Inspection on 17/06/05 for Station House Nursing Home

This inspection was carried out on 17th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Station House Nursing Home 28/11/06

Station House Nursing Home 22/11/05

Station House Nursing Home 25/01/05

Station House Nursing Home 24/08/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Station House Victoria Avenue Crewe Cheshire CW2 7SF Lead Inspector Gill Matthewson Announced 17 June 2005 9:30 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. 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. Station House F51 F01 S18742 Station House V223604 170605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Station House Address Victoria Avenue Crewe Cheshire CW2 7SF 01270 250843 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Community Health Services Limited Mrs Carole Wardle Care Home 69 Category(ies) of Dementia - over 65 years of age (39) registration, with number Dementia (6) of places Old age, not falling within any other category (30) Physical disability (6) Station House F51 F01 S18742 Station House V223604 170605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 This home is registered for a maximum of 69 service users to include:* Up to 39 service users in the category of DE(E) (dementia over the age of 65 years) may be accommodated in Coppenhall Mews * Within the 39 DE(E) beds up to 6 service users in the category of DE(dementia under 65 years of age) may be accommodated * Up to 30 service users in the category of OP (old age not falling within any other category) may be accommodated in Victoria Mews * Within the 30 OP beds up to 6 service users in the category of PD (physicaldisability) may be accommodated 2 The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Date of last inspection 25/01/05 Brief Description of the Service: Station House is a care home providing nursing care for a maximum of 69 people. It is owned by Community Health Services, a subsidiary of Care UK.The home is within half a mile of Crewe town centre, on bus and rail routes, and has its own car park.It is a single storey, purpose built facility and comprises two separate residential units and a day care centre (which does not require registration with the Commission for Social Care Inspection). Victoria Mews has 30 beds for people who are physically frail and Coppenhall Mews has 39 beds for people with dementia.All the home’s bedrooms are single. There are no ensuite facilities. The home has extensive grounds that are well maintained and easily accessible. Station House F51 F01 S18742 Station House V223604 170605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out by two inspectors of the Commission. The lead inspector spent two hours planning the inspection by reviewing previous inspection reports and the service history over the last twelve months. The inspection took place over five hours and included a tour of the building, inspection of records and discussion with eight residents, four relatives and eight staff. A comment card was received fro the continuing NHS health care manager and a report was received from the Environmental Health Officer. Feedback was given to the Home Manager and Deputy Manager immediately following the inspection. Overall, the home is well managed and provides a good standard of care for the residents. What the service does well: All prospective residents undergo a comprehensive assessment of need prior to admission to ensure that the home can meet their needs. Residents and their families feel respected and included in the care planning process. The home ensures that residents’ health care needs are addressed by the employment of sufficient numbers of adequately trained and experienced registered nurses and referral to appropriate health care professionals as needs arise. Residents are able to make choices in relation to their activities of daily living and the home provides a comprehensive programme of activities that can be tailored to meet individual requirements. Residents and relatives are able to express any concerns through the home’s complaints procedure and be assured that these will be looked into and acted upon. The home provides a spacious and pleasant environment for residents to live in. Station House F51 F01 S18742 Station House V223604 170605 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? 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 Station House F51 F01 S18742 Station House V223604 170605 Stage 4.doc Version 1.30 Page 7 contacting your local CSCI office. Station House F51 F01 S18742 Station House V223604 170605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Station House F51 F01 S18742 Station House V223604 170605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 Prospective residents needs are assessed prior to admission to ensure that the home can meet their needs. EVIDENCE: Eight care files were reviewed as part of the case tracking exercise. All contained evidence that pre-admission information had been obtained from social services and the multi-disciplinary health care team prior to admission and that the prospective resident had been assessed by a senior nurse from the home and their needs discussed. This pre-admission consultation included discussion with relatives if appropriate. Station House F51 F01 S18742 Station House V223604 170605 Stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8&9 In the main, the care planning process ensures that residents’ health and personal care needs are met and that they receive their prescribed medication. EVIDENCE: Care plans were in place for identified needs and demonstrated that they were drawn up in consultation with residents and their families. In the main, these contained detailed instructions for staff in how to meet the resident’s health and social care needs. There were two exceptions in Victoria Mews. One resident was a diabetic, but the care plan contained no instructions for monitoring of blood glucose levels. Another resident had a pressure sore that was healing but the care plan did not give instructions on how to dress the wound. See Requirement 1. Care files contained detailed evidence that residents were referred to appropriate health care professionals as required. Records of consultations were documented and any directions documented in the care plan. For example, one resident’s file contained information relating to consultations with the GP, dentist, chiropodist and speech and language therapist. Station House F51 F01 S18742 Station House V223604 170605 Stage 4.doc Version 1.30 Page 11 At the last inspection some residents had been identified as being at risk of dehydration. The care plans had included an instruction to maintain records of fluid intake and output. The inspector noted that the recording on the fluid balance charts was inconsistent. The manager and assistant manager said that they had addressed this matter with care staff and were trying to ensure that the forms were fully completed. This was checked again at this inspection. Recording of fluid intake and output had improved, but in Victoria Mews it was noted that not all fluids taken were being recorded accurately Discussion with the staff identified that some care staff were unclear as to when to complete the charts. See Requirement 2. Medication administration charts contained details of all medication that the residents were prescribed, including the dosage and required frequency of administration. They also demonstrated that medication had been administered as prescribed. Station House F51 F01 S18742 Station House V223604 170605 Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13&14 Residents are able to exercise choice and control over their lives. The home welcomes the involvement of residents’ families and provides residents with individual opportunities to fulfil their social and recreational needs. EVIDENCE: Station House F51 F01 S18742 Station House V223604 170605 Stage 4.doc Version 1.30 Page 13 Staff described the usual daily routine, which began with a handover from the night staff followed by the serving of breakfast. Residents were assisted to get washed and dressed throughout the morning. Those who were physically frail were assisted back to bed during the afternoon; others said they went to bed at a time of their choosing and that routines were flexible to accommodate their needs. The home employed an activity coordinator 40 hours per week, assisted by a care assistant 12 hours per week. The activity coordinator person had a record for each resident that contained information about their lives and interests. From this she had devised a social care plan and a record of all activities undertaken for each resident. The registered provider had held a national competition for the Best Activities Programme in all their homes, for which Station House had been highly commended. An activities programme was on display on notice boards throughout the home. Activities were available every day except Sundays. Activities included such things as painting, crafts, dominoes, board games and trips out. Twice a year the home held a craft fayre and involved residents (if they wished) in making items to sell and manning stalls. Service users from Coppenhall Mews were able to access ‘Sonas’ sessions in the day care unit. Sonas is a multi-sensory programme involving the stimulation of the senses to activate potential for communication. A notice board in the foyer contained photos of residents enjoying various trips out this year. Residents and visitors confirmed that visiting was encouraged. One relative said that she visited every day and that staff made her feel like ‘part of the family.’ Another visitor, whose relative had passed away a few months before, said that she came back to visit because she felt the same. She said she was member of the ‘Friends of Station House’ and returned as a visitor because ‘the staff were so marvellous with mum and me that I want to give something back.’ Residents spoken with said that staff treated them with dignity, they had a choice of when to get up and go to bed and could choose whether they stayed in their room or went to the communal areas or out, if they wished. Station House F51 F01 S18742 Station House V223604 170605 Stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 Residents and relatives have confidence that complaints are taken seriously and acted upon. EVIDENCE: The home had a satisfactory complaints procedure that was displayed in the entrance hall, on the back of all wardrobe doors, and in the guide to the home. Complaints were documented and all details of the investigation and the outcome were recorded. This information was analysed and if any areas for improvement were identified, an action plan was produced and implemented. Residents and visitors said that they were aware of the complaints procedure and that they felt able to approach the staff with concerns and that they would be taken seriously and looked into. Station House F51 F01 S18742 Station House V223604 170605 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,22&26. The home provides a spacious, comfortable and pleasant environment for residents, with a commendable amount of equipment to ensure residents’ comfort and safety. EVIDENCE: Station House F51 F01 S18742 Station House V223604 170605 Stage 4.doc Version 1.30 Page 16 The home was clean and well-maintained and a programme of routine maintenance and renewal was in place. Grounds were tidy, safe, and accessible to service users. A letter from the Environmental Health Officer indicated that the home was not contravening any Food Safety Regulations. Ramps and grab rails were provided in all areas. Corridors and doorways were wide enough for wheelchair access. Appropriate signs were in place to enable residents to locate bathrooms and toilets. There were call bells with an accessible alarm facility in all rooms. The home had an excellent supply of moving and handling and pressure relieving equipment, including six bath hoists, 1 ceiling hoist, 1 large hoist with scales, two stand aids and five other hoists. There were also 30 dynamic pressure relieving mattresses. Two of the bathrooms in Victoria Mews were cluttered with moving and handling equipment that had been stored there. It was not possible for residents or staff to use the bathroom without moving all the hoists and wheelchairs. See Recommendation 1. Station House F51 F01 S18742 Station House V223604 170605 Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29&30. Residents are supported and protected by the home’s staffing, recruitment and training policies and procedures. EVIDENCE: The occupancy at the time of the inspection consisted of 31 residents in Coppenhall Mews and 24 in Victoria Mews. Staffing rotas showed that staffing levels were sufficient to meet the needs of those in residence. The home employed a satisfactory number of registered nurses, although only the acting Unit Manager of Coppenhall Mews was a registered mental nurse. However, the home did employ other registered nurses who had worked at the home for over 10 years. If these staff leave or retire, there may be a shortage of skills in the care of people with mental health needs. See Recommendation 2. Thirty percent of care staff had an NVQ Level 2 in Care but several more were working towards this qualification. All staff had individual personal development plans.The home had a comprehensive training programme in place and future dates had been set for training in equality and diversity, resident involvement, protection of vulnerable adults, infection control, leadership and supervision and medicines management. The personnel files of three staff who had been employed since the last inspection were examined. They all contained the information and documentation required by the Care Homes Regulations, including appropriate references and evidence of criminal records checks. Station House F51 F01 S18742 Station House V223604 170605 Stage 4.doc Version 1.30 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32 & 35 Residents benefit from living in a well managed home. EVIDENCE: A letter from the NHS continuing health care manager indicated that the home was well managed and controlled. Staff who were spoken with said that they felt supported by the managers and the organisation. They said that they felt their concerns (if any) would be listened to and taken seriously. A part time member of staff said that she felt included as part of the team and that her training and support needs were addressed as well as the full timers. She said that this had not been the case in some other places she had worked. Staff sickness levels had reduced from fourteen to four percent in the last six months. Residents and visitors also expressed the view that they felt included and that there was an open atmosphere within the home. Station House F51 F01 S18742 Station House V223604 170605 Stage 4.doc Version 1.30 Page 19 Records of residents’ monies were reviewed and found to be all in order. These were audited in-house on a weekly basis. Station House F51 F01 S18742 Station House V223604 170605 Stage 4.doc Version 1.30 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 4 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 x COMPLAINTS AND PROTECTION 3 x x 4 x x x 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 4 x x x 3 x x 3 x x x Station House F51 F01 S18742 Station House V223604 170605 Stage 4.doc Version 1.30 Page 21 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard OP7 OP8 Regulation 15 17(1)(a) Requirement The registered person must ensure that all residents needs are addressed in the care plan. The registered person must continue to improve the recording of fluids administered to service users at risk of dehydration. (previous timescale of 25.01.05 unmet) Timescale for action 17.06.05 17.06.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP22 OP27 Good Practice Recommendations The registered person should review the storage arrangements for moving and handling equipment in Victoria Mews. The registered person should hold a recruitment drive for registered mental nurses. Station House F51 F01 S18742 Station House V223604 170605 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Unit D, Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Station House F51 F01 S18742 Station House V223604 170605 Stage 4.doc Version 1.30 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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