Inspection on 28/11/06 for Station House Nursing Home

This inspection was carried out on 28th November 2006.

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 22/11/05

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 28th November 2006 09:30 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.V320796.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. Station House Nursing Home DS0000018742.V320796.R01.S.doc Version 5.2 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.V320796.R01.S.doc Version 5.2 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 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 DE (Dementia under 65 years of age) may be accommodated * Up to 30 service users in the category 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 on the category PD (Physical disability) may be accommodated 22nd November 2005 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.V320796.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit took place on 28th November 2006 and took eight and a half hours. It was carried out by an inspector of the Commission and Mrs Enid Holland, an ‘expert by experience’. CSCI are trying to improve the way we engage with people who use services so we gain a real understanding of their views and experiences of social care services. We are currently testing a method of working where ‘experts by experience’ are an important part of the inspection team and help inspectors get a picture of what it is like to live in or use a social care service. The term ‘experts by experience’ used in this report describes people who have been appointed by Help the Aged, under the direction of the Commission for Social Care Inspection, to take part in the inspection of services for older people. The visit was just one part of the inspection. The home was not informed of the date the visit was to take place, but a week prior to the visit the manager was asked to complete a questionnaire to provide the inspector with some information about the service. During the visit the inspector and ‘expert by experience’ spoke with the manager, staff, residents and visitors. They looked around the premises and the inspector looked at various records held by the home. Most residents expressed pleasure in the home. One said “ Overall the home’s not bad. The manager often asks me what I think about it”. Another said “ I get along well with the staff”. Relatives comments included “ I wouldn’t let my relative be anywhere else”, “The staff are very good. If I have any concerns they are addressed by the nurses”, “I am thrilled with the service. My relative loves the social interaction and is busy doing something every day. When I take him out he can’t wait to get back.” Feedback was given to the management team immediately following the inspection. Overall, the home is well managed and provides a good standard of care for the residents. Station House Nursing Home DS0000018742.V320796.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? As part of the ongoing programme of maintenance and renewal, some bedrooms and communal areas have been redecorated. All care plans are now up to date and medication records fully completed to demonstrate that residents’ health care needs are being met on a continuous basis. Station House Nursing Home DS0000018742.V320796.R01.S.doc Version 5.2 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Station House Nursing Home DS0000018742.V320796.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 Station House Nursing Home DS0000018742.V320796.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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents and their representatives have the information necessary to determine whether the home would suit them. They have their needs assessed and a contract that clearly tells them about the service they will receive. EVIDENCE: None of the residents spoken to had knowledge of any written home guide, but four said their next of kin dealt with all their affairs and were content that they would have all the necessary documents. Relatives who were spoken with all said that they had been provided with a copy of the guide before their Station House Nursing Home DS0000018742.V320796.R01.S.doc Version 5.2 Page 10 relative’s admission. The guide contained all the information required by the Care Home Regulations and was written in an easy to read format. The records of six residents were examined as part of the case tracking exercise. All contained a copy of their contract with the home for the provision of services. Contracts were detailed and contained all the required information. They were all signed by the resident or their representative. All files also 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. Two relatives confirmed that much consideration had been given to the residents’ needs by staff in consultation with them prior to admission. Station House Nursing Home DS0000018742.V320796.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 good. This judgement has been made using available evidence including a visit to this service. 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. They 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. Care files contained detailed evidence that residents were referred to appropriate health care professionals as required. Records of consultations Station House Nursing Home DS0000018742.V320796.R01.S.doc Version 5.2 Page 12 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 psychiatrist. Medication administration charts contained details of all medication that the residents were prescribed, including the dosage and required frequency of administration. They demonstrated that medication had been administered as prescribed. Storage arrangements were in accordance with legislation and an audit of controlled drugs was satisfactory. 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. Residents confirmed that staff treated them with respect and helped to maintain their privacy and dignity. Staff were cheerful and were observed attending to residents’ needs without fuss and in a pleasant and competent way. Station House Nursing Home DS0000018742.V320796.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 good. This judgement has been made using available evidence including a visit to this service. 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.V320796.R01.S.doc Version 5.2 Page 14 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 tai chi, board games, manicures, film shows, bingo, visiting entertainers, clothes shows 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. Some residents had been to Bridgmere on 14th November. Residents of Coppenhall Mews were also 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. The home were introducing a system of activity based care. They were introducing a new philosophy with increased emphasis on the continuing benefits of active living. The philosophy included a statement that ‘ the diversity of our residents is our greatest asset and through the formation of positive relationships they can continue to be part of a vibrant community’. The position of care assistant is to be reclassified as Life Skills Support Worker and new staff were to be recruited based on the skills they could bring to the role and their likelihood of contributing to an active and stimulating home. Each resident will have a Keeping Active care plan with the aim of identifying individualised support the resident needs to remain fulfilled, independent and active as possible within the boundaries of their condition. Residents and visitors confirmed that visiting was encouraged. Two relatives said they visited every day and 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. 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 tables were set attractively and water or fruit juice was offered with the meal. 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. Some visitors said that they did complain about the food a few months ago because there was too much repetition but the menus are now much improved. Station House Nursing Home DS0000018742.V320796.R01.S.doc Version 5.2 Page 15 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 good. This judgement has been made using available evidence including a visit to this service. Residents have access to a robust, effective complaints procedure and are protected from abuse. EVIDENCE: The home had a satisfactory complaints procedure, which was displayed in the home and included in the service user guide. Residents and relatives spoken with said they would know how to make a complaint if they weren’t happy. Complaints records contained details of any investigation and subsequent action taken. There had been eight complaints in the last year. One was still under investigation and seven had been resolved. 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. 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. Station House Nursing Home DS0000018742.V320796.R01.S.doc Version 5.2 Page 16 Training was provided on induction with more in depth training at a later date. The home always follow the correct procedure by reporting any concerns to the local authority. Station House Nursing Home DS0000018742.V320796.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home provides a safe environment and most areas are comfortable and pleasant for the residents. EVIDENCE: The home was safe and generally well maintained. A programme of routine maintenance and renewal of the fabric and decoration was in place. Several bedrooms, the communal areas of Victoria Mews and the reception area had been redecorated this year. However, in Coppenhall Mews there was a smell of urine as you entered the unit and the corridor carpets were stained and wearing thin. The carpet was cleaned regularly but had been in place for 14 Station House Nursing Home DS0000018742.V320796.R01.S.doc Version 5.2 Page 18 years. The corridor walls were patchy where the maintenance person had touched them up to cover marks. All areas of the home were clean and hygienic. Residents and visitors spoken with said that the home was always very clean. Appropriate procedures were documented and followed for the prevention of cross infection. Station House Nursing Home DS0000018742.V320796.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to fulfil the aims of the home and meet the needs of the residents. EVIDENCE: Staff rotas showed that the number and skill mix of staff were sufficient for the needs of the residents. The manager and deputy were supernumerary. Three staff files were reviewed. They all contained the required information and documentation and showed that rigorous recruitment procedures had been followed to ensure the protection of the residents. Only one had a current photograph, the other two had copies of passport photos. The home clearly defines the roles and responsibilities of staff through accurate job descriptions. All staff undergo induction training that complies with the Skills for Care induction standards. The home ensures that all staff receive relevant training that is focussed on improving outcomes for residents. Station House Nursing Home DS0000018742.V320796.R01.S.doc Version 5.2 Page 20 Management encourage staff to undertake external qualifications beyond the basic requirements and recognise the benefits of a skilled workforce. Most of the residents and visitors spoken with were very complimentary about the staff. Comments included ‘nothing is too much trouble’, ‘ the care is brilliant’ and ‘the staff are very good’. However, a couple of residents said that a small minority of staff could be a bit abrupt at times. Also, comments have been received from a relative and social services personnel that staff have been abrupt on the telephone. The deputy manager said they were aware of this and dealing with it through training and disciplinary procedures. Some visitors said that there had been a shortage of staff on Coppenhall Mews a while ago but staffing levels were now alright. Station House Nursing Home DS0000018742.V320796.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager is registered with the Commission for Social Care Inspection. She is a first level registered general nurse with 20 years nursing experience. She has held the home manager’s position for over four years and is trained to NVQ Level 4 in management. She is also a qualified NVQ Assessor. Station House Nursing Home DS0000018742.V320796.R01.S.doc Version 5.2 Page 22 The home had a variety of quality assurance tools available to the management. An annual audit of the home had been completed in Autumn 2006 covering all aspects of finance and administration, management of enquiries, complaints, health and safety, maintenance, training, housekeeping, laundry, kitchen, meals and clinical care. The only concerns raised were in relation to there not being enough activities. This was to be addressed with the introduction of the Activity Based Care programme. (See standard 12.) There were ongoing weekly audits of nursing documentation and monthly audits of pressure sores and accidents. Action plans were produced after each audit and passed to the heads of departments to address. 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. Resident and relative involvement meetings were held quarterly, the next being planned for 13th December. Regular staff meetings were held, including a monthly meeting for the qualified nursing staff. Minutes of the meetings were available for inspection. The home had efficient and safe systems for the management of residents’ monies. The home works to a clear health and safety policy. All staff are given a copy and receive the appropriate training. Regular checks are carried out and records are of a good standard and routinely completed. The home has a good record of meeting relevant health and safety requirements. Station House Nursing Home DS0000018742.V320796.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 4 X 3 X X 3 Station House Nursing Home DS0000018742.V320796.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP19 Regulation 16(2)(c)& (k) 23(2)(d) Requirement The registered person must recarpet and redecorate the corridor in Coppenhall Mews. Timescale for action 31/05/07 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 OP29 Good Practice Recommendations Each staff file should hold a current photograph of the staff member. Station House Nursing Home DS0000018742.V320796.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Station House Nursing Home DS0000018742.V320796.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!