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Inspection on 28/07/05 for Stewart House Care Home

Also see our care home review for Stewart House Care Home for more information

This inspection was carried out on 28th July 2005.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home has a very friendly and caring inclusive atmosphere in which residents are well cared for with their dignity and respect being upheld at all times. All residents spoken to were clearly happy with the choice of food that is offered, and with the care that they receive at Stewart House. The care provided at Stewart House is of a very high standard and a truly holistic approach.

What has improved since the last inspection?

Since the last inspection, the carer has gained an NVQ level 2 in care and it is anticipated that she will be updating her knowledge and skills around the administration of medication by attending a training course later in the year, in order to provide adequately for the residents` needs. The home has undergone some refurbishment in that new windows and doors have been installed throughout the home. Two new experienced care staff have been employed to cover for times where the manager is on annual leave, sickness leave and all relevant checks and training have been undertaken.

What the care home could do better:

From what the residents told the inspector during this visit, the inspector feels that the home is providing a very good service. From the standards looked at during this inspection the inspector cannot suggest how the home could do better at this time.

CARE HOMES FOR OLDER PEOPLE STEWART HOUSE 85 Bloxham Road Banbury Oxon OX16 9JS Lead Inspector Jane Handscombe Unannounced 28 July 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. STEWART HOUSE H57-H08 S13186 Stewart House V241551 280705 Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Stewart House Address 85 Bloxham Road, Banbury, Oxon OX16 9JS 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) 01295 259541 Ms Carol Echlin Care home 3 Category(ies) of Dementia - over 65 years of age (2), Old age registration, with number not falling within any other category (3) of places STEWART HOUSE H57-H08 S13186 Stewart House V241551 280705 Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: NA Date of last inspection 20 January 2005 Brief Description of the Service: STEWART HOUSE H57-H08 S13186 Stewart House V241551 280705 Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place during the afternoon of 28th July 2005. The purpose of the visit was to see how the home is meeting the National Minimum Standards. The visit involved speaking to residents to ascertain their views upon the care they receive at the home, staff members and the manager, viewing records held whilst also observing the day to day operations of the home. Whilst on this day there were no family members or visitors at the home, feedback was gained via comment cards and has been included in the findings of this report. The home presented as one with a homely ‘family’ atmosphere, which was presented as clean, tidy and of very good décor. Residents were going about their daily activities in a calm relaxed atmosphere whilst staff were observed to provide care and support to the residents in a calm, unhurried manner and respecting their individuality, privacy and dignity at all times. Comments received from residents during the inspection and from relatives/visitors comments cards included: ‘…of all the homes I have visited this is by far the best, the individual care given is excellent…..meets all the needs of those in her care, a spotless place and a real pleasure to visit.’ ‘She is a very good cook’ ‘I am very happy here’ ‘there isn’t anything to complain about’ What the service does well: The home has a very friendly and caring inclusive atmosphere in which residents are well cared for with their dignity and respect being upheld at all times. All residents spoken to were clearly happy with the choice of food that is offered, and with the care that they receive at Stewart House. STEWART HOUSE H57-H08 S13186 Stewart House V241551 280705 Stage4.doc Version 1.30 Page 6 The care provided at Stewart House is of a very high standard and a truly holistic approach. 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. STEWART HOUSE H57-H08 S13186 Stewart House V241551 280705 Stage4.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 STEWART HOUSE H57-H08 S13186 Stewart House V241551 280705 Stage4.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) 1, 3 and 5 Prospective residents, their families and representatives are given good clear information about the home, the staff who work at the home and details about the services offered, which allows them to gain a full picture so as to make an informed choice about when deciding upon a home to suit their needs. All residents have their needs assessed before admission to the home and this is reviewed after 4 weeks of admission. EVIDENCE: All prospective residents and interested parties are provided with a service users guide, which gives detailed information about the homes aims and objectives, the services offered and the staff so as to enable them to make an informed choice when deciding upon a home to meet their needs. A further copy is to be found in the sitting room, which is accessible to all residents, their friends and families. Prospective service users all have an assessment of needs carried out by either the manager, or if they are referred by social services, by their care manager, to ensure that the home is able to offer the level of support and care that is STEWART HOUSE H57-H08 S13186 Stewart House V241551 280705 Stage4.doc Version 1.30 Page 9 required, and that the service user is confident that their needs will be met. During the residents first month, the manager continues to assess these needs and a review of care is undertaken with all relevant parties within 4-6 weeks of admission. STEWART HOUSE H57-H08 S13186 Stewart House V241551 280705 Stage4.doc Version 1.30 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 standard(s) 7, 8, 9 and 10 Each resident has an individualised plan of care drawn up from an assessment of needs, in which the resident takes part. Reviews of the residents’ needs are undertaken regularly and care plans updated as necessary. Risk assessments are undertaken where a resident wishes to administer and store their own medication. The manager and residents ensure that the right to privacy and dignity is respected and adhered to. EVIDENCE: The inspector viewed all the care plans for the residents in attendance during the inspection, which were found to have been drawn up from a full assessment of needs and were comprehensive, detailed and well documented. Risk assessments are undertaken as are regular reviews of care so as to ensure the residents’ needs are being met and to ensure the health, safety and STEWART HOUSE H57-H08 S13186 Stewart House V241551 280705 Stage4.doc Version 1.30 Page 11 well being of the residents within the home. One resident was observed to have cot sides on the bed and all necessary consultation and authorisation had taken place to address this. Residents who spoke with the inspector on the day of inspection confirmed that they are consulted with and involved in decisions around their health care needs. The manager was observed to respect the residents’ dignity and respect during the inspection, and the residents assured the inspector that this was the case at all times; that no one enters their rooms before knocking upon entry and that they are called by their preferred name. Residents who wish to maintain responsibility for their own medication are protected by the homes policies and procedures for dealing with medication. STEWART HOUSE H57-H08 S13186 Stewart House V241551 280705 Stage4.doc Version 1.30 Page 12 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 and 15 Whilst there are no formal activities in place, the residents informed the inspector that the home is very much in line with their expectations, is run as a family home and in line with what their wishes are. Residents are assisted to attend any local activities/gatherings if they desire. EVIDENCE: Residents spoken to on the day of the inspection informed the inspector that the lifestyle they experience at the home, matches their expectations. Residents enjoy watching television in the lounge and all have a television in their own room, listening to music, receiving visitors and reading books. There is a visiting hairdresser and podiatrist to the home, if the residents require their services. Residents can attend local church services if they require, as does one resident who spoke to the inspector of her weekly attendance. STEWART HOUSE H57-H08 S13186 Stewart House V241551 280705 Stage4.doc Version 1.30 Page 13 Banbury town centre is in close vicinity with a large shopping centre which residents can access via the dial a ride bus service. One resident informed the inspector that the home was ideal for her needs and that ‘I get out and about and go shopping’. Residents were complimentary of the meals offered at Stewart House, which are freshly cooked on the premises and are wholesome and appealing. The meal offered on the day of inspection consisted of pasta spirals in cheese sauce, baked potatoes and green beans followed by a dessert of prunes and custard. The manager ensures to take everyone’s dietary needs and preferences into account when devising the menus in order that their needs are met, and no resident is provided with a meal of their disliking. STEWART HOUSE H57-H08 S13186 Stewart House V241551 280705 Stage4.doc Version 1.30 Page 14 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) 16 and 17 There is a complaints procedure and policy in place, which all residents are aware of and would use if the need arose. EVIDENCE: Residents informed the inspector that they were aware of the complaints procedure, and would be confident to raise any issues with the manager, should the need arise. As one resident stated ‘if I wasn’t satisfied, I would complain’ and another informed the inspector that ‘ there isn’t anything to complain about’ It is noted that no complaints have been received during the last 12 months. Whilst viewing the complaints procedure, the inspector noted a slight amendment was needed to reflect the Commissions name change All residents are placed upon the electoral roll enabling them to take part of the election process either by postal vote or by visiting the local polling station, whichever is their preference. A resident informed the inspector ‘first time I went to the polling station, this time I had a postal vote’. STEWART HOUSE H57-H08 S13186 Stewart House V241551 280705 Stage4.doc Version 1.30 Page 15 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, 24, 25 and 26 Whilst some of the bedrooms are of small size, the home provides comfortable surroundings, which are equipped to meet the residents’ needs. EVIDENCE: Service users spoken to on the day of the inspection were happy with the accommodation provided at Stewart House. The home presented as clean, tidy and ‘homely’ and was in good decorative order throughout. Residents have the use of a garden in which seating is provided for those who require and it is self-contained providing a safe environment. It was observed that residents’ rooms were decorated with memorabilia and personal effects, which is encouraged when a resident moves into the home. STEWART HOUSE H57-H08 S13186 Stewart House V241551 280705 Stage4.doc Version 1.30 Page 16 All rooms were provided with a call bell alarm system and residents reported that where they have had to use this system, a member of staff has responded appropriately. Locks were not seen to be on all bedroom doors and not all had table level lighting, however after discussion with the manager, it was reported that residents are asked and given the choice to have these made available if required. There are sufficient bathing and WC facilities at Stewart House, which presented as very clean and appropriately equipped. STEWART HOUSE H57-H08 S13186 Stewart House V241551 280705 Stage4.doc Version 1.30 Page 17 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 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, 28, 29 and 30 Due to the small size of the home and the needs of the residents within the home, Mrs Echlin, the proprietor and registered manager, provides the majority of care and is supported by 1 part time carer. Recent recruitment at a time of need has resulted in the manager appointing two further part time, experienced carers, who may be called upon when the need arises. All staff have undergone the necessary pre employment checks and the necessary training in order to ensure competency in their roles. EVIDENCE: Residents are supported and protected by the homes recruitment policies and procedures, all the necessary pre employment checks and relevant training of staff are followed up and kept in a personnel file. All staff providing care at Stewart House have undergone relevant training and supervision in order that they can undertake their care duties competently, and further training and updating of training is undertaken where necessary. One carer has completed NVQ care level 2 since the last inspection. The manager has planned future training to include Food Hygiene and Medication administration for staff so as to update their knowledge and skills. STEWART HOUSE H57-H08 S13186 Stewart House V241551 280705 Stage4.doc Version 1.30 Page 18 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, 32 33, 34, 35 and 38 Stewart House is a well managed home, run in the best interests of the residents with safeguards in place to protect their health, safety and well being. EVIDENCE: The manager of the home, has undergone registration with CSCI deeming her a fit person to manage the home. Mrs Echlin has many years of experience supporting and caring for older people, and continues to update her skills and knowledge in order to meet the residents’ needs. Further medication administration training is planned later this year, in order to update her knowledge and skills. STEWART HOUSE H57-H08 S13186 Stewart House V241551 280705 Stage4.doc Version 1.30 Page 19 Residents spoken to during the inspection have every confidence in Mrs Echlin, the care that she provides at the home and feel comfortable in approaching her with any concerns or complaints that they may have. All residents’ finances are dealt with by the resident’s family members or a designated representative. One service user’s personal allowance involves the managers assistance for which all transactions are recorded and receipts kept accordingly. The manager undertakes a formal consultation process on an annual basis to gain the views of those in her care. The last quality assurance undertaken was in June 2005, in which the residents were very complimentary about the care they receive and the services provided at Stewart House. Residents informed the inspector that they are also often consulted with on an informal basis and are free to approach the manager with any suggestions or concerns at any time. STEWART HOUSE H57-H08 S13186 Stewart House V241551 280705 Stage4.doc Version 1.30 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x 3 x 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 3 3 x x x 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 3 3 x x 3 STEWART HOUSE H57-H08 S13186 Stewart House V241551 280705 Stage4.doc Version 1.30 Page 21 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 Regulation Requirement Timescale for action 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 16 Good Practice Recommendations It is reccommended that the complaints procedure be ammended to include the newer regulatory body Commission for Social Care Inspection STEWART HOUSE H57-H08 S13186 Stewart House V241551 280705 Stage4.doc Version 1.30 Page 22 Commission for Social Care Inspection Address 1 Address 2 Address 3 Address 4 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 STEWART HOUSE H57-H08 S13186 Stewart House V241551 280705 Stage4.doc Version 1.30 Page 23 - 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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