Inspection on 04/02/09 for Stephenson Court Nursing Home

This inspection was carried out on 4th February 2009.

CSCI found this care home to be providing an Poor service.

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

Stephenson Court Nursing Home 29/07/09

Stephenson Court Nursing Home 22/07/08

Stephenson Court Nursing Home 14/08/07

Similar services:

The Highlands

Turret Villa Retirement Home

Moor House

Blenheim House

1 Lanark Close

Mendip House

Beaconsfield Court Care Home

Ann Charlton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

CARE HOMES FOR OLDER PEOPLE Stephenson Court Nursing Home Station Road Forest Hall Newcastle Upon Tyne NE12 9BQ Lead Inspector Janet Thompson Key Unannounced Inspection 10:30 4th and 20th February 2009 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 Stephenson Court Nursing Home DS0000069661.V374146.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. Stephenson Court Nursing Home DS0000069661.V374146.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stephenson Court Nursing Home Address Station Road Forest Hall Newcastle Upon Tyne NE12 9BQ 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) 0191 2702000 0191 2150040 stephensoncourt@schealthcare.co.uk Southern Cross Healthcare (Focus) Limited Vacant Care Home 46 Category(ies) of Old age, not falling within any other category registration, with number (45), Physical disability over 65 years of age (2) of places Stephenson Court Nursing Home DS0000069661.V374146.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Should any of the residents in the PD category leave the home, the Commission for Social Care Inspection must be notified immediately. The registered person may provide the following category of service only: Care home with nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, maximum number of places 45. Physical disability, over 65 years of age - Code PD(E), maximum number of places 1. The maximum number of service users who may accommodated is 46. 3. Date of last inspection 22nd July 2008 Brief Description of the Service: The premises are purpose built and are located within a residential area of Forest Hall. The home is close to shops and local facilities including the Metro station. The home can accommodate 46 frail elderly residents who require nursing care. Short stay respite care is also offered when rooms are available. All accommodation is within single rooms with en-suite facilities. There are two dining rooms in the home and three lounges. A passenger lift is available to the first floor. Car parking is situated to the front of the building and there are gardens at the back. The weekly fees for the home vary, information is available on request from the home. Further information about the home can be found in the service users guide, which is located in the main entrance. Stephenson Court Nursing Home DS0000069661.V374146.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 0 stars. This means the people who use this service experience poor quality outcomes. We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations. This will only happen when it is considered that people who use the service are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Before the visit: We looked at: • Information we have received since the last visit to the home. • How the service dealt with any complaints & concerns since the last visit. • Any changes to how the home is run. • The provider’s view of how well they care for people. • The views of people who use the service. The Visit: An unannounced visit was made on 4 February 2009. A further visit was made on 20 February 2009 to check that progress had been made on some issues identified at the first visit. During the visit we: • Talked with people who use the service, relatives, staff, the manager & visitors. • Looked at information about the people who use the service & how well their needs are met, • Looked at other records which must be kept, • Checked that staff had the knowledge, skills & training to meet the needs of the people they care for, • Looked around the building to make sure it was clean, safe & comfortable. We were accompanied on this inspection by an ‘expert by experience’ from Help the Aged. This is a person with past experience or knowledge of issues affecting care of the elderly. The ‘expert’ provided us with a written account of his findings at the visit. These have been quoted throughout this report. Following this inspection feedback was given verbally to a manager from another home that was present at the inspection. Feedback was also given via the telephone to Michelle Armin who is the Operations Manager for the home. Stephenson Court Nursing Home DS0000069661.V374146.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: When we arrived at the home there was no permanent manager. A manager from another home was in contact with staff and was ‘overseeing’ the home. The home was also short staffed. There were three carers missing. The nurses on duty reported that they were under pressure and that staff morale was poor. Throughout the inspection, staff talked to us about lack of leadership in the home and made allegations of staff bullying each other. We thought the staff were focussed on their own issues and were concerned that this had a poor effect on residents’ care. We called the operations manager and requested extra staff. This was provided immediately. The overseeing manager then arranged staffing to cover future shifts. This is something we will continue to monitor closely. Stephenson Court Nursing Home DS0000069661.V374146.R01.S.doc Version 5.2 Page 7 We noticed that residents call bells were not answered promptly. When extra staff arrived at the home they were not directed to work. We noticed that staff spent time talking in groups rather than spending time with residents. At the last inspection, and again at this one, we were concerned that the cook was not following the menu. Staff and a relative told us that there was limited choice of food at times and sometimes not enough food to feed everyone. We saw that the vegetables used were frozen when there were fresh vegetables available. We also noted that the kitchen was not clean enough. Although staff treated residents politely, we did not think the home was run in the best interests of residents. The expert by experience told us: “The upstairs dining room was nice and bright with four tables set for lunch each with knife, fork and spoon and serviette. However, only one table had a salt cellar and the same table had a vase of artificial flowers – none of the others. The fridge in this dining room was dirty down the side and rusty on the bottom ledge and the handle was broken and dirty. A calendar was on the wall and of good design but was dated 26 January 2009. The one in the downstairs dining room was also out of date. The downstairs dining room was clean and functional but only one table had salt. The staff in the home were very friendly but were observed to spend time in groups of two or three for lengthy periods chatting, even when a resident’s communication buzzer was ringing – I mentioned this twice to staff. The home was short staffed during our visit, a matter addressed by the inspector. I was approached by three staff separately and informed of some of the problems in the home – staffing grumbles, lack of leadership and considerable grievance about the cook. The inspector had also picked this up from staff. From observation, staff did relate well to residents but, at all times, it was linked to a specific task rather than having a couple of minutes’ chat.” The health and safety checks in the home were not up to date or could not be found. At the second visit on 20 February 2009 all health and safety checks had been carried out. The records relating to staff training appeared to show that most statutory training was up to date but some records were not correct. At the second visit, training had been arranged for staff in all areas of immediate concern. The premises were not clean enough in some areas. In other areas where decoration had taken place, care had not been taken to protect the floor or other walls and doors. Several places were spotted with paint. No effort had been made to repair a shower out of use on the first floor or redecorate a shower on the ground floor. These were brought to the attention of the manager at the last inspection. At the second visit, action had been taken to start these repairs. Stephenson Court Nursing Home DS0000069661.V374146.R01.S.doc Version 5.2 Page 8 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Stephenson Court Nursing Home DS0000069661.V374146.R01.S.doc Version 5.2 Page 9 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 Stephenson Court Nursing Home DS0000069661.V374146.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3, standard 6 does not apply. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are fully assessed before they enter the home. EVIDENCE: There has been no change to the admission procedure since the last inspection. Care records showed that residents’ care needs are assessed before admission. This information was sufficient for staff to judge if they could meet the needs of each resident. Most of the residents spoken to could not remember the admissions process, but one resident remembers someone visiting her in hospital to check how she was cared for there. Stephenson Court Nursing Home DS0000069661.V374146.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents receive personal care that is not always well planned or reviewed. All staff do not always respect the privacy of residents. EVIDENCE: Four care plans were examined and two were case tracked. This means that we spoke to the individual residents or observed their care then matched our observations to what was written in the care plan. One case tracked care plans did reflect the actual care needed by the resident. However one resident’s risk assessment for tissue viability showed her as low risk when in practice she was high risk. The remainder of the plans contained enough information. Plans had not always been evaluated consistently. Four residents in the home had pressure sores. Three of these had been obtained in hospital. The nurses reported and records confirmed that they Stephenson Court Nursing Home DS0000069661.V374146.R01.S.doc Version 5.2 Page 12 were improving. The treatment of these seemed appropriate and they are regularly reviewed. Residents looked clean and well cared for. Those spoken to said they were well looked after though one resident told the expert that she was not bathed often enough. Residents told us that they could see a Doctor if they were unwell. Records showed that various health professionals were involved in the care of residents. We noticed that not all staff knocked on residents’ doors before entering their room. Those that did knock did not always wait for a reply before going in. Although staff spoke to residents politely and respectfully we felt that some of the practice we witnessed indicated a lack of respect to the resident. The expert by experience told us: “In room No X, a slipper was pushed under the door to keep it open and an empty cup and glass were on the floor. In room No X, where a resident had recently been moved to, family photographs were lying on the floor and the resident was unable to see his TV, which was on a unit lower than the end of his bed. The staff in the home were very friendly but were observed to spend time in groups of two or three for lengthy periods chatting even when a resident’s communication buzzer was ringing – I mentioned this twice to staff. One resident said she would like to be showered more often – once a week is the most she receives. Another resident although not directly complaining stated that he ordered a morning paper but often did not see it until later in the day if at all. He did not want me to raise this with staff but I did make the inspector aware of this”. Medication ordering, administration, storage and disposal were examined. The treatment room where medication is stored was very untidy and not clean enough. The nurses now check the controlled drugs twice per day. We checked three amounts of these and found they were correct. The administration sheets on the ground floor showed a large number of gaps in the recording system. These were for drugs that should be given regularly such as Metformin and Ranitidine. The nurse said these would have been given but not signed for. The administration sheets on the first floor were correctly completed. Stephenson Court Nursing Home DS0000069661.V374146.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People are not fully supported to lead a healthy and fulfilling personal lifestyle that takes account of their wishes and diverse abilities. EVIDENCE: An activities coordinator is employed in the home. A reasonable range of activities is available. Residents’ social needs are assessed. The activities coordinator has been at the home for some time, she is popular with the residents and is always enthusiastic about her job. Residents told us the activities coordinator was “a hard worker”, “always sunny and nice” and that “she tries hard to find things for us to do”. The expert by experience said: “I had a long discussion with the activities organizer who presented as very motivated and enthusiastic. Activities were on display on the notice board although not up to date, but there were photographs of residents joining in with events. Visits outside the home were confirmed as taking place about Stephenson Court Nursing Home DS0000069661.V374146.R01.S.doc Version 5.2 Page 14 three times a year primarily because the home has not had a mini bus for four years and arrangements are made with a local firm for the loan of a bus with just the fuel to pay for. The problem I was told was the difficulty in getting staff released to take the residents out. The activities organizer asked me to arrange for her to talk to the inspector about funding for social events as she was told different things at different times. She referred to seeking permission to book an entertainer, which she did but his bill has not been paid and he is complaining to her. I passed on her request to the inspector. I did observe a volunteer helping a resident learn how to use the computer as well as 10 ladies in a lounge watching a video of the Sound Of Music.” Residents told us that they could have visitors at any reasonable time. We noticed visitors in the home coming and going freely. Several staff told us that residents were not always offered enough to eat and that the menu was not followed. The home has taken on a nutritional system. This is an independent nutritional tool that devises balanced menus and promotes healthy living. To function properly it should be followed as closely as possible. We noted that the vegetables used were frozen even though there were fresh vegetables in the storeroom. We also noted that the vegetables were cooking at 11:00 when lunch was not served until 12:30. Residents themselves did not actually complain about the food. Residents did appear to enjoy the food and the atmosphere in the dining rooms was pleasant and relaxed. It was not apparent if residents were offered hot drinks with the meal. One resident asked for a cup of tea several times. The expert by experience told us: “The upstairs dining room was nice and bright with four tables set for lunch each with knife, fork and spoon and serviette. However only one table had a salt cellar and the same table had a vase of artificial flowers – none of the others. The fridge in this dining room was dirty down the side and rusty on the bottom ledge and the handle was broken and dirty. A calendar was on the wall and of good design but was dated 26th January 2009. The one in the downstairs dining room was also out of date. The downstairs dining room was clean and functional but only one table had salt. I had lunch with the residents but had to serve the main course for myself as no-one served me. I had roast lamb, potatoes, sprouts and carrots followed by rice pudding. The residents said the meal was very nice. I found the lamb very tasty but also very chewy. I was not allowed to pay for my meal.” The main kitchen was not clean enough. There were grease marks down the side of the fridges, the shelves were dusty and there were crumbs on the floor under the shelves. At the last inspection we informed the provider that the kitchen was not hygienic because the legs of the preparation tables were rusty as were some shelves in the fridge. The floor of the kitchen was torn and Stephenson Court Nursing Home DS0000069661.V374146.R01.S.doc Version 5.2 Page 15 lifting. This makes it difficult to clean and presents a trip hazard for the kitchen staff. No action had been taken to address these issues. At the second visit we were informed that a refurbishment of the kitchen has been ordered. Residents told us that they did have a choice in things such as bedtimes, how to spend their day and where to sit. The expert by experience said “I got the impression that residents understood choice and had choice on a range of issues”. One resident told us the only thing that restricted her choice was “having to wait for staff to help when they are busy”. Stephenson Court Nursing Home DS0000069661.V374146.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. People who use the service are not fully protected from harm through lack of staff’s understanding of procedures. EVIDENCE: CSCI received a complaint regarding some of the staffing issues identified at the inspection. The complainant had raised these and other issues within the home but was not satisfied with the outcome. The remaining issues have been passed to the operations director for the organisation to investigate. Shortly after this inspection an adult protection event took place that was not correctly addressed. This indicates a lack of understanding by staff of all grades in the procedures to be followed. Staff training records indicated that 73 of staff had received training in adult protection. Some errors were noted in the training records so it was not clear if this figure was correct. We asked the residents if they knew how to complain. Two said they would tell a staff member, one would speak to a nurse and three said they did not know. One resident told us that there was no one in charge to tell. Stephenson Court Nursing Home DS0000069661.V374146.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents live in a safe comfortable home that is generally pleasant but not fully clean and hygienic. EVIDENCE: The furniture and general décor provides residents with a comfortable homely environment. Recent decoration of the ground floor lounge has improved this for residents. They said the home was warm enough and that they liked their bedrooms. There were no offensive odours in the home. Stephenson Court Nursing Home DS0000069661.V374146.R01.S.doc Version 5.2 Page 18 There was a full complement of cleaning staff in the home on the inspection day. The cleaners did not appear to be busy and were taking a coffee break in the ground floor lounge. We looked in here after it was cleaned and found dust on windowsills and furniture surfaces. At the last inspection we said there were some areas of the home that needed to be more hygienic to protect residents from the spread of infection. No action had been taken to address the following: In the ground floor shower room the drain was rusty, the pipes were exposed and the grouting and skirting were black. At this inspection, the middle of the drain was pulled out and it was filled with black water. The kitchen floor is lifting and worn. This makes it difficult to keep clean. The preparation tables in the kitchen appeared old, they were wobbly and had rusty feet. Some of the shelves in the fridge were rusty. Sinks where staff wash their hands had water running at 52°C. This means staff cannot practice good hand washing techniques under running water. We found at this inspection: In the bathroom on the ground floor there was a prescription cream, a used wipe and spilt bath wash on the shelf. A bag of continence products were left in the bath. The floor was lifting in the middle and was stained. The bath was fitted with jets, the cleaner reported that residents use these but she did not know how to clean them. Throughout the home redecoration had been done without care to the rest of the surroundings. The doors and floors in several areas were spattered with paint. Staff reported that there were insufficient numbers of towels and bed sheets. The expert by experience said: “My first impression of the home was disappointing as doors in the corridor were marked with white paint spots (on brown doors) and many were noticeably chipped. The protective plate on the bottom of each door was badly stained something very evident throughout the home. Pictures on the walls were often uneven and the stair carpets were dirty and worn in places with one area covered in cigarette burns. One of the toilets (WC 3) there were numerous paint spots on the floor. In the upstairs lounge the floor was covered in crumbs (11.45am) and the carpet in the doorway was torn presenting a risk to residents. In bathroom No 3, the base of the hoist was quite dirty and the door was chipped and covered with white paint marks (brown door).” Stephenson Court Nursing Home DS0000069661.V374146.R01.S.doc Version 5.2 Page 19 At the second visit to the home we were informed that an action plan is now in place to improve the environment. Stephenson Court Nursing Home DS0000069661.V374146.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. People using the service are not supported or protected through adequate staff numbers, skill or ability. EVIDENCE: The staffing requirement is currently: Two First Level Nurses at all times. Seven carers in the daytime. Three carers at night. When we arrived at the home there were two nurses and four carers on duty. The nurse was attempting to phone for more staff and give out medication at the same time. We asked the administrator to ask an overseeing manager to attend the home. We also telephoned the operations manager and requested more staff attend the home immediately. This was organised very quickly. The nurses reported to us that the home had been short staffed for some time and staff were under a lot of pressure. Throughout the morning staff approached us and made individual allegations about each other. Staff told us Stephenson Court Nursing Home DS0000069661.V374146.R01.S.doc Version 5.2 Page 21 that other staff members were bullying them. It was apparent that staff were not working as a team and were focussed on their own issues. Staff also told the expert by experience of these issues despite the fact that they did not fully understand his role. When extra staff arrived they were often unoccupied and we noticed that none of the staff or nurses seemed able to give direction. Staff stood in groups chatting instead of answering residents call bells. The inspector several times asked staff to attend to their duties. We were very concerned about the implications the staff problems would have on residents care. We have written to the organisation requesting an investigation into the staff allegations. The expert by experience said: “I was approached by three staff separately and informed of some of the problems in the home – staffing grumbles, lack of leadership and considerable grievance about the cook. The inspector had also picked this up from staff. In summary I would say I was left feeling a little uncomfortable about living in the home as it seemed to me attention to detail and staff relations were a problem. At what cost to resident care I do not know!” Staff training records indicated that most of the statutory training was up to date. Some of the training records were not up to date though. We have therefore asked for a training analysis to be carried out. Staff recruitment was not assessed on this occasion. Stephenson Court Nursing Home DS0000069661.V374146.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 36 and 38. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. People using this service are not protected through reflective management that takes account of the diverse needs of the service. EVIDENCE: The home does not currently have a manager. The home does have a deputy manager who works part time. There are no clear lines of accountability within the home. The issues already addressed in this report reflect the fact that staff are not given direction or leadership. There was no evidence of management planning within the home and the atmosphere was confused and divided. Stephenson Court Nursing Home DS0000069661.V374146.R01.S.doc Version 5.2 Page 23 Since the last manager left there was no evidence of self-monitoring, which would have identified the problems in the staff team. The health and safety checks carried out by the handyman were mostly up to date. The last weekly fire checks were done on 24/01/09 so were a few days out of date. The fire door checks could not be audited, as they were not dated. It was not clear whether checks were carried out on all bedrails and profiling beds as records could only be found for one. An entry dated June 2008 stated the shower room floor was leaking and this room could not be used. A new floor had been ordered. This was raised at the last inspection and has still not been resolved. The hot water at staff hand washing sinks was 52 degrees C. It should be below 43°C. The electrical installation certificate was issued in 2002. These are valid for five years. It is therefore out of date. This compromises the safety of the building and all in it. This was raised at the last inspection and has still not been resolved. The operations manager stated that she was unaware of this and undertook to have it checked immediately. At the second visit to the home we saw that this had been done. We concluded that the home was not running in the best interests of residents. Issues raised in every section of this report have an impact on residents’ lives, welfare and safety. The supervision of staff was not adequate on a daily basis or formal basis. The provider, who will prepare a written response for CSCI, is investigating this. Stephenson Court Nursing Home DS0000069661.V374146.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 1 17 X 18 1 2 X X X X X X 2 STAFFING Standard No Score 27 1 28 2 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 1 2 X X 2 X 1 Stephenson Court Nursing Home DS0000069661.V374146.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. 2. 3. Standard OP7 OP9 OP15 Regulation 12, 15 13(2) 16(2) Requirement Conduct a review of care plans to ensure they reflect actual need and are up to date. Carry out an assessment of the competency of nurses in medication administration. Conduct an audit of the catering arrangements in the home. Ensure the catering areas are clean and residents receive enough to eat. Provide an action to ensure the home is clean and hygienic throughout. Carry out a training analysis for all staff employed and provide the results to CSCI. Timescale for action 01/03/09 01/03/09 01/03/09 4. 5. OP26 OP28 13 15 01/03/09 01/03/09 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 OP15 Good Practice Recommendations Ensure that the devised menu is followed and that DS0000069661.V374146.R01.S.doc Version 5.2 Page 26 Stephenson Court Nursing Home 2. 3. 4. 5. 6. 7. 8. OP9 OP10 OP27 OP31 OP32 OP36 OP33 residents have access to fresh produce. (OUTSTANDING FROM JULY 2008) Ensure all clinical areas are kept clean and tidy. Provide training for staff in person centred care. Ensure that the numbers of staff in the home are sufficient to meet residents’ needs at all times. Provide a registered manager for the home. Provide the commission with an action plan to demonstrate how the home will be managed in the absence of a manager. Provide staff with adequate supervision. Confirm the quality monitoring measures in place to improve the service and consult with users. Stephenson Court Nursing Home DS0000069661.V374146.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Stephenson Court Nursing Home DS0000069661.V374146.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. 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