Inspection on 15/05/08 for Star Residential Home Ltd

This inspection was carried out on 15th May 2008.

CSCI found this care home to be providing an Adequate service.

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

Other inspections for this house

Star Residential Home Ltd 30/04/09

Star Residential Home Ltd 11/12/07

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 15th May 2008 09:45 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.V364520.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.V364520.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.V364520.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. 11th December 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 £379 to £405 depending on residents’ needs. The inspection report is available on the residents’ notice board in the home. Star Residential Home Ltd DS0000069558.V364520.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. 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. We received 12 in total. • 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 four people living there and three members of staff. A tour of the premises was undertaken and a range of policies and documents were viewed The home has been subject to additional inspections due to concerns about the poor quality of care being provided. Details of these reports can be found by contacting the Cambridge and Peterborough office of the CSCI. What the service does well: What has improved since the last inspection? There has been much improvement in this home since its last key inspection in December 2007. Care plans are detailed, comprehensive and give staff excellent guidance in how to meet residents’ needs. They are now meaningfully reviewed and residents sign them to show they agree with how their care is to be delivered. The home’s environment is much improved too: orientation aids have been placed around the home to help residents find their way around and reminiscence items have been hung on the walls of corridors to provide interest for residents and their visitors. The very hot radiator in the toilet outside rooms 14 and 15 has been covered so that residents are not at risk of burning themselves. Residents are now able to lock their bedroom doors, Star Residential Home Ltd DS0000069558.V364520.R01.S.doc Version 5.2 Page 6 giving them more security and privacy and infection control measures are tighter, thereby protecting staff and residents. Staff have undertaken numerous training courses ensuring they are more skilled and knowledgeable about their care practices. The running of the home overall is slowing improving, and the manager has a better understanding of the national minimum standards and how they must be implemented. 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 Star Residential Home Ltd DS0000069558.V364520.R01.S.doc Version 5.2 Page 7 be made available in other formats on request. Star Residential Home Ltd DS0000069558.V364520.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.V364520.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 good. Admission procedures to the home are good, ensuring that residents’ needs can be met there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a statement of purpose and service users’ guide available for prospective residents, giving details of the facilities on offer at the home, and each resident is issued with a contract that states the terms and conditions of their stay, and the fees payable. Prospective residents are actively encouraged to visit the home as part of their admission procedure and one recently admitted resident visited the home with his social worker to assess its facilities before moving in. Another resident told us that her son had visited on her behalf. Each resident has an assessment of their need carried before being admitted to the home, and additional information from other health care professionals is sought where necessary. Star Residential Home Ltd DS0000069558.V364520.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is adequate. Residents’ needs are monitored by the home to ensure their continued well-being and care plans clearly detail their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We read the care plans for three residents at the home. The information they contained was excellent. Residents’ needs were clearly identified, along with detailed guidance for staff in how to meet them. When residents suffered from an illness there was detailed information about how the illness actually affected them in their everyday lives. Residents’ daily routines were recorded, as were any risks to their welfare. The plans had been meaningfully reviewed every month and where possible residents had signed them. However one care assistant told us that she had never read any of the plans despite working at the home since January 2008; she reported that she did not have the time to do this. Residents health care needs are monitored: nutritional and skins assessments are undertaken monthly as are residents’ weights. The home has good links Star Residential Home Ltd DS0000069558.V364520.R01.S.doc Version 5.2 Page 11 with local health care professionals makes appropriate referrals when necessary. Residents told us that staff treated them well and that they received the care and support they needed, in a way they liked. All interactions we observed between staff and residents were respectful and enabling. We checked medication storage and a sample of administration records and noted the following shortfalls: • • • The use of creams and ointments was not being recorded on the MAR sheet by the member of staff actually administering them. When medicines were given on a variable dose basis e.g. “one or two tablets” the dose given was not always recorded. This could lead to residents receiving too much or too little medication. When handwritten additions or alterations were made to the computer printed medication administration record charts, supplied by the pharmacy, these were not always signed and checked for accuracy by a second person No temperature records were kept of the medication storage room. The failure to store medicines at the proper temperature could result in residents receiving a treatment that is ineffective. • Star Residential Home Ltd DS0000069558.V364520.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. 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 a specific member of staff to facilitate activities for residents 4 days a week and there are regular arts and crafts, games, music and exercise sessions. One resident told us that doing the activities relaxed her, and she very much enjoyed the singing and playing dominos. Another told us of a recent trip to the circus which she enjoyed. Trips are planned soon to a local Bronze Age centre and also a show at the Lions Club. Staff take residents into town for shopping. Two staff have recently attended a reminiscence course at Peterborough museum and have used this training to improve activities for residents. These staff have created a ‘memory box’ full of old items (such as coins, pictures and kitchen items) to use with residents and this is proving very popular with them. There was some evidence that residents are encouraged to participate in every day tasks. We saw one resident help fold napkins for lunch and another resident helps set the tables. Family members are made welcome and one resident told us her son visits every week, often having lunch at the home with her. Star Residential Home Ltd DS0000069558.V364520.R01.S.doc Version 5.2 Page 13 Routines at the home are flexible with residents choosing how they spend their day. One told us ‘some of us go to bed early, some prefer later’ Lunch on the day we visited consisted of sausage casserole or quiche and we observed the cook asking residents that morning what they preferred to eat. One resident told us: ‘there’s good food, and plenty of it’; another reported ‘we always get a choice if there is something we don’t like’ Star Residential Home Ltd DS0000069558.V364520.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. The competency of staff who have completed training is not assessed to ensure the safety of people living in the home. 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 (in large print so it is accessible to them). Those residents who completed our surveys told us that they did know how to make a complaint and one commented: ‘I’ve only had to make one complaint and this was dealt with and resolved.’ Three people who live in the home were asked if they could remember being given any information about making a complaint or what to do if they did not feel safe. They all said they did not remember being given any information about it, but two were clear about whom they would speak to if they were unhappy with anything in the home. The other person did not know who to speak to even with prompting. The home has received one serious complaint from a relative concerning its care practices in the last year. This was investigated under local adult safeguarding procedures and most aspects of it were unfounded. The local authority provides safeguarding training for staff at the home, but the level of competence and understanding shown by them during this inspection was very varied. Some staff have not received safeguarding training since 2005, although the manager said all staff have either completed or been put forward for training this year. There was some evidence that 8 staff had completed training in 2008. Star Residential Home Ltd DS0000069558.V364520.R01.S.doc Version 5.2 Page 15 We spoke to three members of staff about their understanding of abuse, and safeguarding the people living in the home. One did not understand much of what was said as English is not her first language. The staff member knew about physical abuse and reporting anything to senior staff. The Manager was confident the staff member was aware of all aspects of safeguarding as she had only recently been on training. The manager and inspector saw the staff member together so that the manager could phrase questions in a way that would help the member of staff, but this only made it clearer that this staff member did not understand safeguarding or whistle blowing. The manager said she would ensure this member of staff repeated her training and that her competency would be assessed. The other two members of staff were clear about types of abuse and what they would do, even though one said she had not had training for three years and the other could not remember having it at all. The home does have policies and procedures about safeguarding but staff have to be able to understand the written word. One staff member is unable to read or write English but “staff read” things to her. The manager said that the policy would have been explained to her, but there was no evidence this had been done or how much had been understood. In discussion with the registered manager she said she had attended basic safeguarding training and is waiting to attend the 3-day course. The manager intends to send senior care staff on the three-day training and one person will undertake the trainers’ course so that some in house training can be provided. The manager had the Greater Peterborough Primary Care Partnership Adult Social Care Adult Protection Procedures dated 1/6/04, amended June 05. The manager is attending a meeting with the group and intended to ask if there has been an updated version. The manager has attended strategy meetings and is aware of the procedure. After the last inspection she had increased staff training since some training had not been updated for several years (including safeguarding last done 2005). Competency of staff after they have completed training is an issue that needs to be addressed. The policies and procedures relating to whistle blowing, grievances etc are from the National Care Homes Association. They were reviewed 10/4/07 and the manager said she was due to review again next week. Star Residential Home Ltd DS0000069558.V364520.R01.S.doc Version 5.2 Page 16 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): 19,26 Quality in this outcome area is good. Recent work has improved the environment for residents, and they live in a well maintained and comfortable home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We undertook a brief tour of the home and found it generally to be clean, hygienic and free from strong smells apart from in two bedrooms. There were clear orientation aids around the home to help residents find their way about, a downstairs bathroom has been converted into a level access shower for residents and areas of the home have been redecorated giving it a brighter feel. The home accommodates a number of residents whose first language is not English and signs for the toilet were in appropriate languages for them. There is a small garden at the rear of the property that was well maintained and had seating areas for residents to use. Alcohol hand rub is available around the home for staff and visitors to reduce the risk of infection. Star Residential Home Ltd DS0000069558.V364520.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. Staff are available in sufficient numbers to meet residents’ needs. This judgement has been made using available evidence including a visit to this service EVIDENCE: There are three staff on between 8am and 10pm, and two ‘waking’ night staff to meet the needs of 17 residents currently. Staff reported that there were enough of them to meet residents’ needs, although mornings could be a busy time and sometimes felt rushed. Staff told us that they had received training relevant to their role and files we checked showed that staff had recently undertaken a variety of training. More than 50 of staff have an NVQ level 2 in care, and 4 are working towards NVQ level 3. However one member of staff had not received any training in moving and handling residents safely despite working at the home for over 5 months. This member of staff told us she regularly helps residents mobilise. Another member of staff’s English was particularly poor and we were concerned as to how effectively she could communicate with residents, and also understand any training that she undertook. Residents who completed the surveys reported that staff were available when they needed them and that they listened and acted on what they said. We checked the personnel files of 3 members of staff and appropriate CRB checks and references had been obtained for two of the staff before they had started working at the home, the other had been employed pre 2002. A Star Residential Home Ltd DS0000069558.V364520.R01.S.doc Version 5.2 Page 18 further (new) staff members file was checked and this had PoVA First, CRB and references in place before the person commenced employment. Star Residential Home Ltd DS0000069558.V364520.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): 31,33,35,38 Quality in this outcome area is adequate. The management of the home is getting better to ensure that residents live in a well run and efficient home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has returned from a long period of absence and has worked hard to meet the many number of requirements made at the last inspection. One relative described the manager as ‘helpful’. She has recently completed her registered manager’s award and staff who completed the survey told us they received good support from her, and now receive regular supervision. However one staff member told us; ‘management could offer more support to workers if they are experiencing problems relating to the residents; another: ‘the home could relate better to domestic staff, especially in areas of equipment up keep, and the stocking of various chemical cleaners’. Star Residential Home Ltd DS0000069558.V364520.R01.S.doc Version 5.2 Page 20 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 £360 in one case). This money should be banked in residents’ personal bank accounts so that it can be held more securely and also gain interest. This was raised at the previous key inspection but little has been done to address it. A number of records in relation to health and safety (lift, gas, legionella, water temperatures) were checked by and found to be in good order. A brief tour of the kitchen was undertaken and all foodstuffs were stored safely and hygienically. However we noted a table was blocking the outside fire escape stairway, preventing residents from evacuating safely in the event of a fire. The manager agreed to move this immediately so a requirement has not been made on this occasion. The manager said there was no formal Quality Assurance system but she used the Regulation 26 visits, discussion with people living in the home and other records to improve practice. The QA system did not include safeguarding. Star Residential Home Ltd DS0000069558.V364520.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 3 3 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 3 x 2 x x 3 Star Residential Home Ltd DS0000069558.V364520.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15(1) Requirement Care staff must have good knowledge of residents’ care plans so they know how to deliver the correct care and support to them. Medicines must be stored in appropriate environmental conditions. This will ensure the quality of medicines used for residents. Previous timescale of 29/02/08 not met. 3. OP9 13(2) 17(1)(a) Complete and accurate records must be kept of all medication administered. Previous timescale of 29/02/08 not met. 4. OP30 18 (1)(a) Staff, who do not have English as their first language, must have the necessary communication skills to understand people living in the home, as well as be able to read written policies and procedures and understand training they DS0000069558.V364520.R01.S.doc Timescale for action 01/07/08 2. OP9 13(2) 15/05/08 15/05/08 01/07/08 Star Residential Home Ltd Version 5.2 Page 23 receive. 5. OP30 13(5) Care staff must receive training in moving and handling residents safely so that they do not put themselves or residents at unnecessary risk. 01/07/08 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. Refer to Standard OP9 Good Practice Recommendations When handwritten additions or alterations are made to the computer printed medication administration record charts, supplied by the pharmacy, these should be signed by the person making the entry and checked for accuracy by a second person. 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. 2. OP35 Star Residential Home Ltd DS0000069558.V364520.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact 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. Extracts may not be used or reproduced without the express permission of CSCI Star Residential Home Ltd DS0000069558.V364520.R01.S.doc Version 5.2 Page 25 - 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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