Inspection on 10/08/06 for Steeton Court

This inspection was carried out on 10th August 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

Steeton Court 08/08/07

Steeton Court 12/01/06

Steeton Court 19/07/05

Steeton Court 15/12/04

Steeton Court 10/06/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Staveley Birk Leas Nursing Home

Carentan House

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

CARE HOMES FOR OLDER PEOPLE Steeton Court Steeton Hall Gardens Steeton Keighley West Yorkshire BD20 6SW Lead Inspector Mary Bentley Key Unannounced Inspection 10th August 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 Steeton Court DS0000019890.V299045.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. Steeton Court DS0000019890.V299045.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Steeton Court Address Steeton Hall Gardens Steeton Keighley West Yorkshire BD20 6SW 01535 656124 01535 658436 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) Mr A Spellman Mrs Jill Gartland Care Home 71 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (61), of places Physical disability (5), Terminally ill (5), Terminally ill over 65 years of age (5) Steeton Court DS0000019890.V299045.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. That three of the places under the category of PD are for named individuals 12th January 2006 Date of last inspection Brief Description of the Service: Steeton Court is a purpose built property located in a residential area of Steeton close to local amenities and public transport routes. The home is registered to provide care to a total of 71 people. Steeton Court is registered to provide nursing care to older people, there are a number of places dedicated to the care of the terminally ill and the home has a 10-bed dementia care unit. The home is built on two floors with access to the first floor by means of two passenger lifts and stair lift. The new passenger lift can accommodate stretchers. Accommodation is provided in 61 single and 5 double rooms and all but one have en-suite facilities. There is ample provision of communal space and the new conservatory provides direct access to the grounds from first floor. There is a designated smoking area for residents. Steeton Court has wellmaintained gardens that are easily accessible to wheelchair users. Car parking is provided at the front of the building. The weekly fees range from £441.49 to £650.00. Services such as hairdressing, chiropody, and newspapers are not included in the fees. An additional charge is also made for some outings such as visits to theatres. Steeton Court DS0000019890.V299045.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. In April 2006 the Commission for Social Care Inspection (CSCI) made some changes to the way in which care services are inspected. Care services are now judged against outcome groups. The inspection report is divided into separate sections for each outcome group for example Choice of Home. An overall judgement is made for each outcome group based on the findings of the inspection. The judgements reflect how well the service delivers outcomes to the people using the service. The judgements categories are “excellent”, “good”, “adequate”, and “poor”. The judgements are recorded within the main body of this report. More detailed information about these changes is available on our website – www.csci.org.uk The last inspection was done in January 2006 and there have not been any additional visits to the home since then. The purpose of this inspection was to inspect all the key standards, (the key standards are identified in the main body of the report), to assess how the needs of people living in the home are being met. The methods used in this inspection included looking at care records and other paperwork such as staff and maintenance records, talking to residents, staff and management, observing care practices in the home and looking at all parts of the home. One inspector sat in on the last 10 minutes of the residents/relatives meeting. The home completed a pre-inspection questionnaire and the information provided was used as part of the inspection. The inspection was unannounced; it was carried out on 10 August 2006 by two inspectors between the hours of 9.30am and 4.30pm. Feedback was given to the manager and deputy manager at the end of the visit. Comment cards were sent to a number of residents and relatives before the inspection. These provide people with an opportunity to share their views of the service with the CSCI. Information obtained in this way is discussed with the home without identifying who has provided it. Residents and relatives returned sixteen comment cards; their feedback has been included in the relevant sections of this report. Comment cards were also sent to a number of GP practices, three were returned and showed they were satisfied with the service provided by the home. What the service does well: Steeton Court DS0000019890.V299045.R01.S.doc Version 5.2 Page 6 The admission procedures are good; prospective residents and their representatives are encouraged to visit the home and are given clear information to help them make an informed decision. One relative said, “We spent a lot of time looking for a nursing home visiting more than once and feel we have chosen well. The staff are friendly, caring and competent”. The home is decorated to a high standard and provides a pleasant and comfortable place for people to live; one person described the environment as “excellent” and another said “We are very pleased with the care and cleanliness of the home; we feel our relative is well looked after”. The gardens are well maintained and a gazebo provides a shady area for residents to sit and enjoy the summer weather. The activities programme is varied and while residents are encouraged to join in it was clear that their decisions about whether to take part or not are respected. The activities organiser was described as excellent and people said she tried hard to meet individual needs. There are no restrictions on visiting, and residents can see their visitors in private. Residents and their representatives are given the opportunity to give their views of the service, residents’ meetings are held every two months and questionnaires are sent to residents and relatives every year. The majority of residents and relatives were aware of whom to speak to if they were unhappy about any aspect of the service. What has improved since the last inspection? What they could do better: Steeton Court DS0000019890.V299045.R01.S.doc Version 5.2 Page 7 The numbers of staff on duty should be adequate to make sure that residents’ needs are met in a timely way. However some comments from residents and relatives suggested that this is not always the case and some people felt that nursing staff were reluctant to help out with “hands on” care when care staff were busy. The management team needs to review working practices to make sure that residents’ needs are met without undue delays. The home should continue to develop a person centred approach to care and this should not be confined to the dementia care unit. There is some awareness of equality and diversity but this needs to be developed to promote a greater awareness of how to address residents’ needs in the areas of race, ethnicity, age, sexuality, gender, and disability. While the majority of residents were satisfied with the food feedback from residents suggested a number of areas where the new catering manager can make improvements. Particular attention should be given to residents who have special dietary needs and those who are “faddy” about food. Two requirements and a number of recommendations for good practice have been made; they are detailed at the end of the report. 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. Steeton Court DS0000019890.V299045.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 Steeton Court DS0000019890.V299045.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 & 5. Standard 6 does not apply to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. People are helped to make an informed choice; they are encouraged to visit the home before making a decision about moving in and are given clear written information about the range of services provided. The needs of prospective residents are assessed before admission. EVIDENCE: The care records of a resident recently admitted to Heathcliffe (the dementia unit) showed that a senior member of staff had carried out a pre-admission assessment. Information had also been obtained from other professionals involved in the persons care. A further assessment was completed 24 hours after admission to determine that the information was accurate and relevant to the placement. The assessment information included a clear diagnosis of dementia. There was no evidence to show whether the resident and/or their family had the opportunity to visit the home prior to the admission. Other relatives said they had visited the home before making a decision about Steeton Court DS0000019890.V299045.R01.S.doc Version 5.2 Page 10 admission, sometimes more than once, and one person said they had chosen the home because it was friendly and welcoming. The home provides good clear information about the range of services offered. Residents said they were satisfied with the information they had been given and confirmed they had received contracts. One person said that the finance and administrative systems are very efficient. Steeton Court DS0000019890.V299045.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 at least once during a 12 month period. 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 the home. Residents’ care needs are met in a way that respects their privacy and dignity and their needs are set out in individualised plans of care. Residents are protected by the homes systems for dealing with medication. EVIDENCE: The care records of five residents were looked at in detail, some before and some during the visit to the home. The records related to residents living on different units within the home. The care plans have been much improved and it was evident that a lot of time and effort had gone into producing more effective records. It was clear that the majority of staff now have a better understanding of the care planning process. The next step should be to look at condensing some of the information to make the records more user friendly and more accessible to residents, relatives and staff. The majority of care records were very detailed and informative, particularly those on Heathcliffe. On some of the other units there is still room for improvement, particularly in relation to the amount of personal detail in the Steeton Court DS0000019890.V299045.R01.S.doc Version 5.2 Page 12 plans, for example by including information on preferred times of going to bed and getting up. Most care plans showed evidence of consultation with residents, their representatives, and key workers. Families said they are kept informed about their relatives care and are consulted if residents cannot make decisions for themselves, however some relatives felt there was a lack of understanding of “person centred care” Comprehensive assessments had been completed for all aspect of daily living, together with the required risk assessments. The risk assessments relating to the use of bed rails should be reviewed to make it clearer why bed rails are being used and the information provided to families should make it clear exactly what the associated risks are. At the last inspection there was some concern about how the needs of residents that had been identified as being nutritionally at risk were being met. This aspect of care has improved considerably and there was detailed information in the records relating to nutritional needs. The home has become more proactive in getting specialist input from dieticians and has challenged GPs when there has been a reluctance to make the appropriate referrals. This is good practice. It was evident from discussions with staff that there was a much greater awareness of the need to provide additional drinks and nutritious snacks outside of meal times. The home’s accident monitoring showed that there has been a reduction in the number of falls, which the manager attributed to increased staff awareness. This was supported by information in the care records that also showed an increased use of aids such as sensor pads and hip protectors. The privacy and dignity of residents is respected and relatives and GPs confirmed that visits could take place in private. The home has the required policies and procedures in place to make sure that medicines are managed safely. The records looked at were up to date. The deputy manager audits the medication systems every month and if there are any shortfalls she deals with them immediately. Steeton Court DS0000019890.V299045.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 at least once during a 12 month period. 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 the home. The home offers an excellent range of activities and tries very hard to meet individual needs. The management team has responded very positively to concerns raised at the last inspection about the shortfalls in social care on the dementia unit and is working very hard to address these. Residents are encouraged to exercise choice and control over their lives and are supported in maintaining contact with their family and friends. EVIDENCE: Residents and relatives gave very positive feedback about the range of activities offered by the home. Two staff are employed to organise activities throughout the home. One activity organiser was interviewed during the inspection and it was evident that she had a good knowledge of the differing needs of the residents living at the home. She recognised that the activities for the residents living on the dementia unit were sometimes different to those in the main home. Research is being done to look at what activities and equipment are needed to further improve the range of activities. Regular concerts and entertainers visit the home and a wide range of games are organised. Outings are arranged and residents are consulted with regard Steeton Court DS0000019890.V299045.R01.S.doc Version 5.2 Page 14 to places to visit. Residents are encouraged to take part in activities, however the decision about whether to attend or not remains with them. Many of the residents we talked to like to choose to attend activities, which were of particular interest to them. Relatives and carers are invited to attend activities, which helps to make it a social occasion for all. A monthly newsletter is produced which gives an account of events that have taken place and gives the schedule of planned events for the coming month. A resident said, “Activities are very good, the organiser is excellent and tries hard to meet individual needs” During conversations with residents and visitors it was evident that a high degree of choice is offered in all aspects of daily life. Many residents rely on staff for assistance with personal care tasks, however they still feel they are able to contribute and make choices with regard to choice of clothing, meals, and other daily routines. Menus are displayed in the home and residents are offered choices at every meal. The meals were nicely presented and when necessary residents are encouraged and/or helped to eat. Catering is a regular agenda item on the residents’ meetings that are held every two months; the new catering manager was introduced at the meeting held on the day of the inspection. Although she had only been in post approximately two weeks when the inspection took place staff said they had noticed an improvement and the kitchen and dining room were more organised. Comments on food varied, the majority of residents spoken to during the visit said they enjoyed the food, however from the comment cards it was clear that there are some issues for the new catering manager to address. The following are some of the comments received • • • “The quality of food is good but I am a fussy eater and it has taken time to discover what I will eat despite the fact that this information was given to them when I came to the home” “Food is always cold when it gets to my room, tea is stewed”. “Sometimes the meals lack taste. Lack of gravy turns a semi solid meal into a solid meal and puree turns into soup. Don’t like yoghurt and no alternative is given” The kitchenette on the dementia unit has been moved to a larger room since the last inspection and is now well used. Improvements have also been made to the way in which residents’ nutritional needs are monitored and more detailed information is given to the catering staff. Steeton Court DS0000019890.V299045.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. The required policies and procedures are in place for dealing with complaints and the protection of vulnerable adults. Staff are familiar with the procedures thereby ensuring that residents are protected. EVIDENCE: The home has a complaints’ procedure and complaints are dealt with appropriately. The CSCI received one complaint about the home since the last inspection; this was referred to the provider and was dealt with appropriately. One relative said that complaints made to the manager or deputy are dealt with promptly and feedback is always given. The majority of relatives said they were aware of the complaints’ procedure and the majority of residents said they were aware of whom to speak to if they were unhappy about anything. GPs said they had not received any complaints about the service. Staff have good understanding of what constitutes abuse and how to report any concerns, they are aware of external agencies they can contact if necessary. The local authority Adult Protection procedures are available throughout the home; there is a copy in the staff room. The manager has shown that she understands how to use the Adult Protection procedures and has no hesitation in doing so. The manager and deputy have attended external training on Adult Protection, all staff receive Adult Protection training in the home and are booked to attend external training. Steeton Court DS0000019890.V299045.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 24, 25 & 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the home. The home is clean, comfortable, and safe and provides a very pleasant place for people to live. EVIDENCE: A full tour of the home was undertaken during this visit. Accommodation is provided on the ground and first floors and is arranged in 4 units. Heathcliffe, the dementia unit, has restricted access by means of a security device. All the remaining units allow free access for residents throughout the building. The environment was maintained to a good standard of decoration and was clean. Residents and relatives said the home is usually clean and fresh; one resident commented on dead flowers being left in bedrooms, the home had already identified this problem and was dealing with it. Steeton Court DS0000019890.V299045.R01.S.doc Version 5.2 Page 17 Good quality fixtures and fittings are provided. A good range of communal facilities is offered that can meet the differing needs of residents and visitors. These include small quiet areas and a very large lounge that can be used for meetings and entertainers. One person said, “The environment is excellent” The majority of the bedrooms are singles with en-suite facilities. A small number of double bedrooms are still provided and are of particular benefit for close friends and married couples. At the last inspection concern was raised about one double room being shared by a married couple. The room was cluttered making it difficult for the residents to move around safely and for visitors to find somewhere to sit, although it took some time to do the furniture has now been re-arranged, this has made a big improvement and has contributed to reduction in the number of falls. The home is in the process of removing the baths from the en-suite facilities and this will make the en-suite toilets more accessible to residents. Residents and relatives are encouraged to personalise their bedrooms with pictures, ornaments, and small items of furniture. Many residents have a telephone in their bedrooms. The management of the home have a flexible approach to the environment meeting the individual needs of residents. This was evidenced during discussion with a relative who was being offered the opportunity to move his partner to a room that could better accommodate her large wheelchair. This is good practice. At the moment the dementia unit on the ground floor is not fully suited to the needs of the residents. This relates to the size and suitability of the communal space. One relative said they thought the TV lounge was a bit small for the number of residents. However following consultation with staff on the unit the owner has agreed to add a conservatory, new larger dining area, and an enclosed outside space for service users. The new facilities will greatly enhance the environment and is seen as a very positive response by the owner to the needs of the residents and staff. The laundry is suitably equipped to meet residents’ needs and there are good systems in place to reduce the risk of cross infection. Steeton Court DS0000019890.V299045.R01.S.doc Version 5.2 Page 18 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, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. The home has adequate numbers of staff on duty however in light of some of the feedback received from residents and relatives the management team should review working practices to make sure that residents needs are met in a timely way. The recruitment procedures are robust and offer protection to residents. Staff are supported in developing their skills and knowledge. EVIDENCE: Duty rosters are available for all grades of staff; the hours of work should be shown on the rosters. A survey carried out by the home in January 2006 showed that the majority of people who responded felt staff were courteous, well presented, respectful, patient and tolerant and adequately trained. Residents and relatives who provided feedback to the CSCI in the course of this inspection spoke very highly of care staff describing them as hard working, caring, responsive, and competent. In terms of staff numbers the home appears to be well staffed, separate staff are employed for housekeeping and catering duties and hostesses are employed to help with serving morning and afternoon drinks and meals. Steeton Court DS0000019890.V299045.R01.S.doc Version 5.2 Page 19 However comments about the availability of staff were varied. While the majority of residents were satisfied that there were enough staff to meet their needs in a timely way some people felt that staff were often too busy. One person said “ I seem to wait a while before the buzzer is answered” and another said “ Care staff are usually very responsive, but nursing staff seem reluctant to assist with care tasks if care staff are not available”. This suggests that the issue of staff availability may be more to do with working practices than with the actual numbers of staff on duty. During the inspection a number of staff were spoken to and a senior care assistant and the nurse from the dementia unit were interviewed in private. Both showed a very good knowledge of the needs of the residents and the daily routines. They felt that the staff morale and general levels of care had improved and a very good range of activities was now offered. The senior care staff had a very good awareness of the key worker role and saw it as a positive experience for individual residents and a good point of contact for relatives. The nurse in charge of the dementia unit has made a number of changes to improve staff involvement in the decision making process. She has also made significant improvements to the record keeping system. She felt that the improvements were as a result of now having staff working on the unit who demonstrated a wish to work with that particular client group. The nurse felt that if she could be involved in the recruitment of staff for the unit she would be able to make sure that continued. The inspectors felt this would be a positive step in maintaining and improving the current standards on the unit. Since the last inspection the home has appointed a “team leader”, she described her role as being to support the care staff teams working on the different units and to develop team working, for example by including housekeeping staff in unit team meetings so that they have a better understanding of residents’ needs. She is very enthusiastic about her role and feels she is well supported by the management team. The home has made significant improvements with regard to staff training since the last inspection and particular attention has been given to training on the care of people with dementia. Detailed information about training was provided with the pre-inspection questionnaire. Although only 20 of the care staff team have achieved a National Vocational Qualification (NVQ) the remaining care staff team are all registered for NVQ training. The home currently relies on external NVQ assessors however six staff are training to be assessors, this will help to reduce the time it takes to complete the course. All new staff receive induction training and there is a record of this training. Annual staff appraisals were being done at the time of the visit, one member of staff said she was very pleased with her appraisal. The files of three recently appointed staff were looked at and showed that all the required checks were completed before they started work in the home. To Steeton Court DS0000019890.V299045.R01.S.doc Version 5.2 Page 20 comply with new CSCI guidance the manager was advised that copies of CRB (Criminal Record Bureau) disclosures should be retained for inspection. Steeton Court DS0000019890.V299045.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. The home is well managed, staff are supported in their roles and residents and their representatives are given the opportunity to put forward their views on the running of the home and the quality of the services provided. EVIDENCE: The manager is a nurse and has many years experience in the care of older people. Her application to the CSCI to be the registered manager has been approved since the last inspection. She has completed the course work for the Registered Managers Award and is waiting for it to be assessed when the college re-opens in September. One of the main concerns at the last inspection related to the management of the home, specifically concerns about poor communication and poor Steeton Court DS0000019890.V299045.R01.S.doc Version 5.2 Page 22 relationships between management and staff resulting in low staff morale. This was particularly worrying because the home had been through an unsettled period with the two managers prior to Mrs Gartland leaving after a relatively short time. It was therefore very encouraging to find that this aspect of the service had improved significantly. Staff were positive about their roles, they said they felt supported and found both the manager and the deputy manager very approachable. It is acknowledged that the manager has worked hard to achieve this improvement and credit must also be given to the new deputy who has been very supportive in this process. The home holds meetings for residents and relatives every two months and all aspects of the service are discussed, copies of the notes of the meetings are sent to all relatives and are available in the home. During the meeting held on the day of this visit some residents said they found it difficult to hear what was going on and although someone later tells them what was discussed the fact that they cannot hear means they cannot take an active part in the meeting. As the home has a microphone it is recommended that it be used in these meetings. Relatives said they were kept informed and consulted about how care needs would be met. Questionnaires were sent to relatives and residents in January 2006 and are due to be issued again in September 2006, the results of these surveys are discussed in the residents’ meetings. Staff questionnaires are due to be sent out later in the year when the programme of staff appraisals has been completed. The manager does monthly audits of all aspects of the service and the findings are made available to staff. The owner visits the home regularly and once a month a carries out a more detailed visit during which he looks at various aspects of the service and speaks to residents and staff. Reports from these visits are sent to the CSCI. The home does not get involved with managing residents’ personal finances, small amounts of spending money are kept for some residents. The money is held securely and records are kept of all transactions made on behalf of residents. In most cases additional services are arranged by the home and added to the monthly invoice. The home has four trained moving and handling co-ordinators and all staff are up to date with moving and handling training. Fire training is up to date and updates on basic food hygiene have been arranged for all catering staff. The home is planning to provide First Aid training in house. The information provided by the home showed that there are systems in place to make sure that the maintenance and servicing of installations and equipment is done at the required intervals. Senior care assistants are responsible for checking bed rails. It was clear that they understand the risks associated with the use of bed rails and know what they are checking for. Steeton Court DS0000019890.V299045.R01.S.doc Version 5.2 Page 23 Accidents are recorded and as noted in the Health and Personal Care section of this report there has been a reduction in the number of falls suffered by residents. Steeton Court DS0000019890.V299045.R01.S.doc Version 5.2 Page 24 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 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 4 3 4 3 X 4 3 4 STAFFING Standard No Score 27 2 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X X 3 Steeton Court DS0000019890.V299045.R01.S.doc Version 5.2 Page 25 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 OP27 Regulation 18 Requirement The registered persons must keep staffing levels and working practices under review to make sure that there are enough staff available to meet residents’ needs in a timely way. Timescale for action 31/10/06 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 OP3 Good Practice Recommendations The pre-admission assessment records should show whether prospective residents and/or their representatives have had the opportunity to visit the home before making a decision about admission. Consideration should be given to fitting a Loop system for the benefit of people with hearing aids. The duty rosters should show the actual hours worked. A minimum of 50 of care staff should be trained to NVQ level 2 or equivalent. The senior nurse on the dementia unit should be involved in the recruitment and selection of staff for the unit. A microphone should be used for residents’ meetings so DS0000019890.V299045.R01.S.doc Version 5.2 Page 26 2 3 43 5 6 OP19 OP27 OP28 OP29 OP32 Steeton Court 7 OP38 that all the residents who attend can hear what is going on and take part. The risk assessment for the use of bed rails should be reviewed. The moving and handling assessment form should be reviewed. Steeton Court DS0000019890.V299045.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 Steeton Court DS0000019890.V299045.R01.S.doc Version 5.2 Page 28 - 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. 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