Inspection on 22/11/05 for Station House Nursing Home

This inspection was carried out on 22nd November 2005.

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

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

Other inspections for this house

Station House Nursing Home 28/11/06

Station House Nursing Home 17/06/05

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 Nursing Home Victoria Avenue Crewe Cheshire CW2 7SF Lead Inspector A Gillian Matthewson Unannounced Inspection 09:30 22 November 2005 nd 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 Station House Nursing Home DS0000018742.V257087.R01.S.doc Version 5.0 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. Station House Nursing Home DS0000018742.V257087.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Station House Nursing Home Address Victoria Avenue Crewe Cheshire CW2 7SF 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) 01270 250843 01270 250845 Community Health Services Limited Mrs Carole Wardle Care Home 69 Category(ies) of Dementia (6), Dementia - over 65 years of age registration, with number (39), Old age, not falling within any other of places category (30), Physical disability (6) Station House Nursing Home DS0000018742.V257087.R01.S.doc Version 5.0 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 (physical disability) may be accommodated The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 17/06/05 2. Date of last inspection 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 en-suite facilities. The home has extensive grounds that are well maintained and easily accessible. Station House Nursing Home DS0000018742.V257087.R01.S.doc Version 5.0 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 one hour planning the inspection by reviewing previous inspection reports and the service history over the last twelve months. The inspection took place over four hours and included inspection of records and discussion with six residents, six relatives and seven staff. 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. The home provides residents with a comprehensive programme of activities and a varied and well balanced diet. Both can be tailored to meet individual requirements. Residents are protected by the home’s adult protection policies and procedures and the staff’s awareness of human rights. The home provides a spacious and pleasant environment for residents to live in. The home is well run by a competent, professional manager who regularly reviews aspects of the home’s performance and plans how improvements are to be made. Station House Nursing Home DS0000018742.V257087.R01.S.doc Version 5.0 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 contacting your local CSCI office. Station House Nursing Home DS0000018742.V257087.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Station House Nursing Home DS0000018742.V257087.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Prospective residents needs are assessed prior to admission to ensure that the home can meet their needs. EVIDENCE: Seven 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 Nursing Home DS0000018742.V257087.R01.S.doc Version 5.0 Page 9 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 the following standard(s): 7, 8, 9 & 10. In the main, the care planning process ensures that residents’ health and personal care needs are met and that they receive their prescribed medication. Residents feel they are treated with respect. 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 and there was evidence that they were being followed. However, there was one exception in Victoria Mews. A resident admitted in May had a care plan for recent weight loss. This contained instructions that the resident should be weighed weekly and a record maintained of all dietary intake. These instructions had not been carried out, one reason given being that the home had not had any scales suitable for use by this resident. The resident had been seen by the dietician in August, who had given further instructions to reduce weight loss. These had not been included in the care plan. In October the home had purchased suitable scales and the resident was found to have lost a considerable amount of weight but the care plan was still Station House Nursing Home DS0000018742.V257087.R01.S.doc Version 5.0 Page 10 not being followed with regard to recording the dietary intake and had not been updated. 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, dietician, chiropodist, speech and language therapist and rehabilitation consultant. A physiotherapist and an occupational therapist employed by the local NHS primary care trust were visiting some residents receiving transitional care at the time of the inspection. They confirmed that the staff in the home followed their instructions and that they had no concerns about the standard of care. Medication administration charts contained details of all medication that the residents were prescribed, including the dosage and required frequency of administration. In the main, they demonstrated that medication had been administered as prescribed. However, there were some gaps where medication was not signed as having been administered. These mainly related to the previous evening. The medication was missing from the blister packs, therefore it was likely that the medication had been administered, but not signed for. The home manager agreed to follow this up with the staff concerned. Storage arrangements were in accordance with legislation and an audit of controlled drugs was satisfactory. See Requirement 2. There are no shared rooms. A system is in place whereby a green light outside a bedroom indicates that staff are providing personal care in that room. Interactions between staff and residents were observed to be positive and appropriate. Residents confirmed that staff treated them with respect and were mindful of their privacy and dignity. Station House Nursing Home DS0000018742.V257087.R01.S.doc Version 5.0 Page 11 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 the following standard(s): 12, 13 & 15. The home welcomes the involvement of residents’ families and provides residents with individual opportunities to fulfil their social and recreational needs. There is a balanced and varied selection of food available that meets residents’ tastes. EVIDENCE: Station House Nursing Home DS0000018742.V257087.R01.S.doc Version 5.0 Page 12 The home employed an activity coordinator 40 hours per week, assisted by a care assistant 12 hours per week. The activity coordinator 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. 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. On the day of the inspection the activity coordinator was organising a shopping trip to the Trafford Centre for the following week. Twice a year the home held a craft fayre and involved residents (if they wished) in making items to sell and manning stalls. Residents of 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 she visited every day and two other relatives said that the staff were very supportive of the family as well as the resident. The menus offered a well balanced, nutritious diet with plenty of choice. A member of staff was consulting residents on menus for the following 24 hours. Choices were offered from the menu, but residents were also able to request other items not on the menu. The home had recently carried out a residents’ survey inviting comments on the catering. Most of the responses were positive. Residents could take their meals in the dining room or their own room. Staff were observed assisting residents with their midday meal in a sensitive and unhurried manner. The meal was a choice between chicken in barbeque sauce with creamed potatoes and vegetables or cauliflower cheese followed by fruit pie and custard or rice pudding. Pureed and liquidised meals were provided as required. The food was well presented and looked appetising. Residents spoken with said that the food was good. Station House Nursing Home DS0000018742.V257087.R01.S.doc Version 5.0 Page 13 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 the following standard(s): 18 Staff have excellent knowledge and understanding of adult protection issues, which minimises the risk of abuse. EVIDENCE: Appropriate adult protection policies and procedures were in place. The home also had copies of Department of Health guidance ‘No Secrets’ and Cheshire Adult Protection Policy and Procedures available. Five members of staff spoken with were aware of the home’s adult protection and whistle blowing policies and procedures and confirmed that they had received training in this regard. They were able to describe what would constitute abuse and the reporting procedures. Training was provided on induction with more in depth training at a later date. Several of the home’s staff had attended recent training and more was planned the following month. Station House Nursing Home DS0000018742.V257087.R01.S.doc Version 5.0 Page 14 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 the following standard(s): 26. There is a high standard of hygiene within the home. EVIDENCE: All areas of the home were clean and hygienic. One of the visitors said that the home was always very clean and there were never any unpleasant odours. The company that own the home were undertaking a project on the management of methicillin resistant staphylococcus aureus (MRSA). All residents were swabbed on admission and treatment implemented as required. Appropriate procedures were documented and followed for the prevention of cross infection. Station House Nursing Home DS0000018742.V257087.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 Staffing numbers and skill mix are sufficient to meet the residents’ needs. EVIDENCE: At the time of the inspection there were 54 residents, 30 residents in Coppenhall Mews and 24 in Victoria Mews. Staffing rotas showed that the home provided a minimum of 14 staff in the morning, 11 in the afternoon and 7 at night. The manager and deputy were supernumerary to these figures. All the visitors spoken with were very complimentary about the staff. Comments included ‘the staff are lovely’, ‘they are very supportive’, ‘they have looked after my friend wonderfully well.’ Station House Nursing Home DS0000018742.V257087.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 & 33. The home regularly reviews aspects of its performance through a good programme of self-review and consultation with residents, relatives and staff. EVIDENCE: The manager is registered with the Commission for Social Care Inspection. She is a first level registered general nurse with 19 years nursing experience. She has held the home manager’s position for over three years and is trained to NVQ Level 4 in management. She is also a qualified NVQ Assessor. The home had a variety of quality assurance tools available to the management. An annual audit of the home had been completed in June 2005 covering all aspects of finance and administration, management of enquiries, complaints, health and safety, maintenance, training, housekeeping, laundry, kitchen, meals and clinical care. The overall score was 92 . In addition there Station House Nursing Home DS0000018742.V257087.R01.S.doc Version 5.0 Page 17 were ongoing weekly audits of nursing documentation and monthly audits of pressure sores and accidents. Action plans were produced after each audit. An operations manager of the company that owns the home carried out visits every month to monitor the quality of service and submitted reports of these visits to CSCi. These included discussions with residents, relatives and staff. Regular staff meetings were held, including a monthly meeting for the qualified nursing staff. Minutes of the meetings were available for inspection. Station House Nursing Home DS0000018742.V257087.R01.S.doc Version 5.0 Page 18 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 3 X X 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 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 X X X X X X X 4 STAFFING Standard No Score 27 4 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X x Station House Nursing Home DS0000018742.V257087.R01.S.doc Version 5.0 Page 19 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 Standard OP7 Regulation 12(1)(a) 15(2) Requirement The registered person must ensure that staff follow the instructions in care plans and that the care plans are updated as required. The registered person must ensure that staff sign for all medication administered. Timescale for action 30/11/05 2 OP9 13(2) 30/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Station House Nursing Home DS0000018742.V257087.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Northwich Local Office 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 Nursing Home DS0000018742.V257087.R01.S.doc Version 5.0 Page 21 - 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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