Inspection on 14/12/06 for Stirling Park

This inspection was carried out on 14th December 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 Park 05/11/08

Stirling Park 23/02/06

Stirling Park 19/10/04

Stirling Park 03/06/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Townley Road, 2-3

Orchard House Nursing Home

St Josephs Rest Home

Foxley Lane (121a)

Tudor Lodge

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

CARE HOMES FOR OLDER PEOPLE Stirling Park 87 Stirling Road Wood Green London N22 5BN Lead Inspector Mr Tom McKervey Key Unannounced Inspection 14th December 2006 09:30 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 Park DS0000010725.V324190.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 Park DS0000010725.V324190.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stirling Park Address 87 Stirling Road Wood Green London N22 5BN 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) 020 8889 0319 020 8352 4734 Mr Bernard Raymond Hogan Mrs Pauline Christine Janet Hogan Mrs Pauline Hogan Care Home 6 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (2), Old age, of places not falling within any other category (6) Stirling Park DS0000010725.V324190.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. One specified service user who has dementia may remain accommodated in the home. The home must advise the regulating authority at such times as the specified service user vacates the home. 23rd February 2006 Date of last inspection Brief Description of the Service: 87 Stirling Park is a registered care home for six older people, two of whom may also have mental health needs. The home also accommodates one service user with a diagnosis of dementia. The home is privately owned with the registered manager also being the registered provider jointly with her husband. Members of the proprietors’ family also work at the home as carers. The home is a large converted two storey domestic premises, which has been extended to further improve the facilities offered. The ground floor contains a communal kitchen/ dining room, and a lounge. There is also a single and a double bedroom, bath and toilet facilities on the ground floor. The first floor contains three single bedrooms, a staff sleep-in room, a bath, toilet facilities and a laundry room. There are handrails along the corridors and in the bath and toilet rooms. The office is located at the rear of the building, where there is a large well-kept garden. There is an off-road parking space at the front of the home and there are good public transport links to the area. The residents enjoy the presence of a friendly little dog which is owned by the proprietors. There is no lift in the home, which makes the first floor inaccessible to people with a physical disability. The fees for the service range from £385 to £412 per week, depending on Stirling Park DS0000010725.V324190.R01.S.doc Version 5.2 Page 5 single or double occupancy. Following Inspecting for Better Lives, the provider must make information available about the service, including inspection reports, to service users and other stakeholders. Stirling Park DS0000010725.V324190.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection, which took place over a period of four and a half hours, was carried out as part of the Commission’s inspection programme and to check compliance with the key standards. At the time of the inspection, there were five residents living in the home and there was one vacancy. The manager, proprietor and three members of staff were present during the inspection. The inspection process included a full tour of the premises, talking to residents and two members of staff independently, about their experiences of living and working in the home. Residents’ and staffs’ records were examined in addition to other documents pertaining to the running of the home. There were no visitors to the home on the day of the visit. Prior to this inspection, letters and comment cards from residents and their relatives were sent to the inspector. These were very complimentary about the service. What the service does well: There is a friendly and relaxed atmosphere in this home. The residents and their friends and relatives are very complimentary about the care provided by the staff. The standard of catering is very good and the residents have a wide range of stimulating activities. The home is decorated to a good standard and is clean, tidy and free from offensive odours. People who live and work at the home find the manager to be approachable and receptive to their views. There are adequate numbers of staff with the skills, experience and attitude to meet the needs of the residents. Stirling Park DS0000010725.V324190.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Stirling Park DS0000010725.V324190.R01.S.doc Version 5.2 Page 8 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 Park DS0000010725.V324190.R01.S.doc Version 5.2 Page 9 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): 1, 2, 3, 4. The home does not provide intermediate care. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are service agreements in place so that the residents and their representatives are aware of the cost and terms and conditions of the service. There is good information provided about the service for potential service users. Residents’ needs are fully assessed before, and at the time of admission. The home is able to meet the needs of the current residents. EVIDENCE: Stirling Park DS0000010725.V324190.R01.S.doc Version 5.2 Page 10 At the time of this inspection, there were five residents living at the home with one vacancy. No new service users had been admitted, and all the residents were spoken to. There was a comprehensive “Residents’ Handbook”, which the manager said was given to residents and relatives to read when they came to the home. This document contained full information, including the Statement of Purpose and Service User Guide. A copy of the last inspection report was placed in the hallway for residents and visitors to read. A sample of three residents’ case files contained evidence of assessments by care managers and senior staff from the home before, and at the time of admission. There were also contracts/service level agreements from the local authority, detailing the terms and conditions of the service and the fees charged. These documents were signed by the residents or their representatives. Two residents who were spoken to, confirmed that they were happy living in the home and said the staff were very caring. From observing the care given to the residents, it was evident that the home was meeting their needs. It is evident from written comments from relatives of the service users which were sent to the Commission, that there is a high level of satisfaction with the service. For example; “I just wanted to say what an excellent residential home Stirling Park is. The staff are always very friendly and always accommodating to individual needs”. The relative of a resident who had recently died wrote; “I was greatly impressed by the attention that she received from the friendly and supportive nature of the carers. The needs of the residents appeared to be paramount.” Three of the residents are quite elderly and frail and have bedrooms on the ground floor. The other two residents are able to use the stairs to access their bedrooms on the first floor. However, because there is no lift, the home may not be able to fully meet the needs of people with mobility problems who have to be accommodated upstairs. Stirling Park DS0000010725.V324190.R01.S.doc Version 5.2 Page 11 Stirling Park DS0000010725.V324190.R01.S.doc Version 5.2 Page 12 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 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents’ care plans are comprehensive, reviewed regularly, and provide guidance for staff about meeting the residents’ needs. There are good records of a range of care being provided by health professionals. There are appropriate procedures and staff are trained to ensure that medication is administered safely. The residents are treated with dignity and respect. EVIDENCE: Stirling Park DS0000010725.V324190.R01.S.doc Version 5.2 Page 13 A sample of residents’ care plans showed that thorough assessments of their needs had been carried out and recorded. The care plans were being reviewed regularly and there was evidence that the local authority care managers came to the home annually, to ensure that the residents’ placements in the home were still appropriate. The residents and their relatives were involved in these reviews Each resident is registered with a local GP, and the case files contained evidence of healthcare appointments with a wide range of health professionals. A consultant psychiatrist had reviewed the mental health status of a resident who experiences confusion, which led to their medication being reviewed. Another resident was seen by a specialist regarding severe weight loss and was receiving supplements to their diet. One resident was bed-bound. The manager said that the staff regularly support this person to change position to prevent pressure ulcers developing. However, a requirement is made to provide a chart to advise staff and record how often this needs to take place. The medicines and the administration record sheets were checked and were found to be correct on the day of the inspection. The medication was stored safely. The staff have been trained to administer medication safely and following training by the district nurse, the manager aadministers insulin to a resident who has diabetes. In a written comment, the district nurse was very complimentary about the care provided by the staff. Residents who were spoken to, said that the staff treated them with respect, and this was also observed by the inspector. Staff were seen knocking on residents’ bedroom doors before entering. This comment was sent in a letter to the inspector from a relative; “ I always arrive unexpectedly at Stirling Lodge and I have never found anything untoward to concern me. Mum is always clean and comfortable. She is treated with great respect and affection”. Stirling Park DS0000010725.V324190.R01.S.doc Version 5.2 Page 14 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): All of these standards were inspected. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There is a good range of activities provided for the residents that are appropriate and stimulating. The residents are supported in making choices about their lives in the home. Residents say they are very satisfied with the food provided. EVIDENCE: The residents who were spoken to said the staff are very attentive and caring. They described several activities that were provided such as exercise to music, reminiscence using photo albums, art sessions, karaoke, and video sessions. Stirling Park DS0000010725.V324190.R01.S.doc Version 5.2 Page 15 At the time of the inspection some people were reading newspapers, books or watching television in their bedrooms. Staff were also observed engaged with residents in discussing their old photographs. In addition to the above, pub outings and shopping trips were recorded in the daily notes. One resident goes out once a week with fiends from the Jewish community. Visits to the home are recorded in the visitors’ book. At the time of the inspection, there were no visitors, but in written comments, relatives said that they were always warmly welcomed by the staff and that they were always kept informed about any issues affecting the residents. Residents said that they went to bed and got up at a time of their choosing and they could refuse to join in activities. The menus showed a good variety of meals and the residents were very complimentary about the food provided. One resident receives supplements to their meals to help them to gain weight. They said they are able to choose what and when to eat. During the inspection, the staff were observed supporting a dependent resident to eat in a sensitive, unhurried manner. One relative wrote; “What I’m particularly impressed with is the flexibility shown at mealtimes and what is available. It is definitely client orientated”. Stirling Park DS0000010725.V324190.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 & 18 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There are appropriate complaints and adult protection policies and procedures to safeguard the interests and welfare of the residents. Staff are aware of their responsibilities in relation to issues of abuse of vulnerable people. EVIDENCE: Residents who were spoken to, said the staff and the manager were very approachable and would address any concerns promptly. Relatives of service users who provided written comments, said that they were aware of the homes’ complaints procedure, which they are given at the time of admission to the home. No complaints were recorded since the last inspection. There is a policy on adult protection and a copy of the local authority’s procedures on the protection of vulnerable people from abuse. Stirling Park DS0000010725.V324190.R01.S.doc Version 5.2 Page 17 It was evident from the records and discussions with the staff, that they had been trained on the subject of adult protection. Stirling Park DS0000010725.V324190.R01.S.doc Version 5.2 Page 18 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, 20, 21, 24 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a home that is well maintained. The residents are able to bring personal possessions with them when they move in, and they have bedrooms that meet their needs and expectations. The home is kept clean and tidy and there are no offensive odours. Disposable towels need to be provided to prevent infection. EVIDENCE: Stirling Park DS0000010725.V324190.R01.S.doc Version 5.2 Page 19 During a tour of the premises, the inspector visited four bedrooms. They were spacious and tastefully decorated, with many of the residents’ personal belongings in evidence. The exterior of the property and the garden appeared to be well maintained. The laundry room was well equipped with a washing machine with sluicing facility and there is wash hand basin. There are adequate procedures in place for dealing with incontinence including disposal of soiled waste. The lounge and dining areas were appropriately furnished and comfortable and there was adequate lighting, which was domestic in style. It was noted when inspecting bathrooms and toilets that ordinary towels were being used. A requirement is made for disposable paper towels to be provided to prevent cross infection. The home was very clean and tidy and there were no offensive odours. Stirling Park DS0000010725.V324190.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 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are sufficient numbers of staff available at all times to meet the residents’ needs. Care staff are appropriately trained to care for the residents. There are proper staff recruitment practices to safeguard residents’ welfare. EVIDENCE: The staff rota showed that there are normally three care staff working at the home during the daytime, and there is a waking and a sleep-in member of staff at night. The manager is also at the home every day including most nights. The staff on shift on the day of the inspection reflected the rota. Stirling Park DS0000010725.V324190.R01.S.doc Version 5.2 Page 21 Appropriate recruitment procedures are followed and the staffs’ files showed that written references and Criminal Records Bureau clearance had been obtained before they started working at the home. There is a low turnover of staff, most of whom had worked at the home for many years. Three care staff have attained the National Vocational Qualification, (NVQ) level 2. Two staff who were spoken to independently, said how much they enjoyed working at the home, and described the training they had undergone, which included; a written induction, moving and handling, first aid, food hygiene, dementia care and the administration of medicines. There is also a “staff handbook”, containing important policies and procedures, which the staff sign that they have read and understood at their induction. Stirling Park DS0000010725.V324190.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, 35, 36 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager has the appropriate experience to run the home efficiently and the atmosphere in the home is very relaxed. The residents and staff are consulted about the service and are able to express their views. Residents’ financial interests are protected by sound policies and procedures. Formal supervision must be implemented for staff to support them in their role as carers. The home environment is generally safe, but this could be compromised by the electric wiring system not being checked since the year 2000. Stirling Park DS0000010725.V324190.R01.S.doc Version 5.2 Page 23 EVIDENCE: The registered manager and her husband have owned and run the home for many years. The manager is currently training to attain the management qualification NVQ level 4, and expects to complete this in April 2007. At the time of the inspection, the inspector observed that the interactions between the manager, residents and staff were relaxed and friendly. Residents and staff who were interviewed independently, spoke highly of the manager’s ability to run the home safely and efficiently. The manager had addressed the requirements form the last inspection satisfactorily. An audit of residents’ views about the service they receive was carried out in the past year, which was very positive. This is also confirmed by the highly complimentary comments sent to the Commission by friends and relatives of the residents. The staff said that meetings were held monthly and they were able to express their views and suggestions to improve the service, which were respected by the manager. The inspector was informed that the home does not take responsibility for residents’ personal finances, but that families or local authorities are appointees for people who live at the home. One resident manages her own financial affairs. Records of expenses incurred by residents for newspapers and hairdressing are kept. There is a policy regarding staff receiving gifts, which safeguards residents’ interests. In discussion with the manager and the staff, it was apparent that formal supervision sessions between staff and their line manager, were not taking place and a requirement is made to address this issue. There were current certificates of safety seen for the home’s gas boiler and fire protection systems. Records showed that the emergency lights and the fire alarms are checked weekly and the fire doors are checked monthly. Stirling Park DS0000010725.V324190.R01.S.doc Version 5.2 Page 24 Portable electric appliances had been tested recently, but the home’s electric wiring had not been checked since 2000. There was a current employers liability insurance certificate on display. A requirement is made to address this issue. A fire risk assessment of the building was documented, and the staff have been trained in health and safety. At the time of the inspection, the home was clean and free from offensive odours. Stirling Park DS0000010725.V324190.R01.S.doc Version 5.2 Page 25 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 3 3 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 3 3 3 3 X X 3 X 2 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 3 4 3 X 3 2 X 2 Stirling Park DS0000010725.V324190.R01.S.doc Version 5.2 Page 26 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. Standard OP8 Regulation 12(1)(a) Timescale for action The registered person must 31/01/07 provide a chart for recording the frequency of changes of position for a specific resident who is cared for in bed for long periods. The registered person must 31/01/07 provide disposable hand towels in communal toilets and bathrooms. The registered person must 31/01/07 ensure that care staff receive at least six formal supervision sessions per year. The registered person must 28/02/07 ensure that the home’s electric wiring system is tested for safety. Requirement 2. OP26 13(3) 3. OP36 18(2) 4. OP38 13(4)(c) Stirling Park DS0000010725.V324190.R01.S.doc Version 5.2 Page 27 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Stirling Park DS0000010725.V324190.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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 Stirling Park DS0000010725.V324190.R01.S.doc Version 5.2 Page 29 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!