Inspection on 09/01/06 for Stirlings

This inspection was carried out on 9th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Stirlings 29/01/07

Stirlings 11/05/05

Stirlings 20/01/05

Stirlings 21/10/04

Similar services:

Flint House

St Vincents

The Cotswold Home

Fairways

Newbeech House

Winton House

Treloar College

Rush Court

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

CARE HOMES FOR OLDER PEOPLE Stirlings Garston Lane Wantage Oxfordshire OX12 7AX Lead Inspector Jane Handscombe Unannounced Inspection 9th January 2006 11:00 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 Stirlings DS0000028949.V276802.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. Stirlings DS0000028949.V276802.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Stirlings Address Garston Lane Wantage Oxfordshire OX12 7AX 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) 01235 762444 01235 763995 manager.sterlings@osjatoxon.co.uk The Orders Of St John Care Trust Mrs Maggie Knowles Care Home 40 Category(ies) of Past or present alcohol dependence over 65 registration, with number years of age (3), Past or present drug of places dependence over 65 years of age (15), Learning disability over 65 years of age (3), Old age, not falling within any other category (18), Physical disability over 65 years of age (20) Stirlings DS0000028949.V276802.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The total number of persons that may be accommodated at any one time must not exceed 40. 11th May 2005 Date of last inspection Brief Description of the Service: Stirlings is a care home providing personal care and accommodation for 40 older people, 5 of whom need help with rehabilitation (intermediate care). The care home is provided by The Orders of St John Care Trust, who are responsible for many care homes in Oxfordshire that were formerly provided by the County Council. Stirlings is located near to the centre of Wantage, close to local amenities. The property is a two storey building with a lift fitted and divided internally into 5 areas. All bedrooms are single and there are no ensuite facilities. The home has well maintained grounds that are easily accessible. Stirlings DS0000028949.V276802.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place on the 9th January 2006. The purpose of the visit was to see how the home is meeting the National Minimum Standards. The visit involved speaking to residents in order to ascertain their views upon the care and the services they receive at the home, the staff members and the manager of the home, viewing care plans and assessments, whilst observing the general day to day operations of the home. The home presented as one, which was of a homely atmosphere and clean and tidy throughout. Residents were going about their daily activities in a calm relaxed manner. Staff were seen to provide care and support in an unhurried manner whilst respecting the residents’ dignity and respect at all times. Comments received from residents during the inspection included: ‘If I need anything I can always go down and chat with the manager. I am always made to feel welcome.’ ‘they are very good’ ‘the food is very good, I have no complaints’ ‘they took us to London just before Christmas to see the lights, it was very nice’ ‘it is always nice and clean’ Comments received from staff included: ‘I don’t think I could find a better manager’ ‘I think everyone has helped me’ the manager …’very nice, always out to help her staff when needed, she’s brilliant’ The inspector would like to thank the residents and staff members for their assistance during the inspection. Stirlings DS0000028949.V276802.R01.S.doc Version 5.1 Page 6 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. Stirlings DS0000028949.V276802.R01.S.doc Version 5.1 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 Stirlings DS0000028949.V276802.R01.S.doc Version 5.1 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): The inspector did not make a judgement on the outcomes in this section as all the key standards were assessed during the last inspection. EVIDENCE: Stirlings DS0000028949.V276802.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, 9, 10 and 11 All residents have a clear, detailed plan of care, drawn up from an assessment of need, which is regularly reviewed to reflect any changing care needs. The staff understand the issues around privacy and dignity, and residents are treated with respect. Every effort to ensure the best possible care is provided and at the time of death, staff will treat residents with care, sensitivity and respect. EVIDENCE: The inspector examined a sample of service users’ care plans, and found them to be comprehensive and to clearly state their individual care needs. Regular monthly reviews of the care plans are undertaken and documented. Generally, monthly reviews and risk assessments are undertaken and clearly documented within the care plans, as are their monthly recording of weight, although on the day of inspection the residents’ files viewed informed the inspector that the recording of weight had not been kept up to date, with the last recordings having been undertaken in September 2005, some 4 months prior to the inspection. The manager informed the inspector that this was due Stirlings DS0000028949.V276802.R01.S.doc Version 5.1 Page 10 to the equipment being faulty and was being sent for repair the following day. A requirement has been made within the report to address this issue. The inspector examined the medication systems in place, found them to be up to date and complete, and observed the medication round. A system of recording the temperatures on a daily basis is in place. The ethos of the care provision at Stirlings is client centred and staff were observed to treat the service users with respect and dignity at all times. Appropriate terms of address are used, and attention is given to maintaining social contacts with relatives and friends. This subject is core to the induction training for all staff employed. Stirlings DS0000028949.V276802.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, 13 and 15 The home encourages residents to maintain contact with family and friends and involvement in the local community accords with the residents’ preferences. All residents receive a wholesome nutritious diet, which is cooked freshly on the premises. There is a programme of activities for the residents to enjoy, which offer stimulation and variety. EVIDENCE: Residents spoken to informed the inspector that they were able to choose how they wished to spend their day and were not made to feel uncomfortable if they chose to stay in their own room, and not join fellow residents. Stirlings DS0000028949.V276802.R01.S.doc Version 5.1 Page 12 They reported enthusiastically about the varied programme of activities offered at the home and assured the inspector that they are offered variety and are able to exercise choice in relation to their leisure and social activities, their meals and routines of their daily living. Information regarding available activities was seen to be posted on notice boards around the home providing evidence of variety. The home also has a visiting hairdresser, a chiropodist, a trolley shop and a monthly church service takes place within the home for those who wish to attend. The staff make every effort to find out details regarding individual resident’s life styles, and preferences and these are documented in the care plans. Residents are encouraged to maintain contact with the local community and their families, friends and visitors are always made to feel very welcome. The meals provided at the home are varied, well balanced and cooked freshly on the premises. Residents were complimentary about the food provided; one resident informed the inspector that ‘the food is very good, I have no complaints’ whilst another stated ‘we had a Christmas dinner, turkey, bottle of wine…..it was lovely’. It was noted that menus are not on display within the home and upon enquiry the manager informed the inspector that residents were consulted with on the day, as to the choice available to them. During the last inspection, which took place in May 2005, the inspector was informed that menus were to be put in place, although this was not seen to be the case during this visit. It is a good practice recommendation to display a daily menu in advance of residents taking their meals. Stirlings DS0000028949.V276802.R01.S.doc Version 5.1 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 the following standard(s): 17 and 18 The home makes every effort to ensure that residents are protected from abuse and that their legal rights are protected. EVIDENCE: The home facilitates access to an independent advocacy service if the need should arise, details of which are displayed upon notice boards within the home. All residents are registered on the electoral role to ensure that residents are enabled to take part in the local and national elections, either by postal votes or visiting the local polling station as they require. The home has in place robust procedures in circumstances where there are any suspicions concerning possible abuse. Staff are all aware of the procedures and further training on the protection of vulnerable adults has been arranged and is to be delivered to all staff next month. Stirlings DS0000028949.V276802.R01.S.doc Version 5.1 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 the following standard(s): 19, 21 and 26 Overall residents generally live in a comfortable, well-maintained environment with safe access to all parts of the home and grounds. However, there were some areas of poor practice around obstruction to some communal facilities and the storage of hazardous substances which the inspector viewed as a possible threat to the health, safety and welfare of both the residents and staff members within the home. EVIDENCE: On the day of the inspection, the home presented as clean and tidy with a homely atmosphere. There are a satisfactory number of bathrooms and bathing facilities, most of which were easily accessible and clearly marked, although one bathroom was found to store a mattress, headboard, and personal belongings which did cause obstruction and a possible threat to the residents’ and staff members’ health and safety. This was brought to the manager’s attention, who informed the inspector that it would be dealt with. Stirlings DS0000028949.V276802.R01.S.doc Version 5.1 Page 15 Two further areas of poor practice were found when touring the premises, one being that a communal bathroom was found to contain tablets of soap; the sharing of soap could possibly lead to cross infection and therefore a recommendation that the staff should ensure to remove resident’s personal soap from communal washing and bathing facilities to avoid this has been made. Further areas of poor practice include that in which hazardous substances were found to be stored in the kitchen area and not locked away as is required and the daily monitoring of the temperatures for all the refrigerators in the communal areas had not been undertaken since September 2005. Recommendations and requirements have been made to address these issues. Stirlings DS0000028949.V276802.R01.S.doc Version 5.1 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 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): 29 and 30 The home follows a thorough recruitment process to ensure that residents are in safe hands and training opportunities are readily available to all staff to ensure competency in their roles and to allow for personal development. EVIDENCE: A sample of staff files was observed which highlighted a thorough recruitment procedure, based on equal opportunities and ensuring the protection of the service users is followed. All members of staff undergo induction training upon appointment to their posts, and are offered ongoing training, which equips them to meet the assessed needs of the residents within the home. Stirlings DS0000028949.V276802.R01.S.doc Version 5.1 Page 17 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): 35, 37 and 38 Systems are in place within the home, and adhered to, in order to safeguard the residents’ financial interests. Poor practices were found to be taking place which could pose a risk to the health, safety and welfare of both the residents and staff members within the home. EVIDENCE: The inspector met with the administrator and discussed the management of the residents’ finances. The systems and records were examined and found to be in good order and provided a clear audit trail to safeguard the residents’ financial interest. Stirlings have safeguards in place to protect both the residents’ and staffs’ health, safety and welfare, although these were not always being adhered to as described in the section headed Environment. Stirlings DS0000028949.V276802.R01.S.doc Version 5.1 Page 18 The recruitment practices undertaken by the manager provide safeguards for the residents, all appropriate pre employment checks are carried out and staff files contained all the relevant information and documentation to evidence this. Requirements have been made within this report to ensure that the health, safety and welfare of the residents are paramount. Stirlings DS0000028949.V276802.R01.S.doc Version 5.1 Page 19 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 X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 3 18 3 2 X 2 X X X X 3 STAFFING Standard No Score 27 X 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X 2 2 Stirlings DS0000028949.V276802.R01.S.doc Version 5.1 Page 20 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 OP21 Regulation 23(2) Requirement The registered manager must ensure appropriate storage to allow residents easy access to all parts of the home without obstruction, thereby ensuring their health, safety and welfare. The registered manager must store hazardous substances safely. Timescale for action 23/01/06 2 OP38 13(4)c 23/01/06 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 OP21 Good Practice Recommendations It is a good practice recommendation that staff should ensure to remove residents’ personal soap from communal washing and bathing facilities to avoid the possibility of cross infection. It is a good practice recommendation to display a daily menu in advance of residents taking their meals. 2 OP15 Stirlings DS0000028949.V276802.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU 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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