Inspection on 17/10/06 for Stenson Court

This inspection was carried out on 17th October 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Stenson Court 21/01/06

Stenson Court 06/09/05

Stenson Court 30/12/04

Stenson Court 13/07/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Stenson Court 10 Greenfield Lane Balby Doncaster South Yorkshire DN4 0PT Lead Inspector Stuart Hannay Key Unannounced Inspection 09:30 17th October 2006 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 Stenson Court DS0000032034.V288972.R01.S.doc Version 5.1 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. Stenson Court DS0000032034.V288972.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Stenson Court Address 10 Greenfield Lane Balby Doncaster South Yorkshire DN4 0PT 01302 853122 01302 853122 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) Doncaster Metropolitan Borough Council Mrs Rosalyn Elizabeth Birkin Care Home 30 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (10) of places Stenson Court DS0000032034.V288972.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The support for a variety of day care centres must not impact on the staffing needs of Stenson Court; there must be no removal of staff from the homes rota to meet a shortfall in the day centre staffing. Wheelchair dependent service users must be allocated private accommodation that has 12 square metres of useable floor space. Date of last inspection Brief Description of the Service: Stenson Court is a residential care home for both elderly service users and elderly mentally infirm residents above the age of 65; it is owned and operated by Doncaster Metropolitan Borough Council. The home can accommodate up to 20 elderly mentally infirm residents and up to 10 elderly residents; it also provides up to 6 day-care places (2 for the elderly; 4 for the elderly mentally infirm). All private accommodation is in single bedrooms and all the accommodation for the elderly mentally infirm is on the ground floor in a purpose built unit. The accommodation for the elderly residents is in the main building with 5 bedrooms on the ground floor with five more on the first floor served by a lift. There are conservatories with views of the gardens and the busy road to the front of the home. There are also six lounges that vary in size; two have their own sink units and tea and coffee making facilities. There is a patio that has a pergola for a roof and a room with patio doors that open onto this facility. The fees at the time of this inspection (October 2006) were £330.00 per week for the ‘residential’ service users and £490.00 per week for the service users in the EMI part of the home. Stenson Court DS0000032034.V288972.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection lasted for nearly 7 hours. Eight service users, three relatives and two staff members were interviewed to obtain their views about the service. The inspector also spent time with some of the service users who were not able to be formally interviewed. A check was made of the environment and the following records were checked: staff training, fire safety, service users’ care plans, the service users’ guide and staff recruitment records. A check was made of the storage and recording of medication. The Manager was on leave on the day of the inspection and the inspection was conducted with the help of the deputy manager. What the service does well: What has improved since the last inspection? Stenson Court DS0000032034.V288972.R01.S.doc Version 5.1 Page 6 The home has taken over the recruitment processes at the application stage to ensure that staff can be recruited more quickly. When all the relevant information has been gathered it is passed to the council’s HR department for criminal records and adult protection checks. 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. Stenson Court DS0000032034.V288972.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Stenson Court DS0000032034.V288972.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessments of the service users had been made prior to them coming into the home, ensuring that the staff were able to meet their needs. The staff team had received a range of training to ensure that they understood the needs of the service users. EVIDENCE: Three care plans checked showed that assessments had been made of the service users prior to them moving into the home. Where necessary, service users had been reassessed whilst at the home to ensure that their needs could be met. There was evidence that the home had obtained assessments from other professionals such as social workers. Stenson Court DS0000032034.V288972.R01.S.doc Version 5.1 Page 9 The home does not provide intermediate care but there is day care provision and respite care at the home. Two service users interviewed said that they had had the opportunity to visit the home prior to moving in. Two relatives spoken with also said that they had had a chance to visit the home prior to their relative moving in. Stenson Court DS0000032034.V288972.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were plans in place to identify what help and support service users needed. They appeared well cared for and their care plans indicated that health and personal care needs are identified; appropriate action is taken to ensure these needs were met. Risk assessments needed to be updated and expanded to ensure that they identified any restrictions on service users. Service users felt that the staff treated them in a friendly way and took care to maintain their dignity. The medication system was generally well managed. Stenson Court DS0000032034.V288972.R01.S.doc Version 5.1 Page 11 EVIDENCE: The care plans of three service users, whom the inspector had interviewed or met with, were checked. These contained assessments of their needs, what help they needed and how staff should provide this help. The care plans had been regularly reviewed. Two of the service users interviewed had described what help they needed and their individual care plans reflected this. The plans included information about the service users’ health needs and any contact they had had with other professionals, such as GPs, district nurses, opticians, dentists and chiropodists. Risk was generally well managed at the home but the risk assessments in the care plans needed to be improved and updated. The home needs to clearly identify the reasons behind restricting any service user’s access to certain areas of the building, especially if this is related to the safe supervision of the individual or other service users. The daily notes should include information about any restrictions on any of the service users. The medication system was well managed and had been checked by the home’s pharmacist in the month prior to the inspection. The medication was securely stored and all labels and administration information was clear. All medicines were clearly labelled with the service users’ names. The home’s controlled drugs were securely stored and full records were kept of their administration, including witness signatures. The Medication Administration Record (MAR) sheets were clearly filled in and all medication was accounted for. There was a system for receiving medication into the home and for the returning of any unused medicines to the pharmacist. Most information on the MAR sheets was pre-printed by the supplying pharmacist, however some information had been entered on the sheets by staff. Although his was clearly recorded, the person making the entry had not signed the MAR sheet. In order to reduce the possibility of the service users being given the wrong medication or wrong dosage, there should also be a signature from a second person to say that the information has been copied accurately. Service users were able to manage their own medication if they wished and had been assessed as capable of doing this safely. No service users were currently doing this – those spoken with said that they were happy for staff to manage their medication on their behalf. Stenson Court DS0000032034.V288972.R01.S.doc Version 5.1 Page 12 All the service users who were able to clearly describe the service said that the staff treated them with respect and kindness and they looked after them well. All interaction between staff and service users observed by the inspector reinforced this impression. One service user felt that there were certain restrictions placed upon him that were unfair. This was discussed with the deputy manager on the day of the inspection and the need for improved risk assessments was identified. Stenson Court DS0000032034.V288972.R01.S.doc Version 5.1 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, and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The majority of service users who were able to clearly say did not feel that there were enough suitable activities provided at the home to keep them stimulated. Visits from relatives and friends were encouraged, ensuring that service users kept in touch with people who were important to them. Service users said that the food was good and they were offered plenty of choice; special dietary needs and preferences were recorded in the individual care plans to ensure people received appropriate nutrition and foods that they liked. EVIDENCE: Service users, staff and relatives interviewed confirmed that the routines at the home were as flexible as possible. Service users said that they could have a lie-in in the morning if they wished and were able to agree times for baths. They said that mealtimes were set but if they were late for any reason, or preferred to eat in their room, the staff were responsive to this. Most of the service users said that they liked the food, one commented that “it’s fine but not like I would cook for myself at home”. The cook was aware of any special diets and was knowledgeable about individual’s likes and dislikes. There was information about service users’ dietary needs in the care plans. Stenson Court DS0000032034.V288972.R01.S.doc Version 5.1 Page 14 Service users interviewed said that there were events and entertainments held at the home, including visiting singers, special parties at bonfire night, Halloween etc. however, four service users said that they would like to have more regular activities provided by the staff. They felt that they were well cared for and well looked after at the home, but they did not feel that staff had sufficient time to do activities with them on a daily basis. Service users, visitors and staff all confirmed that visiting hours were extremely flexible. Service users said that staff helped them to keep in touch with people who were important to them. Stenson Court DS0000032034.V288972.R01.S.doc Version 5.1 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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints guidance was available in appropriate formats to allow service users to raise any concerns. Service users and relatives felt that the atmosphere at the home allowed them to raise issues without fear of intimidation. There was staff training on recognising and reporting abuse. EVIDENCE: The home had complaints procedures, which were available to service users and their relatives. There were no formal ongoing complaints at the home. Service users said that they would be comfortable in raising complaints and one service user interviewed said that he had done this and the home had responded well. There are adult protection policies and procedures in place. These have been invoked and an incident in the previous 12 months was fully investigated and decisive action taken. As noted above, in the “Health and Personal Care” section, risk assessments needed to be updated in some care plans. Stenson Court DS0000032034.V288972.R01.S.doc Version 5.1 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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was clean, tidy and generally well maintained ensuring that the service users live in pleasant and comfortable surroundings. Some extra storage space is necessary to ensure healthcare products can be discreetly stored in service users’ rooms and the garden area needed some attention. EVIDENCE: The home was clean and fresh smelling on the day of the inspection. There are a number of lounges, enabling service users to have quiet and more private space if they wish to see visitors outside of their rooms. The communal areas were pleasantly decorated and light. Five bedrooms were checked and these were clean, tidy and well decorated. Service users spoken with said that they were happy with their rooms. The home needs to ensure that continence or healthcare products are discreetly stored in service users’ rooms. Stenson Court DS0000032034.V288972.R01.S.doc Version 5.1 Page 17 There was a build up of leaves in the garden area which could be potentially hazardous for service users and the gardens needed some general maintenance. Stenson Court DS0000032034.V288972.R01.S.doc Version 5.1 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 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There were sufficient staff deployed to ensure that the service users’ physical and healthcare needs could be met, however the dependency levels meant that staff could not always provide stimulating activities for the service users. Staff had received training in understanding service users’ needs and how to provide a safe service. Checks had been made on staff to reduce the risks to vulnerable people EVIDENCE: In interviews with the deputy manager and the staff, they said that on the majority of shifts there were at least 5 staff in the morning and 5 staff in the afternoon. At night there were 3 staff. The manager’s hours were supernumerary. Staff interviewed felt that these levels were sufficient to provide personal care to service users and to safely supervise them. The rotas were checked from mid-August 2006 to the date of the inspection (mid-October 2006) and these showed that of 70 afternoon shifts checked, the home had worked with 4 staff on 30 occasions. Staff interviewed acknowledged that this made it more difficult to look after the service users properly. The rotas checked indicated that this situation had improved significantly in the previous 4 weeks and the vast majority of afternoon shifts had 5 staff on duty. Stenson Court DS0000032034.V288972.R01.S.doc Version 5.1 Page 19 The deputy manager said that the situation should further improve with the recruitment to the vacancies at the home. The home had not had any new recruits since the previous inspection. The deputy manager said that the home was now processing the applications up to the point of potential staff needing POVA and CRB checks, when the information was passed to the council’s Human Resources department. She said that this had significantly speeded up the process from when this was managed centrally. Two care staff interviewed had achieved NVQ Level II in care and the home had their own NVQ assessors. The staff interviewed had undertaken manual handling, food hygiene and fire safety training within the previous 12 months. Stenson Court DS0000032034.V288972.R01.S.doc Version 5.1 Page 20 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): 32, 33, 35, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff and service users felt that the managers at the home had their best interests in mind. Staff received professional supervision to monitor their practice and to ensure they were able to meet the needs of the service users but these sessions needed to be held more regularly. Health and safety and fire records were well-maintained reducing the risk to service users. Stenson Court DS0000032034.V288972.R01.S.doc Version 5.1 Page 21 EVIDENCE: The manager was not working on the day of the inspection and the deputy manager assisted the inspector throughout the day. She demonstrated a good knowledge of the service users and the management of the home. All the staff, service users and relatives spoken with said that the senior staff were approachable and very supportive. This was evident during the inspection when care staff raised concerns or passed on information to the senior staff about service users. Service users and relatives were able to come into the office when the door wasn’t closed for privacy or reasons of confidentiality. Service users felt that their views and opinions about the service were taken into account by the staff. The providers (DMBC) had carried out regular, unannounced monthly visits to the home to monitor the care. None of the staff are appointees for the service users or manage accounts on their behalf, except for personal allowances. There is an established system of professional staff supervision at the home. This includes ongoing assessment of how staff are working, what training they might need or want and discussions about the service users for whom they are key worker. However, staff have not had supervision sessions at the required frequency of 6 per sessions per year. The home’s major electrical and gas systems had been checked and serviced within the previous 12 months. There was a new call system being installed on the day of the inspection. The fire system had been serviced and regular checks had been made of the alarms and emergency lighting. Staff interviewed were able to describe the procedure to be followed in the event of a fire. There were no obvious hazards noted on the day of the inspection. Disorientated service users were not able to access potentially hazardous areas such as the laundries or kitchens. Stenson Court DS0000032034.V288972.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 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 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 3 X X 2 X 3 Stenson Court DS0000032034.V288972.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? YES 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 OP29 Regulation 18 Requirement The Registered Person must ensure that the DMBC employs adequate numbers of staff (care staff, activities, housekeeping laundry, and catering staff) to meet the resident’s needs. (Previous timescale: 01/04/06) Risk assessments must be updated and must include details of any restrictions placed on service users. Handwritten entries on MAR sheets must be signed by the person making the entry. A witness must also sign to confirm the instructions are accurate. The range of activities must be increased in line with the wishes of the service users. The leaves must be cleared from the garden and there must be better maintenance of the garden areas. The frequency of staff supervision sessions must be increased. DS0000032034.V288972.R01.S.doc Timescale for action 01/01/07 2. OP7 12, 13 (4) (b) (c) 13 (2) 30/01/07 3. OP9 30/11/06 4. 5. OP12 OP19 12 23 (2) (b) 30/01/07 30/01/07 6. OP36 18 (2) 30/01/07 Stenson Court Version 5.1 Page 24 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 OP19 Good Practice Recommendations Storage space should be provided for service users to discreetly store continence or health products. Stenson Court DS0000032034.V288972.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR 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 Stenson Court DS0000032034.V288972.R01.S.doc Version 5.1 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. 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