CARE HOMES FOR OLDER PEOPLE
STELLA HOUSE Cobblers Lane Pontefract West Yorkshire WF8 2SS Lead Inspector
Mavis Pickard Unannounced 25 May 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. STELLA HOUSE J51J01_S6218_Stella House_V221738_250505.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Stella House Address Cobblers Lane Pontefract West Yorkshire WF8 4JF 01977 600247 01977 600247 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr & Mrs J Fieldhouse Mrs Jill Fieldhouse CRH Care Home - personal care only 41 Category(ies) of OP - Old Age - 41 registration, with number MD(E) Mental Disorder - over 65 - 41 of places DE(E) Dementia - Over 65 - 41 STELLA HOUSE J51J01_S6218_Stella House_V221738_250505.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 17/01/2005 Brief Description of the Service: Stella House is a care home providing personal care and accommodation for 41 older people. The home, that is privately owned by Mr and Mrs Fieldhouse, is situated in a residential area outside the centre of Pontefract. Mrs Fieldhouse is the registered manager. The premises, which are mainly purpose built, are situated on the site of a former farm and house and set in well-maintained gardens with parking space for staff and visitors. Service user accommodation is provided on 2 floors. There is a passenger lift to the upper level. The home also provides a stair lift. The home has 39 single bedrooms and one shared bedroom. STELLA HOUSE J51J01_S6218_Stella House_V221738_250505.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. During this 4 hour unannounced inspection, it was found that the home is running well and that residents who said they liked living in the home were being well cared for by a group of experienced staff who showed interest in their role. Staff spoken to during the inspection said that they liked working in the home and that they welcomed the high level of training the home provides for them. The general appearance of the home is clean, bright and attractive. What the service does well:
The home has an owner/registered manager and an assistant manager who are both qualified to National Vocational Qualification [NVQ] Level 4 and have achieved a Registered Manager Award [RMA]. Both have been involved with Stella House for a number of years. They are both committed in continuing to raise standards of care provided within residential care for older people. The home provides continual training for its staff and for the staff of its sister home Millfields, on all aspects of residential care. The manager ensures, through careful recruitment, that staff who work in the home have the best interests of residents at heart. The home has team leaders who work alongside carers on every shift to make sure that best practice is achieved. Private areas of the home, such as bedrooms, are decorated and furnished nicely and people spoken to said that their needs are met. Shared spaces, such as lounges and dining rooms, are clean, bright and attractive. The home is centrally heated and hot water is regulated to a safe temperature. The patio and garden areas of the home accessible to residents are maintained in an attractive way and have a safe water feature. The atmosphere in the home is open and inclusive, people can come and go as they please and as far as their ability allows. Families are made to feel welcome, as are visitors. The Inspector was made to feel welcome and the home owner/registered manager and the assistant manager said that they welcome unannounced visits. STELLA HOUSE J51J01_S6218_Stella House_V221738_250505.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. STELLA HOUSE J51J01_S6218_Stella House_V221738_250505.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection STELLA HOUSE J51J01_S6218_Stella House_V221738_250505.doc Version 1.30 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 standard(s) 3,4 & 6 All residents have a comprehensive assessment of their needs prior to admission to the home. Residents and their relative/representative know, prior to admission, that the home can met their needs. EVIDENCE: The case files of two most recently admitted residents were read. Both case files contained a comprehensive pre-admission assessment either by the home’s staff or, in the case of 1 resident who was admitted from another area, from the resident’s social worker. The family of a recently admitted resident were spoken with, they said that their relative had recently moved into the home for respite care and hoped to stay. The assistant manager, Ms Neave, said that a meeting was to take place the following day with the resident and his family, the home’s representative and the resident’s social worker to see if this can be arranged. Stella House does not provide intermediate care.
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The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8 &10 Residents have an individual care plan which sets out their needs. The needs of residents are met. Residents are treated with respect. EVIDENCE: Having inspected the case files of two newly admitted residents, the Inspector found residents’ health and social care needs are set out in an individual care plan. The assistant manager said that all care plans are regularly reviewed. Residents have a comprehensive care plan which sets out individual perceived needs in relation to mobility, continence, eating and drinking, weight, social and activity etc. These plans give evidence of the perceived need, what action is to be taken to meet that need and goals which are aspired to, showing over time how these may be achieved. Care plans give evidence of health care needs including medication and the actions taken by the home to meet these needs. An example of this is that a newly admitted resident had lost his hearing aid prior to admission, he has been told that, because of staff holidays, the hearing aid clinic cannot do the work necessary to replace his aid until July
STELLA HOUSE J51J01_S6218_Stella House_V221738_250505.doc Version 1.30 Page 10 2005. This is causing him some discomfort as he cannot effectively communicate with other residents, his family or staff. The assistant manager said that she would see if the clinic will lend him an aid in the meantime and intends to visit the clinic regarding this issue. From speaking with people living in the home generally, and from direct observation of interaction taking place between residents and staff and between residents and visitors, the Inspector could see that residents are treated with respect and that their privacy is maintained. STELLA HOUSE J51J01_S6218_Stella House_V221738_250505.doc Version 1.30 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 standard(s) 12,13 &14 Residents are given the choice of how they spend their lives and are encouraged to keep in contact with their family/representatives and the local community. EVIDENCE: Residents spoken with said that the lifestyle they have at the home, although not the same as in their own home, is very pleasant and that staff do all they can to make sure that residents can take part in leisure activities that meet their expectations. There were visitors in the home during the inspection, the Inspector spoke informally with several people visiting their relatives/friends and spoke more formally with two family members visiting a newly admitted resident. Residents spoken with told the Inspector that they are helped by the home’s staff to have a choice on how they live their lives within the home. STELLA HOUSE J51J01_S6218_Stella House_V221738_250505.doc Version 1.30 Page 12 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 Although the home has employed staff prior to CRB/POVA and/or ‘Pova First’ clearance, because the registered manager said that they work only under close supervision, the Inspector is confident that the safety of residents has not been compromised. EVIDENCE: The home has appropriate policies and procedures, including robust recruitment procedures, to make sure people accommodated are safe from abuse. However the records show that there have been occasions when staff have worked in the home prior to them having received Protection of Vulnerable Adults [POVA] clearance. The provider/manager stated that all people employed are subject to Criminal Record Bureaux [CRB] and POVA clearance but that, because of the length of time it can take to receive these clearances, recruits sometimes work or undertake training in the home under close supervision before the clearances are received. STELLA HOUSE J51J01_S6218_Stella House_V221738_250505.doc Version 1.30 Page 13 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20 &26 Residents have access to safe and comfortable indoor and outdoor space. The home is clean and well maintained. EVIDENCE: The home presented as being clean, bright and welcoming. Residents can use all parts of the home by the provision of shaft and stair lifts and by level access to all parts of the house. Not all parts of the garden are fully accessible as the home is built on a slope. However, there is level access to the paved patio area to the front and to the lawned areas where seats are provided. The rear of the garden also has paved and level areas where residents can either sit out or take part in gardening activities. The home has a pleasant outlook and a safe water feature, which residents said they enjoyed.
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The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 & 30 There are sufficient experienced and competent staff employed to meet the needs of residents and to ensure their safety. EVIDENCE: The home employs an assistant manager who has achieved a National Vocational Qualification [NVQ] in care and management at Level 4 and a Registered Managers Award [RMA]. Team leaders are employed to lead care staff throughout each part of the working day. Records show, and the Inspector observed, that sufficient experienced staff are employed to meet the needs of residents. The home has robust policies and procedures for the recruitment of staff. [Please refer to standard 18] Care staff were seen to be supportive and helpful to residents, ensuring that their needs are met. During this visit the Inspector spoke with two recently employed care workers about their recruitment, induction and initial training who said that they receive the training they need to do their jobs. STELLA HOUSE J51J01_S6218_Stella House_V221738_250505.doc Version 1.30 Page 15 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 & 33 A competent, experienced qualified person manages the home. The home is run in the best interests of residents. EVIDENCE: The provider/registered manager is a qualified nurse who has successfully completed a National Vocational Qualification [NVQ] Level 4 and a Registered Managers’ Award [RMA]. The home has a system to check if the service it provides meets people’s needs and expectations. There is an annual survey which asks residents, families/friends and visiting professionals about their experience of the services provided. The results of this survey are acted upon and published in an annual action plan for the home, a copy of the most recent plan has been provided to the Commission.
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This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x
COMPLAINTS AND PROTECTION 3 3 x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 1 3 x 3 x x x x x STELLA HOUSE J51J01_S6218_Stella House_V221738_250505.doc Version 1.30 Page 17 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 18 Regulation 19 Requirement The registered person must ensure that satisfactory Protection of Vulnerable Adults [POVA] clearance has been received prior to staff being allowed to work in the home. Timescale for action with immediate effect [25/5/05] RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations STELLA HOUSE J51J01_S6218_Stella House_V221738_250505.doc Version 1.30 Page 18 Commission for Social Care Inspection Park View House Woodvale Office Park Woodvale Road Brighouse, HD6 4AB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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