Inspection on 25/10/06 for Stirling House

This inspection was carried out on 25th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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

Stirling House 24/03/09

Stirling House 28/02/06

Stirling House 01/09/05

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 Devon PL5 3QA Lead Inspector Kim Fowler Unannounced Inspection 09:30 25 October 2006 th 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 Stirling House DS0000030938.V300348.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. Stirling House DS0000030938.V300348.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stirling House Address Honicknowle Green Honicknowle Plymouth Devon PL5 3QA 01752 704881 01752 778024 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) Woodlands.school@plymouth.gov.uk 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 DS0000030938.V300348.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th February 2006 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 DS0000030938.V300348.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over two days. The registered manager Caroline Patterson was available on the second day. One of the deputy managers and other staff assisted the inspector on the first day of the inspection. This included introduction to service users and feedback on training and care practices. The inspector made a tour of the building and spoke to service users, family and friends visiting and a Community Care Worker. Documents relating to the care planning process and the management of the home were examined. Prior to the inspection, resident comment cards had been sent to the care home to allow service users to comment upon their experiences. Five cards were returned to the Commission. Three staff comment cards were also received as well as three professional feedback cards. Any comments are discussed in the relevant section of the report. What the service does well: What has improved since the last inspection? What they could do better: Pre-admission assessments must be completed to ensure that resident’s needs can be met at the home and staff have access to the necessary information to provide the appropriate level of care. Stirling House DS0000030938.V300348.R01.S.doc Version 5.2 Page 6 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. Stirling House DS0000030938.V300348.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Stirling House DS0000030938.V300348.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2/3 The quality in this outcome area is adequate. This judgement has been made using the available evidence including a visit to the service. Pre-admission assessments are not routinely undertaken for respite service users and therefore service users cannot be certain that their needs can be fully met at Stirling House. EVIDENCE: Six service users files were examined and all contained contracts with Plymouth City Council, the placing authority. Three files were for service users admitted for respite care and three files were for long stay service users. The manager confirmed that most service users are admitted via a Care Manager for individual service users. Other service users are admitted using the local authority “care break” scheme. Only one of the three respite service user’s files examined had a completed pre-admission assessment. Stirling House DS0000030938.V300348.R01.S.doc Version 5.2 Page 9 All three long stay service users files held a completed pre-admission assessment either by the placing authority or Stirling House referral/initial assessment form. These documents are important for prospective service users to assure them that not only can their health care needs be met but also their emotional, social, cultural or religious needs. Stirling House does not offer Intermediate Care. Stirling House DS0000030938.V300348.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7/8/9/10 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The staff and manager provide good personal and health care support to the service users in the home, ensuring the promotion of privacy and dignity at all times. EVIDENCE: All six of the service user’s individual files examined contained care plans. These care plans provide staff with information to meet service users needs. However one service user’s care plan had not been completed with full details. The three long stay service user’s care plans were based on completed assessments. The long stay service users care plans are reviewed regularly and dated and signed by staff and some service users where possible. All three respite service users files held a completed care plan. Stirling House DS0000030938.V300348.R01.S.doc Version 5.2 Page 11 All service users have a designated key worker to assist service users with completion of individual care plans and an overview of individual needs. Evidence was recorded on individual files that service users are referred to the District Nurse team as necessary. Regular meetings are held with the District Nurse team to review the health care needs of each service user. Files recorded that there was input from other professionals including GP’s, chiropodist and consultants based at the local hospital. Additional support to assist individuals is sourced from other agencies when needed. For example, support from the National Osteoporosis Society and the Falls Clinic. The Commission received three Health and Social Care Professional feedback cards. Quoted from the cards were: “Stirling House provides excellent care. I can congratulate them all on the care they provide” “They are quick and efficient in bringing any problems to our attention”. “Visiting Stirling House I have always found the staff to be both professional and caring”. Another quoted “my experience with this home in the past has not been satisfactory, I have been informed that things have improved”. A District Nurse’s file was held in the service users bedroom. The service user confirmed that the District Nurse visits them regularly and in the privacy of their bedroom. One service user was observed during the inspection requesting to see their GP. The staff were observed arranging this and discussing with the service user the concerns and symptoms they felt and reassuring the service user at all times. The staff on duty were observed carrying out a medication round. The staff talked through the procedure with the inspector and confirmed that two staff always carry out the administration of medication. Both staff witnessed the dispensing of medication and sign when the medication is administered. Thus ensuring that service users receive the correct medication. Many of the service users currently living at the home were spoken with during this inspection. All service users confirmed that the staff respect their privacy Stirling House DS0000030938.V300348.R01.S.doc Version 5.2 Page 12 and dignity. Several quoted that the staff “Always shut bedroom doors when personal care is carried out”. Service users were also able to say that they receive visitors in private and also that medical consultation or other professional visits are carried out in the privacy of individual bedrooms. During a tour of the premises it was observed that several service user’s bedrooms had their own telephones for their own private use. A payphone is available if required. Stirling House DS0000030938.V300348.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12/13/14/15 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The service users at Stirling House can be confident that the home offers freshly prepared and wholesome meals. The home welcomes and encourages families and friends to visit. EVIDENCE: Many of the service users were able to confirm that there were activities regularly arranged in the home. These activities were either organised by the staff or by visitors to the home. This included bingo and quizzes. One service user stated that they had chosen a particular activity and this activity was then arranged by the home. Several service users said they had “enjoyed the choir” that sang for them recently. Staff were observed practising the Christmas show. Service users stated that visitors are welcome at any reasonable time. The visitors are able to use individual bedrooms or one of the lounges situated throughout the home. Stirling House DS0000030938.V300348.R01.S.doc Version 5.2 Page 14 All service users spoken with felt that they were able to make individual choices about everyday issues in their lives. These choices also included choosing food from the daily menu on offer. Information was recorded onto service users care plans regarding who manages service users money. A completed risk assessment was also in place to support service users use the safe provided in each bedroom. This helps to ensure the safe management of money. Personal possessions were seen in individual bedrooms during a tour of the premises. During the inspection four visitors were spoken with and they all confirmed reasonable visiting times and private meetings if needed. One visitor confirmed that they had received information about the home including the Statement of Purpose. On discussion with the service users about the food provided the quotes received were “excellent”, “a good choice” or “wonderful”. All service users made positive comments about the food provided. The menus were sent with the pre-inspection questionnaire and the cooks were spoken with during the inspection about the menus and food on offer. It was evident from the food served at lunchtime and the evening tea being prepared, that the food was home cooked using fresh products. The meal was well presented and freshly prepared. Stirling House DS0000030938.V300348.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16/18 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The service users can be confident that any complaints or concerns raised will be listened to, acted upon and well managed by the home, which protects the welfare of the service users. EVIDENCE: Plymouth City Council owns Stirling House and has its own complaints department and all complaints received are documented. Any outcomes and actions taken are also recorded. The Commission has not received any complaints about Stirling House. The complaints procedure is clearly displayed in the main entrance area. All five service users stated that they knew how to make a complaint and to whom. Some quoted that they would “speak to the manager”. All service users spoken with and three visitors stated that they would approach the management of the home or the staff on duty if they had any concerns or complaints. Some service users stated that they had lived at the home for many years and had never needed to make a complaint. Stirling House DS0000030938.V300348.R01.S.doc Version 5.2 Page 16 Many written compliments from family, friends and sevice users were observed. The Service Users Guide held in individual bedrooms contained the home’s complaints procedure. Three staff who returned questionnaires to the Commission stated they understood the Adult Protection procedure. The manager confirmed that most staff had now completed adult protection training with Plymouth Adult Protection Co-ordinator. The manager informed the inspector of one Adult Protection issue currently being dealt with. It was evident from the information given to the inspector that the manager was fully aware of the procedure and was managing the situation in accordance with guidelines. It was clear from the information given to the inspector from staff that they had a clear knowledge and understanding of the Adult Protection process. Stirling House DS0000030938.V300348.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19/26 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Stirling House continues to maintain a clean and suitable environment and service users live in an attractive and comfortable home that is regularly maintained. EVIDENCE: The home is suitable for its stated purpose. The home is registered for 32 older people. However it currently only admits a maximum of 28 due to room sizes and staffing levels. Many bedrooms are undersize, however none of the service users spoken with had any concerns and this information is recorded into the homes Statement of Purpose provided to all new prospective service users. A tour of the premises found the home to be a warm, bright and comfortable environment. Stirling House DS0000030938.V300348.R01.S.doc Version 5.2 Page 18 Ongoing redecoration work was being carried out on the ground floor. This included the painting of the dining area, the corridor and the sun lounge. The grounds are accessible to all service users and a lift is provided to access the upper floors. The home has a CCTV camera fitted covering the main entrance of the building for the security of the service users and staff. The home has plenty of communal space and all rooms were well used through out the day. The home has a designated smoking room for the comfort of all service users living at the home. Other facilities on offer within the home are a call bell system. All bedrooms have fitted wash hand basin, lockable doors and a lockable safe in each bedroom. A full tour of the premises found the home to be clean, pleasant and hygienic throughout. There is a laundry shute available to transport soiled laundry from the upper floors to maintain infection control. And the home has an infection control policy in place. Many of the service users and visitors spoken with commented that the home “is always clean” and “ the staff are always cleaning”. One professional feedback card sent to the Commission quoted “ The home has always presented a good standard of appearance and hygiene”. Stirling House DS0000030938.V300348.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27/28/29/30 The quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. Residents are supported by well-motivated and caring staff in sufficient numbers to meet the needs of those currently living at the home. EVIDENCE: Staff rotas were sent to the Commission with the pre-inspection questionnaire. These rotas show that there are four staff on each shift. A recommendation from a previous inspection report was to increase the staffing levels for each shift. The home has not increased the levels. However they have reduced the number of service users from 32 to 28 staying in the home at any time. One of the staff questionnaires sent to the Commission states that the home requires “adequate staffing levels”. The staff interviewed and the remaining questionnaires also went on to say that if there are any service users who need a lot of attention then this can stretch the staff on duty. There is also a duty manager on each shift and these managers also carry out sleep in duties to answer emergencies and for extra help when needed. Domestic, laundry and kitchen staff support the staff team. The home has the use of its own bank/relief staff to cover vacant shifts. Stirling House DS0000030938.V300348.R01.S.doc Version 5.2 Page 20 The pre-inspection questionnaire states that 20 care staff are currently employed at the home. Of these 20 staff 12 have already gained an NVQ qualification at level 2 or above. There are three staff currently undertaking this qualification. The staff interviewed all confirmed they had completed CRB (Criminal Record Bureau) checks. Of these, three were newly appointed staff and they confirmed they had completed their CRB’s before starting work. All staff interviewed confirmed that Stirling House and Plymouth City Council regularly provide updated mandatory training for all staff. This included First Aid, Manual Handling and Health and Safety. All staff files showed updated training certificates, including First Aid, obtained by staff working at the home. One feedback questionnaire sent to the Commission quoted “ I have always found the staff to be both professional and caring”. Another quotes “many residents have expressed gratitude for the care and attention they receive”. Stirling House DS0000030938.V300348.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31/33/35/38 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The Registered Manager is competent and well trained, has the respect of the staff team and is highly thought of by the service users. EVIDENCE: The Registered Manager Caroline Patterson has worked at the home for a number of years and has many years experience in working in care. The manager confirmed that she regularly updates her training. This includes regular Manual Handing and Health and Safety training. The manager has also completed her Registered Managers award. Stirling House DS0000030938.V300348.R01.S.doc Version 5.2 Page 22 All service users and visitors spoken with stated that the manager, duty managers and the staff team of the home are approachable. All spoke highly of the whole staff team. The registered provider’s monthly visit reports are sent to the Commission and contain information and feedback on all aspects of the home. This includes talking to service users, staff, looking at records held at the home and a tour of premises. The newly completed Quality Assurance surveys were read and are due to be published by the home. All previous results had been printed in the homes newsletter. The home remains under the Plymouth City Council accounting and finance policies and procedures. Two service users have money managed by the home. The remaining service users have their money managed by family members or by themselves. The money managed by the home was examined and checked during this inspection. The money for these two service users is currently paid into the home suspense account. Evidence was seen in the form of correspondence that the home has unsuccessfully tried to open local bank accounts for both service users. Both service users have a safe available in their bedrooms. The manager is in the process of seeking Power of Attorney or a solicitor to manage the money on behalf of the service user. This would help protect the service users money and finance transactions. Sampling of records indicated equipment that is serviced regularly and maintained in good order. Health and Safety is a priority in the home and records showed that fire safety training and fire protection is in place and up to date. A fire drill was carried out during the first day of the inspection. The staff responded correctly. However a temporary member of staff did not leave the building straight away. The manager planned to inform any temporary member of staff of the Fire procedure. The accident records were accurate. Files showed that information is recorded onto accident forms and also written into service user daily records with appropriate action taken when needed. Stirling House DS0000030938.V300348.R01.S.doc Version 5.2 Page 23 Stirling House DS0000030938.V300348.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 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 4 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 4 X 3 X 3 X X 3 Stirling House DS0000030938.V300348.R01.S.doc Version 5.2 Page 25 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. 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 OP3 Good Practice Recommendations All service users should have completed pre-admission assessments on file. Stirling House DS0000030938.V300348.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton 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. 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