Inspection on 23/02/06 for Stirling Park

This inspection was carried out on 23rd February 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 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 Park 05/11/08

Stirling Park 14/12/06

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 Teferi Degeneh Unannounced Inspection 11:45 23 February 2006 rd 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.V279343.R01.S.doc Version 5.1 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.V279343.R01.S.doc Version 5.1 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.V279343.R01.S.doc Version 5.1 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. 19th October 2005 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.The home is a large converted two storey domestic premises, which has just undergone major building works to further improve the facilities offered. The ground floor contains a communal kitchen/ dining room, lounge, single bedroom, a shared room, and bath and toilet facilities. The first floor contains three existing single bedrooms, staff sleep-in room, bath and toilet facilities and a new laundry room. There are handrails along the corridors and in the bath and toilet rooms. The manager is currently negotiating with relevant authorities the feasibility of installing a stair lift to make the first floor accessible to people with a physical disability. The office is behind the lounge at the back of the building. There is a large well-kept garden at the back of the home. Stirling Park DS0000010725.V279343.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was undertaken on 23rd February 2006 between 11:45 am and 3 pm. The inspection activity included the assessments of the files of the people who live at the home and the staff, and the observation of the premises and the facilities. Health and safety records were also inspected. All the six people who live at the home were seen and many of them have shared their views about their experiences of living at the home. The registered manager and all the care staff on shift were formally and informally spoken to. 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. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Stirling Park DS0000010725.V279343.R01.S.doc Version 5.1 Page 6 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.V279343.R01.S.doc Version 5.1 Page 7 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, and 6 The admission procedures are not satisfactory with the evidence that a service user has been admitted without their assessment being completed. This means that new service users are not confident whether or not the home can meet their needs. The contracts given to new service users can be improved. New service users do not know their rights and responsibilities and the amount of fees. EVIDENCE: The home does not provide intermediate care. One new person has been admitted to the home since the last inspection. The files of this person and other two people who live at the home were inspected. All people who live at the home were spoken to and observed. The new newly admitted person does not have an assessment of their needs in their file. The registered person said the new service user has been at the home for about a month and before that they had been known to the home. Written contract was also not available in the new service user’s file. However, through conversations with the registered Stirling Park DS0000010725.V279343.R01.S.doc Version 5.1 Page 8 person it was established that a solicitor and the relatives of the service user were aware of the service user’s admission to the home. The other files, which were assessed, contained evidence of signed contracts with terms and conditions of service and the assessment of service users. The service users said that they are happy living at the home and their needs are met. One service user said: “The place is wonderful; you cannot fault it; they are so caring”. Stirling Park DS0000010725.V279343.R01.S.doc Version 5.1 Page 9 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, and 9 There are satisfactory procedures and practices to ensure that service users health care needs are met. The storage, handling and administration of medicines are satisfactory. However, the care plans are not good enough to cover all areas of needs highlighted in the assessments. This means that some areas of needs may not be addressed and service users may be at risk. EVIDENCE: At the last inspection the registered person was required to ensure that care plans reflect the assessed needs of service users. The registered person has reviewed care plans but still the plans do not reflect the asseemenets of service users. A long discussion was held with the registered person regarding the need to consider assessment of needs when drawing up care plans. The registered person confirmed in discussions that she will update care plans for all service users. The files inspected and discussions with the registered person indicated that service users, relatives and, as appropriate, professionals are invited to attend annual review meetings of service users. All service users are registered with their general practitioners. On the day of the inspection two doctors were at the home visiting one person. From records and a discussion with the registered person and some service users it was evident that service users had access to dentists, opticians, and chiropodists. A service user said Stirling Park DS0000010725.V279343.R01.S.doc Version 5.1 Page 10 the home and a visiting professional have supported them to lose weight through diet and exercises. The registered person stated that the staff regularly check incidents of pressure sores and take appropriate action. At the time of the visit there were no incidents of pressure sores. Medication is administered by the staff. It was clear from a discussion with the registered person and the assessments of records that the staff who administer medication have undertaken training on medication administration. The medicines and the medication administraion record sheets were checked and were found to be correct on the day of the inspection. Stirling Park DS0000010725.V279343.R01.S.doc Version 5.1 Page 11 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, and 15 The meals provided at this home are good. Service users are satisfied with the quality, quantity and presentation of the meals. The home has worked hard to provide service users with varieties of social and leisure activities that meet their needs. Service users are encouraged and support to engage. EVIDENCE: The people who live at the home and who were spoken to said the staff are extremely good. They said they take part in activities such as exercise to music, reminiscence groups, art sessions, karaoke, and video sessions. At the time of the inspection some people were reading newspapers, books or watching television in their bedrooms. The other people were seen participating in music activities with care staff. One person said the staff take them out for a walk and to shops. The people who live at the home said the food is good and they are provided with meals that meet their needs. They said they are asked their preferences and they are able to choose what and when to eat. At the last inspection a relative made a comment: “the food was excellent”. At this inspection the staff were observed providing appropriate support with feeding. Stirling Park DS0000010725.V279343.R01.S.doc Version 5.1 Page 12 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, and 18 There are satisfactory complaints and adult protection policies and procedures. The people who live at the home are reassured and feel safe by the home’s complaints and adult protection policies. EVIDENCE: The people who live at the home said they could talk to the registered person or the staff if they have concerns. They said the staff and the registered person are easy to talk to. Four relatives of service users who completed comments cards at the previous inspection confirmed that they are aware of the homes’ complaints procedures. No complaints have been recorded since the last inspection. There is a policy on adult protection. The registered person has also obtained a copy of the local authority’s policy and procedures on the protection of vulnerable people from abuse. It was evident from discussions with the registered person that the staff have undertaken training on adult protection. Stirling Park DS0000010725.V279343.R01.S.doc Version 5.1 Page 13 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, and 26 The premises and the facilities of the home are good and service users feel that they live in a safe and comfortable environment. EVIDENCE: The laundry room, situated on the first floor, has 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 home was clean and tidy. The people who live at the home said they are happy with their rooms and the communal areas. It was noted at the previous inspection that visitors have been happy with the cleanliness and the conditions of the home. An environmental health officer visited the home and made two recommendations. A requirement is made below regarding these recommendations. Stirling Park DS0000010725.V279343.R01.S.doc Version 5.1 Page 14 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, and 29 The number, experience and skills of the staff are adequate to meet the needs of service users. The recruitment procedure has improved and service users feel that they are supported by professional and dependable staff team who have undergone recruitment procedures including CRB checks. EVIDENCE: The rota, which was assessed, showed that there are minimums of three care staff working at the home during the early and late shifts. The manager is also at the home every day including most nights. The night shifts are covered by a sleeping-in and a waking member of staff. The staff on shift on the day of the inspection reflected the rota. The home has a total of eight care staff. The registered manager and her husband, a joint provider, also work at the home. All the people spoken to said the staff are good and they are satisfied with the way they care for them. The staff were seen talking to and caring for the people appropriately. It was evident from observations that there were genuine trust and understanding between people who live at the home and the staff. The home has a recruitment procedure and the files of the staff showed that written references have been received for all the staff. Discussions with the registered person and the staff indicated that there is low staff turnover with a number of the staff working at the home for many years. The registered person has complied with the requirement from the last inspection regarding a CRB for one member of staff. A satisfactory CRB certificate was seen in the file of a member of staff who previously did not undergo a CRB check. The staff have attended various training programmes such as first aid, basic food hygiene, adult protection, and dementia. The registered person confirmed that Stirling Park DS0000010725.V279343.R01.S.doc Version 5.1 Page 15 two care staff have a care qualification equivalent to NVQ level 2 and there is a plan for the others to undertake similar training to achieve care qualification. Stirling Park DS0000010725.V279343.R01.S.doc Version 5.1 Page 16 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): 33, 35, and 38 Even though there are a number of positive health and safety practices, risks to service users’ have not been totally eliminated. This is evidenced by lack of evidence as to how pets are controlled from contacting work surfaces. The manager has done a good job in consulting with service users and visitors. Service users feel that they are able to express their views and influence the quality of services and facilities provided at the hoe. EVIDENCE: The registered person said the home does not keep service users’ finances. She said that families or local authorities are appointees for people who live at the home. It was confirmed that an inventory of service users’ personal items are kept by the home. The registered person also confirmed that the home keeps records of expenses made by service users on things such as newspapers and hairdressing. Lockable drawers are provided in each bedroom Stirling Park DS0000010725.V279343.R01.S.doc Version 5.1 Page 17 for keeping valuable items. A discussion with the registered person and the inspection of the home’s records showed that a number of health and safety checks and services have taken place. It was recorded that the fire alarms were inspected on 17/11/05 and portable electrical appliances were tested on 9/8/05. The inspection of the fire alarms and the electrical appliances indicated that they are all in good working order. The gas boiler was serviced on 13/6/05 and the fire extinguishers were checked on 13/9/05. Records showed that the emergency lights are checked and recorded weekly and the fire doors checked monthly. The home was clean and free from offensive odours. An environmental health officer visited the home on 27/6/05 and made two recommendations: a) temperature should be recorded in units; and b) ensure all efforts are made to prevent pets from contacting work surfaces. The registered person has implemented the first recommendation by ensuring that units are written in Celsius. However, there was no action plan as to how the second recommendation can be complied with. At the last inspection the registered person was required to put in place effective quality assurance and quality monitoring systems, which seek the views of service users, visitors and professionals. The registered person as devloped questionnaires for service users, relatives and professional. The questionnaires have been distributed to and collected from the relevant people and the outcome of their feed back has been collated andsummarised. The people’s feedback about the home has been positive with some people stating: “I visited [a service user] many times since [the service user] came to Stirling Park from [previous home] and [the service user] was so happy and contented”. Stirling Park DS0000010725.V279343.R01.S.doc Version 5.1 Page 18 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 2 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X 2 Stirling Park DS0000010725.V279343.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? Yes 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 OP2 Regulation 5(1)(c) Requirement Timescale for action 15/04/06 2 OP3 14(1)(2) 3 OP7 15(1)(2) 4 OP38 23 The registered person must provide service users with a standard form of contract for the provision of services and facilities provided at the home. The registered person must 15/04/06 ensure the needs of new service users are assessed and appropriate care plans are developed before admission. The registered person must 30/04/06 ensure that care plans reflect service users’ assessments. It is required that the assessments of service users and care plans are reviewed regularly with the involvement of service users, social workers and, as appropriate, representatives. (Timescale of 31/07/05 not met). The registered person must 30/04/06 ensure that the matters raised by the environmental health officer on 26/06/05 are complied with. A copy the evidence of compliance must be forwarded to the CSCI Inspector. Stirling Park DS0000010725.V279343.R01.S.doc Version 5.1 Page 20 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.V279343.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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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