback is included in this report. Eight requirements and two recommendations have been made as a result of this report. What the service does well: What has improved since the last inspection? Recent decoration and furnishings have improved the environment for residents. Residents’ care plans are reviewed regularly and meaningfully so that changes in their needs are monitored closely. Although there was still an unpleasant odour in some parts of the home, it was much less pungent and offensive compared to previous visits. Star Residential Home Ltd DS0000069558.V356071.R01.S.doc Version 5.2 Page 6 What they could do better: There is much this home must do to improve its service and ensure residents are protected: • • • • The home’s fees must be included in any contract signed by residents, so that they are fully aware of the amount payable, and by whom. Care plans covering all aspects of residents’ health must be implemented to ensure their needs are met. Medication recording and management needs to be tighter so that there is a clear record of what residents have been administered. All items of maintenance noted under standards 19-26 must be addressed so that residents live in a safe and pleasant environment. In particular the very hot radiator in the toilet outside rooms 14 and 15 must be covered so that residents are not at risk of burning themselves. Some areas of the home are rather bleak and institutionalised. Upstairs corridors should be made more interesting and homely by the addition of pictures, plants, fiddle boards and interesting objects for residents to look at. Appropriate locks must be fitted to bedroom doors so that residents can lock their rooms for privacy and safety Infection control needs to improve. The open cat litter tray must be removed from the communal lounge area; antibacterial hand gel must be made available in the bottles provided and all toilets must have toilet roll in them. Training needs improve and all staff must receive training in food hygiene, infection control, health and safety, and COSHH so that staff have the knowledge and skills to protect residents. Large amount of residents’ monies should not be kept in the home. Instead, it should be put in residents’ own personal bank accounts so it can be held safely and also accrue interest. All incidents affecting the well being of residents must be reported to the CSCI so that these events can be monitored. • • • • • • 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 Star Residential Home Ltd DS0000069558.V356071.R01.S.doc Version 5.2 Page 7 be made available in other formats on request. Star Residential Home Ltd DS0000069558.V356071.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 Star Residential Home Ltd DS0000069558.V356071.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): 1,2,3,5 Quality in this outcome area is adequate. Information about the home is available for prospective residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is statement of purpose and service users’ guide available for prospective residents, giving details of the facilities on offer at the home. However some of the language used in these documents is inappropriate and references to residents sometimes ‘acting like children’ must be removed. The home’s brochure advertises a website address. This website, however, is still under construction and gives little information about the home. Each resident is given a contract that states the terms and conditions of their stay at the home. However in both contracts checked the information concerning the amount of weekly fees actually payable had not been completed, despite residents having signed them. Prospective residents are actively encouraged to visit the home as part of their admission procedure. The files of two recently admitted residents were Star Residential Home Ltd DS0000069558.V356071.R01.S.doc Version 5.2 Page 10 checked and contained pre-admission information about their needs provided by the local primary care trust. Star Residential Home Ltd DS0000069558.V356071.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): 7,8,9,10 Quality in this outcome area is poor. Residents’ health care needs are not well met at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three care plans were viewed, two of the plans were satisfactory with evidence of residents’ needs and the action required to meet them clearly recorded. The plans had also been reviewed regularly with good detail. However, the care notes of one resident who had developed a pressure sore whilst at the home where examined. The following worrying points were noted: • • • • • The resident was diabetic but there was no specific care plan drawn up as to how her diabetes was to be managed by staff This resident’s blood sugar levels had not been monitored for a period of four months This resident’s weight had not been monitored for a period of three months, despite her being nutrionally at risk No assessment of her risk of pressure sores had been undertaken This resident developed a pressure sore on her right heal on 9/10/07 but no care plan detailing how this was to be managed was implemented. DS0000069558.V356071.R01.S.doc Version 5.2 Page 12 Star Residential Home Ltd Medication storage and records were checked and the following worrying shortfalls were noted: • • • • • The date on which bottles of liquid medications had been opened had not been recorded The number of tablets recorded in the controlled drug register did not correspond to the actual number of tablets held in stock Staff members had not signed the MAR sheet to indicate that were giving creams and ointments to residents Hand written additions to the MAR sheets had not been signed or dated. The medication trolley was sticky and dirty, as were many of the bottles containing liquid medication, to the extent that their instruction labels were no longer readable. All interactions between staff and residents were relaxed, encouraging and respectful. We observed staff deal with one incontinent resident sensitively and discretely. A number of bedrooms (rooms 4,5,16,17,18,20 and 21) had inappropriate looks on them that did not allow residents to lock their bedroom doors should they wish for privacy or security. The confidential care notes for one resident were found in a magazine rack in the main lounge. Star Residential Home Ltd DS0000069558.V356071.R01.S.doc Version 5.2 Page 13 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): 12,13,14,15 Quality in this outcome area is adequate. Residents have access to activities to keep them entertained and mealtimes are enjoyable. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home employs an activities co-ordinator 4 days a week to provide stimulation and entertainment for residents. On the day of the visit there was a hairdresser and a chiropodist present, and a lady from a local church-giving communion to residents. However information about forthcoming activities is not well-advertised or circulated to residents in a format suited to their capacities. One member of staff felt that there should be more trips out for the residents. Residents told us that their visitors are made to feel welcome by staff at the home; they also told us that they liked the meals that were served. There is always a choice of menu and on the day of the visit lunch consisted of pork casserole or lasagne, followed by jam and coconut sponge. Lunch was relaxed and pleasant and those residents that needed help to eat were given it sensitively and discretely. Star Residential Home Ltd DS0000069558.V356071.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is adequate. Residents have access to a complaints procedure. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information about how to complain is contained in the residents’ guide and in each resident’s bedroom. Those residents who completed our surveys told us that they did know how to make a complaint. CSCI has received one serious complaint about the quality of care provided to a resident at the home and manager is currently investigating the concerns raised. The home has adequate policies in relation to adult protection and staff receive training in this so they are aware of the different types of abuse and local reporting guidelines. Despite this the home failed to report a serious incident when one resident was pushed over by another, causing her to fracture her hip. Star Residential Home Ltd DS0000069558.V356071.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,24, 26 Quality in this outcome area is adequate. Recent work at the home has improved the environment for residents, however infection control needs to be better to fully protect residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There have been a number of improvements in the home’s environment since the last inspection; there is new flooring and furniture in the dining area; a new carpet in the lounge area; one bathroom has been refurbished and specialist scales have been purchased to weigh residents. Residents clearly appreciated these changes and one told us: ‘recent decorations have made a big improvement in the overall look of the place’. However following was noted: • • • The shower in room 15 could not be used as there was a crack in the basin There was a very hot uncovered radiator in the toilet by room rooms 14 and 15 Woodwork around door frames is badly chipped and unsightly DS0000069558.V356071.R01.S.doc Version 5.2 Page 16 Star Residential Home Ltd • • • • The upstairs corridors are long, uninteresting and look very institutionalised. There is a lack of orientation aids around the home to help residents find their way about. The upstairs corridors are very similar looking and it’s easy to get lost. A number of wheelchairs were stacked unsafely under the stairway The plaster work outside room 24 is damaged Infection control needs to be tighter in the home. There is an open cat litter tray in the main lounge; as well as smelling, this is unhygienic in a communal part of the home and should be removed. Some residents’ toilets were without toilet paper and bottles of antibacterial hand gel were empty. Star Residential Home Ltd DS0000069558.V356071.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is adequate. Some staff do not have adequate training and skills to meet the needs of residents at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are four staff on between 8am and 1.30pm, three staff on between 1.30pm and 10pm, and two ‘waking’ night staff to meet the needs of up to 30 residents. Residents told us that there was enough staff around to help them when needed and staff reported that they did get enough time to spend with residents in addition to their other care tasks. The home employs a number of oversees staff, whose first language is not English. Although their care practices were observed to be good, it is of concern that they might have difficulty in communicating effectively with residents as we struggled to understand, and be understood, by these staff. Staff training is variable with some having received a range of training, including NVQ 2. However other staff receive limited training and one member of care staff had not received any training in food hygiene, infection control, health and safety, and COSHH (despite also working as a domestic assistant in charge of numerous cleaning chemicals). This person’s moving and handling training was also out of date. Three members of staff reported, via the homes own internal staff quality assurance survey, that they felt the training provided did not meet their needs. Although staff are reported to have attended Star Residential Home Ltd DS0000069558.V356071.R01.S.doc Version 5.2 Page 18 training in dementia care their knowledge about dementia, its different forms, common symptoms and the course of the disease was very basic. The personnel files of two recently recruited staff were checked. All appropriate pre-employment checks had been completed, although the references for one staff member had both come from the same company, despite this person having been employed at a number of different work places previously. Star Residential Home Ltd DS0000069558.V356071.R01.S.doc Version 5.2 Page 19 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): 31,33,35,37,38 Quality in this outcome area is adequate. Management of the home is currently unstable; potentially affecting the service residents receive. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s registered manager has had long-term sickness since September of this year. A senior carer has been acting up in her absence, with additional support provide by the home’s owner. It is not clear when the manager will be well enough to return to her duties. In her absence, the home has been failing to notify the CSCI of events affecting the well being of residents. A sample of residents’ residents monies’, cash sheets and receipts were checked. All were found to be in good order, although the home is holding large amounts for a number of residents (up to £250 in some cases). This money should be banked in residents’ personal bank accounts so that it can be held more securely and also gain interest. Star Residential Home Ltd DS0000069558.V356071.R01.S.doc Version 5.2 Page 20 A number of records in relation to health and safety (lift and hoist servicing, gas, portable appliance testing and fire alarms) were checked by and found to be in good order. However, the very hot radiator in the toilet outside rooms 14 and 15 must be covered so that residents are not at risk of burning themselves. A brief tour of the kitchen was undertaken and all foodstuffs were stored safely and hygienically. Star Residential Home Ltd DS0000069558.V356071.R01.S.doc Version 5.2 Page 21 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 2 1 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 1 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 2 x x x x x x 2 STAFFING Standard No Score 27 3 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x x x 2 x 2 3 Star Residential Home Ltd DS0000069558.V356071.R01.S.doc Version 5.2 Page 22 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. 1. 2. Standard OP2 OP8 Regulation 5(1)(b) 15(1) Requirement Details of the fees payable must be included in any contract signed by residents Care plans must be drawn up for all aspects’ of residents’ health, (including diabetes, pressure sores), so it is clear how these are going to be met An accurate record of all medications administered to residents must be kept so that they are protected The local adult protection team must be informed of any physical assaults between residents. All items of maintenance noted under standards 19 and 26 of this report must be addressed so that residents live in a safe and pleasant environment. Residents must be able to lock their bedroom doors for privacy and security. Infection control must be improved so that residents are protected. In particular the cat litter tray must be removed form the communal area and antibacterial gel must be made DS0000069558.V356071.R01.S.doc Timescale for action 01/03/08 01/03/08 3. OP9 17(1)(a) 01/01/08 4 4 OP18 OP19 13(6) 23(2)(b) 01/01/08 01/03/08 5 6 OP24 OP26 12(4)(a) 16(2)(j) 01/04/08 01/01/08 Star Residential Home Ltd Version 5.2 Page 23 7 8 OP30 OP37 18(c) 37 available for staff to wash their hands with. Staff must receive training in infection control, food hygiene, COSHH and health and safety. CSCI must be notified, without delay, of any event that affects the well being and safety of residents 01/03/08 01/01/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2 Refer to Standard OP19 OP35 Good Practice Recommendations Upstairs corridors should be made more interesting and homely, and orientation aids should be provided to help residents find their way about the home. The home should not accrue large amount of money on behalf of residents. Instead it should be put in residents’ own personal bank accounts so it can be held safely and accrue interest. Star Residential Home Ltd DS0000069558.V356071.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Inspection Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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. 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