Inspection on 01/09/05 for Stirling House

This inspection was carried out on 1st September 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Stirling House 24/03/09

Stirling House 25/10/06

Stirling House 28/02/06

Stirling House 12/10/04

Stirling House 13/05/04

Stirling House 11/02/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Stirling House Honicknowle Green Honicknowle Plymouth PL5 3QA Lead Inspector Kim Fowler Announced 1st September 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. Stirling House D52-D04 S30938 Stirling House V239051 010905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Stirling House Address Honicknowle Green, Honicknowle, Plymouth, Devon, PL5 3QA 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) 01752 790531 Plymouth City Council Caroline Paterson Care Home 32 Category(ies) of Old Age, not falling within any other category registration, with number (32), Physical Disability - over 65 years of age of places (32) Stirling House D52-D04 S30938 Stirling House V239051 010905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12/10/04 Brief Description of the Service: Stirling House is a detached 3-storey, purpose built property situated in the residential area of Honicknowle, Plymouth, close to local shops and amenities. The Home is owned and managed by Plymouth City Council. The home provides accommodation and personal care for a maximum of 32 persons over the age of 65 who may also have a physical disability. The Home has 32 single bedrooms, 16 on the 1st floor and 16 on the 2nd floor, none of which have en suite facilities. There are bathing and toilet facilities on all 3 floors, close to bedrooms and communal areas. Both the 1st and 2nd floors have 2 dining rooms/kitchen areas and 2 lounge rooms, one of which is designated as a smoking lounge. On the ground floor are the main kitchen, a large dining room, lounge and a separate sun lounge/activities room. A shaft lift provides access to all floor levels. There is a call bell system throughout the Home. Service Users are enabled to access any health or social care services they require and various social activities are arranged by the Home. The rear garden is spacious, including a patio and grassed area, and accessible for all the Service Users. Stirling House D52-D04 S30938 Stirling House V239051 010905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 6 hours and was a planned Announced inspection. A full tour of the premises took place and staff and care records were inspected. The Registered Manager, a visitor and 19 of the service users were spoken with during this inspection. The CSCI received 5 Relatives/Visitors comment cards and 5 Service users comment card. What the service does well: 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. Stirling House D52-D04 S30938 Stirling House V239051 010905 Stage 4.doc Version 1.40 Page 6 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Stirling House D52-D04 S30938 Stirling House V239051 010905 Stage 4.doc Version 1.40 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 Stirling House D52-D04 S30938 Stirling House V239051 010905 Stage 4.doc Version 1.40 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) 1/2/3/4/5 The information provided to each service user, in a welcome pack containing the homes Statement of Purpose and Service Users Guide, assist the service users and their relatives to make an informed choice of a care home. EVIDENCE: The homes Statement of Purpose and Service Users Guide are available to each service user on admission. Service users contribute to personal items like chiropody. All contracts are via Plymouth City Council social service department and all service users are admitted via the Care Management team or the Care break scheme. Case tracking provided evidence that the Care Plans had a contract and were signed by the service user. These contracts also contained the terms and condition of occupancy. Of the 3 service users care plans seen it was evident that the pre-admission assessment had been completed. The Asst. Manager completes these for each new admission when they visit the service users. Information provided by service users during interview and from questionnaires received by the Commission, indicate that all staff met service users individual needs. Staff have a wide range of experience and skills in caring for older people with assessed physical and mobility needs. The specialist health and social care professional service is sought and the home holds monthly meetings with the District Nurse team to Stirling House D52-D04 S30938 Stirling House V239051 010905 Stage 4.doc Version 1.40 Page 9 look at each service users care needs. All care needs are recorded into individual care plans and the staff group have access to these to assist them to met service users needs. The service user spoken with during this inspection stated that they visit the home for a trial visit and their first stay is for a onemonth trial period. The home plan a Care Management review after this date to review and confirm the placement. The home does not except emergency admissions. The visits the Asst. Managers make to carry out the pre-admission assessment were seen as evidence in service users care plans. Stirling House D52-D04 S30938 Stirling House V239051 010905 Stage 4.doc Version 1.40 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) 7/8/9/10/11 The home continues to provide good personal support for service users in the home. EVIDENCE: Case tracking of 3 care plans provided evidence that the home completes care plans based on the completed assessment. These are reviewed monthly and any changes recorded. The home has a key worker system in place and also holds monthly District Nurse meetings to review the health care needs of each service user at the home. All service users are able to access all health care services and these are arranged with the GP or District Nurse. Additional support is sought when needed. McMillan nurses and the falls team have been used in the past. The service users confirmed they saw the District Nurse, GP and other professional when needed. The homes pharmacist carries out the staff training and this was completed last week. The pharmacist also carries out a 6 monthly assessment and the medication procedure was observed during the inspection with 2 staff completing this task. The home uses a monitored dosage system and the Controlled drugs records were checked. This record indicated that for one service user, who had left the service, their medication had not left the home with them. The service users spoken with confirmed that they are treated with privacy and dignity and respect. Service Stirling House D52-D04 S30938 Stirling House V239051 010905 Stage 4.doc Version 1.40 Page 11 users can have visits in private, as all rooms are single. All consultations are carried out in individual bedrooms. Some of the service users have their own telephones in their room, some have mobiles and there is a payphone for their use. Information given by the manager regarding a service user who passed away in the home indicated that they were able to remain in the home and were treated with dignity and respect. Many of this service user family were visiting and the service user was moved to a larger room to help support them as well as having a specialist bed provided. The home is currently in discussion with the McMillan Nurse team in preparation for one service user who is unwell. Stirling House D52-D04 S30938 Stirling House V239051 010905 Stage 4.doc Version 1.40 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) 12/13/14/15 The service users in this home can be confident that the home will enable them to make decisions about their own lives. EVIDENCE: Service users stated that the home is what they expected and there are activities available if they wish. Visitors are welcome in the home at any reasonable time and service users can use their individual bedrooms or one of the many lounges to entertain guests. All service users spoken with during the inspection felt that they are able to make choices in their own lives. Many service users spoken with stated either they or their families manage their money. The inspector saw the main meal being served and the meal was very appealing and well presented. The Asst. cook was on duty and showed the inspector the well-kept records of food, fridge and freezer temperature. All meals eaten are recorded and the cooks or staff go to see service users to ask for their choice for the following day. Special diets were seen being catered for. All service users spoke highly of the food, the quantity and the quality available. The staff were observed assisting service users at mealtimes. Stirling House D52-D04 S30938 Stirling House V239051 010905 Stage 4.doc Version 1.40 Page 13 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) 16/17/18 The service users in this home can be confident that their complaints or concerns will be listened to and acted upon. EVIDENCE: Plymouth City Council have a complaints department and all complaints received are recorded and documented and the actions and outcomes are also recorded. The Service Users Guide has a complaints policy and the home has the complaints procedure displayed in the home. The feed back cards received by the Commission and the service users spoken with indicated that the service users knew about the complaints procedure and who to raise concerns and complaints with. Postal votes were received by the home but no service users choose to go to the Polling station. One service user confirmed that they had received a postal vote. 2 Asst. Managers are due to attend the Adult Protection course training next week. And the Adult Protection co-ordinator came the home to brief the staff. The home has a copy of the Adult Protection policy. Stirling House D52-D04 S30938 Stirling House V239051 010905 Stage 4.doc Version 1.40 Page 14 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) 19/20/21/22/23/24/25/26 This home continues to maintain a suitable environment for its stated purpose EVIDENCE: The home is suitable for its stated purpose though most bedrooms do not meet the spatial standards identified by the National Minimum Standards. None of the service users spoken with had any concerns regarding spatial standards and this information is recorded into the homes Statement of Purpose. The home was found to be a warm and comfortable environment. Ongoing updating is carried out via Plymouth City council. The grounds are level and accessible to service users. The home has a security CCTV system on the outside of the building. The home has plenty of communal space on offer were visits or social activities can take place. The home also has several small dining areas and lounge areas for people who visit. The home has a designated smoking room. The home has sufficient toilets and all in close proximity to lounge and bedroom areas. None of the bedrooms have en-suite facilities but do have wash hand basins. All facilities seen during the inspection were clean. The home has a call bell system in place, a lift, risk assessments and moving Stirling House D52-D04 S30938 Stirling House V239051 010905 Stage 4.doc Version 1.40 Page 15 and handling risk assessments for each service user. These include a “falls” assessment seen on file for several service users. Mobility aids are in place to aid the maintenance of service users independence. A requirement from the last inspection was for all rooms to have a double socket fitted to each bedroom has been carried out. All bedrooms have locks and service users are offered a key. Each bedroom has a lockable storage space. The manager confirmed that the windows have window restrictors fitted. All rooms have radiators that are guarded and individually controlled. Thermostatic valves are fitted to hot water outlets. The home has a policy on Legionella and the record of water temperatures were examined. The premises were found to be clean, pleasant and hygienic though out with no unpleasant odours. Laundry facilities are situated on the ground floor and a laundry chute is used to transport soiled linen to the laundry from the upper floors of the building. The home has infection control policies in place. Stirling House D52-D04 S30938 Stirling House V239051 010905 Stage 4.doc Version 1.40 Page 16 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) 27/28/29/30 Plymouth City Council and the homes manager support the staff training to enabling service users to receive the best possible service. EVIDENCE: The home has 32 service users of which 7 are short stay and 25 long stay. The rota seen during this inspection and the rota sent with the pre-inspection questionnaire both show that the home currently has 4 staff on each shift. The previous Registered Homes Act indicated that the staffing levels for this number of service users should be higher. The Registered Providers monthly reports send to the Commission also state the low staff levels as did a visitors feed back comment cards sent to the Commission and also a visitor spoken too during the inspection. The manager informed the inspector that she is in discussion with her senior manager to try to increase staff levels. The home has 5 Asst. Managers and one is always on duty and sleeps in. The home currently has one 37 hour care asst. post vacant and a kitchen domestic post vacant. The manager stated that the recruitment to these posts have been difficult. The home has regular staff who try to cover these vacant hours to minimise the use of agency. The home has 12 care staff who have completed the NVQ at level 2 and above. 4 of the 5 asst. managers also have an NVQ. The home uses Plymouth City Council recruitment and selection process. All staff had completed CRB’s and POVA checks as confirmed by the pre-inspection questionnaire. Case tracking provided evidence on 2 staff files that both files contained the relevant documents to meet this standard. One staff member spoken to confirmed they had regular staff training. The training is provided in house and includes Fire Safety and an Adult Protection course is booked for Stirling House D52-D04 S30938 Stirling House V239051 010905 Stage 4.doc Version 1.40 Page 17 next week for 2 asst. managers to attend. The pharmacist recently carried out medication training for staff. Stirling House D52-D04 S30938 Stirling House V239051 010905 Stage 4.doc Version 1.40 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) 31/32/33/34/35/36/37/38 The Registered Manager of this home is very good and ensures that records are effectively maintained. The staff team are well trained and above all service users are happy and their needs are met. EVIDENCE: The Registered Manager is qualified, competent and has many years experience of managing. The manager regularly updates her training and knowledge and is due to start the Registered Managers award in September. All service users spoken with agreed that the manager and the staff of the home are approachable and has an inclusive atmosphere. Service users spoke highly of all the management team. The registered providers monthly visit reports are sent to the Commission. The quality assurance questionnaires are completed by the service users and were seen and read during this inspection. This information was evaluated and published in the homes newsletter. The Emma Stirling trust also has a regular newsletter and the inspector attend a regular Emma Stirling meeting that was attend by service users, local Stirling House D52-D04 S30938 Stirling House V239051 010905 Stage 4.doc Version 1.40 Page 19 councillors, trustees and Plymouth City Council staff. This newsletter also had information about the evaluated questionnaire. Evident during this meeting was the home and other members discussing how to spend money for the service users benefit. The home comes under the umbrella of Plymouth City Council accounting and finance policies and procedure. The homes budget is set yearly and the manager is involved in the setting of the budget. The home has a clerical officer who maintains all records. The home encourages family or the service users to manage their own money. Service users and their families are encouraged to control their own money for as long as possible, and records evidenced that service users personal money was well managed and accurate. However, service users money must be kept individually in personal accounts in the service users name, and not in pooled suspense accounts. This is currently under review to resolve this issue. The home holds money for 3 service users and the cash held was also pooled into one tin and should be kept individually. One staff confirmed they have supervision and staff had a copy of Plymouth City Council terms and conditions of employment including probation periods and disciplinary policies. All records seen were updated and reviewed regularly. Service users are able to access their records on request and all records are secure. The homes fire log showed that the home carries out regular fire drills and training and the home has the fire safety appliances regularly maintained. The home has qualified first aiders on duty, and the accident book was seen to be up to date, and comprehensively completed. Fridge and freezer temperatures are taken daily. The home has a contract for the collection of clinical waste, and there is an infection control policy. The home has measures in place to control Legionella, and boilers and central heating systems are regularly serviced. The Manager has completed risk assessments on all safe working practice topics. Hoist and stair lift servicing records were seen. The home insurance certificate was seen. Stirling House D52-D04 S30938 Stirling House V239051 010905 Stage 4.doc Version 1.40 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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 2 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 3 3 3 4 3 3 2 3 3 3 Stirling House D52-D04 S30938 Stirling House V239051 010905 Stage 4.doc Version 1.40 Page 21 yes 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. 2. 3. 4. Refer to Standard 9 27 35 35 Good Practice Recommendations Controlled drugs should be signed for when a service user is discharged with the medication The home should consider increasing the staff nember on each shift. The use of a ‘suspense account’ to administer personal money belonging to service users should be reconsidered and an alternative system devised. Money held in the safe for service users must not be pooled. Stirling House D52-D04 S30938 Stirling House V239051 010905 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton Devon, TQ13 7UP 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 Stirling House D52-D04 S30938 Stirling House V239051 010905 Stage 4.doc Version 1.40 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. 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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