CARE HOMES FOR OLDER PEOPLE
Stockdove House 12 Stockdove Way Cleveleys Lancashire FY5 2AP Lead Inspector
Mr Kevan Royston Unannounced Inspection 27th September 2007 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 Stockdove House DS0000009711.V343061.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. Stockdove House DS0000009711.V343061.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Stockdove House Address 12 Stockdove Way Cleveleys Lancashire FY5 2AP 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) 01253 855967 Mr David Joseph Lalgee vacant post Care Home 13 Category(ies) of Old age, not falling within any other category registration, with number (13) of places Stockdove House DS0000009711.V343061.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 05/0706 Brief Description of the Service: Stockdove House is an adapted property that has retained a great deal of the atmosphere of a large family house and is situated in a residential area close to local shops and amenities. The home is registered to accommodate a maximum of 13 persons over the age of 65years. Accommodation comprises of a lounge and dining room on the ground floor. There are three double bedrooms, one of which has en -suite facilities and seven single bedrooms, two having en -suite facilities. The double bedrooms are occupied as singles unless persons wishing to share make a specific request. There are sufficient toilet and bathing facilities to meet the needs of the residents. A passenger lift enables residents easily access the first floor. The fees for the home range from £350.00-£360.00. There are additional charges made for hairdressing and chiropody, which may vary. There is a statement of Purpose/Service user Guide, which is given to all prospective residents. This written information explains the care service that is offered, who the owners and staff are and what the resident can expect if he or she decides to live at the home. Stockdove House DS0000009711.V343061.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced visit that took place on the 27/09/07 over a period of approximately 5 hours as part of the inspection process. We spoke to the manager three residents, two family members of staff, one person visiting and a group of residents sitting in the lounge to get their views of the home. As part of the inspection process we talked to people using the service and asked staff about those peoples needs. We also looked at their rooms, care plans, records and daily notes this is called case tracking. Other residents are invited to pass their opinions to us if they wish. We sent out surveys to Doctors, relatives and residents for their views on how the home is run. Five from relatives, two residents and three from doctors were returned, giving their comments and views of the home. The home is mainly staffed by family members. We were however able to look at records of a new member of staff. We walked around the building and watched people living and working to see how everyone supported and talked to each other. Looking at documentation, policies and procedures formed the basis of the inspection process. What the service does well:
There is a small, friendly, mainly family staff team who have been at the home for a long time, enabling relationships to develop between residents and staff and ensure a better understanding of resident’s needs and in turn good support and care can be provided. A comment from a survey returned from a Doctor said, “A small home therefore there is a very personal relationship with their clients”. One staff member spoken to said, “With the family mainly at the home and being small we know the residents well and can identify if any problems arise”. A comment from a relative visiting the home was, “They seem very friendly and caring”. Other comments from relatives included, “They are helping my grandmother maintain her dignity and providing fantastic love and care”. Also, “Stockdove has a very friendly atmosphere”. A resident spoken to said, “I am very happy here I know everyone well”. Stockdove House DS0000009711.V343061.R01.S.doc Version 5.2 Page 6 Family and staff who have received training in Food and Hygiene provide food and meals for the residents. Comments from residents and relatives were good in relation to the quality of meals and included, “The meals are very good”. And, “If I don’t like something a choice is offered”. We saw fresh vegetables being prepared for lunch and one staff member spoken to said, “We always try and use good fresh produce where we can”. What has improved since the last inspection? What they could do better:
There remains a recommendation for the manager to complete the necessary qualifications in management and care which is needed to manage a care home. The premises and general environment at the home should be improved by redecoration and some refurbishment to provide more pleasant surroundings to live in. One relative survey said, “We feel the home is in need of up grading”. A staff member spoken to said, “We have plans to redecorate”. Staff recruitment practices are not robust and procedures must improve to make sure that only suitable staff are employed at the home for the safety of the residents. The manager must ensure all the necessary checks are fully completed and in place before staff start work in the home. Staff records would be improved if the start date for employment were clearly marked so to identify the required recruitment checks are in place before the staff member starts work. The manager and staff should look at more ways to provide activities and trips out so all residents’ interests are looked at and provided for. The manager should seek the views of families, residents and friends to show how the home is achieving its stated aims and objectives. Staff must receive formal training in medication before they administer medicines to residents to ensure they have basic knowledge of medication and safeguard the residents. Stockdove House DS0000009711.V343061.R01.S.doc Version 5.2 Page 7 The manager must seek information and advise from their local pharmacist in relation to policies and medicines given out to residents at the home. 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. Stockdove House DS0000009711.V343061.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 Stockdove House DS0000009711.V343061.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): 2,3 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission and assessment procedures were clear and precise to ensure the needs of the residents are met. EVIDENCE: Each resident had a contract or a statement of terms and conditions signed by the resident or relative. Contracts contained all the information required by the National Minimum Standards, so the homeowners and residents agree to what the service provides. Records of residents looked at, confirmed care plans are in place and developed from sound assessments ensuring residents needs had been identified and recorded. One relative of a resident recently admitted said, “We went through everything with the manager”. Residents funded by social services had been assessed by social workers with information on file for the
Stockdove House DS0000009711.V343061.R01.S.doc Version 5.2 Page 10 manager to carry out there own initial assessment to develop a care plan and ensure all health, welfare and social needs are identified and recorded. One staff member spoken to said, “We make sure we get the correct information as much as possible before resident’s are admitted”. Standard 6 was not assessed, as the home does not provide intermediate care. Stockdove House DS0000009711.V343061.R01.S.doc Version 5.2 Page 11 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 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Promotion of health is taken seriously. Resident’s welfare is monitored and health needs are identified and met. EVIDENCE: Records of resident’s looked at, were accurate and had information about their health, welfare and social care needs that supported the staff to maintain and promote each individuals daily needs. Care plans were up to date and regular reviews taking place with involvement of the residents and relatives where possible ensuring the welfare and general wellbeing of residents is continuously monitored. A Doctor wrote, “They provide a gentle caring atmosphere”. One relative stated, “I am kept informed of her situation”. Risk assessments were in place and in some cases updated to reflect any changes. One staff member spoken to said, “Risk is reviewed when changes are required”. Stockdove House DS0000009711.V343061.R01.S.doc Version 5.2 Page 12 Medication policies and procedures looked at have been updated to ensure residents are safe, however further improvements are required. Training for staff administering medicines must be undertaken on a formal basis to ensure that medicines are administered by skilled and competent staff. We looked at the storage of medicines, creams and cough syrups and found they are stored properly and in a locked cupboard. The manager should seek information and advise from their local pharmacist in relation to policies and medicines given out to residents at the home. During the visit staff were showing residents respect and privacy by helping with lunch with one individual in a sensitive manner. Staff were also observed knocking on doors and talking to residents with respect. One relative wrote, “They treat the residents with respect”. Stockdove House DS0000009711.V343061.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Meals are well managed and provide daily variation and interest for people living in the home. Activities and social events could be improved to provide stimulation for the residents. EVIDENCE: Lunchtime meals were seen being prepared, and were wholesome, home baked with fresh produce used providing a nutritious meal. Staff generally prepare meals for the residents and all have completed their Food and Hygiene training. Evidence of certificates confirmed and discussion with staff confirmed this. Comments about the standard of food and meals were positive and included. “Always plenty”, And, “If I don’t like any thing they soon offer me an alternative”. One relative visiting said, “The food looks nice, my mother is a big eater”. Care plans looked at contained information about their religious and social needs, interests, hobbies, family and social contacts. Observation and discussion during the visit confirmed the majority of the present resident group
Stockdove House DS0000009711.V343061.R01.S.doc Version 5.2 Page 14 are frail and spend most of the time watching television or sitting in the lounge area. One relative wrote, “There are no obvious forms of stimulation other than constant TV”. We spoke to the staff about resident’s social interests and hobbies, one member said, “Its difficult at times due to the frailty”. Another said, “We try and go out as much as possible”. The manager and staff should look at more ways to provide activities and trips out so all residents’ interests and hobbies are looked at and provided for as much as possible. There is a visitor’s policy, which allows friends and relatives to come any time of the day. One relative visiting said, “I can come at any time”. A member of staff spoken to said, “There are no restrictions of times to visit”. We looked in some resident’s rooms and found personal belongings are allowed into the home so to create a homely atmosphere. Stockdove House DS0000009711.V343061.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are systems for recording and reporting of complaints ensuring people feel listened to. The manager and staff have a knowledge and understanding of adult protection issues, which safeguards residents from abuse. EVIDENCE: There is a complaints procedure, which is made available to all residents on admission and written in the Statement of Purpose and Service User Guide to ensure they feel protected. Residents and relatives in surveys returned and discussion confirmed their awareness of who to complain to if they had any concerns. Comments included, “I have every confidence any concerns would be dealt with appropriately”. And, any problems I would address them directly to the manager”. There have been no complaints since the previous inspection. We looked at records and found there is a procedure and policy for dealing with allegations of abuse and safeguarding adults to protect people living at the home. One member of staff spoken to said, “ National Vocational Qualification (NVQ) training has a session dealing with abuse issues and awareness”. Stockdove House DS0000009711.V343061.R01.S.doc Version 5.2 Page 16 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 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The environment is safe, clean and maintained. However some parts of the building would look better redecorated and refurbished to make sure the residents are safe and live in pleasant surroundings. EVIDENCE: We had a walk around the building and found it to be clean and homely. Parts of the home should be redecorated and refurbished in particular some bedrooms and hallways to keep the premises pleasant for the residents to live in. Paintwork on some doors on the ground floor need repainting, carpets in bedrooms are looking worn and need replacing also some furnishings in the bedrooms of resident’s need updating in particular chairs and furniture.. One relative commented in a survey returned, “Brighter furnishings would be better, it’s in need of upgrading”. Also, one relative wrote, “The approach to
Stockdove House DS0000009711.V343061.R01.S.doc Version 5.2 Page 17 the front door is poor”. There is a rolling programme of maintenance and there are plans to redecorate the manager said, “We have plans to improve the building and install a walk in shower”. There are policies and guidance for laundry processes and for the control of infection ensuring the home is kept clean, pleasant and hygienic. Stockdove House DS0000009711.V343061.R01.S.doc Version 5.2 Page 18 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 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The procedures and checks for the recruitment of staff are not robust enough to ensure suitable staff are employed to safeguard the residents. EVIDENCE: Staff rotas and observation of the number of staff on duty at the time of the visit confirmed there were sufficient numbers to ensure the resident’s are supported and their needs are being met. Comments from residents supported this and included, “They are lovely”. And, “Staff are very caring”. A relative spoken to during the visit said, “There is always someone around”. This is mainly a family run home however there has only been one new member of staff employed since the last inspection and examination of records show recruitment procedures must be updated to ensure all required checks are in place prior to employment starting and ensure suitable staff are employed. One staff file looked at included evidence of induction training and an application form, however the application form must request a full employment history with any gaps explained, a medical declaration and two references. The Criminal Records Bureau (CRB), disclosure had been completed and evidence of qualifications on file.
Stockdove House DS0000009711.V343061.R01.S.doc Version 5.2 Page 19 Training is ongoing for staff development and staff are encouraged to attend courses to ensure they are competent and have the skills to provide the care and support for the residents. Records looked at and discussion with the manager confirm there is over 50 of care staff that has completed National Vocational Qualification (NVQ) level 2 in care. One member of staff said, “Yes I found the NVQ training useful”. One resident spoken to said, “The staff seem to know what they are doing”. Stockdove House DS0000009711.V343061.R01.S.doc Version 5.2 Page 20 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): 31,33,35 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is managed satisfactorily with systems, policies and procedures in place. However views from relatives and friends on how the home is run would benefit the residents and inform the manager where improvements could be made. EVIDENCE: There remains a recommendation for the manager, who should complete the qualifications recommended to manage a care home. The manager spoken to said, “I hope to complete the training next year”. Although this is mainly a family run home comments from residents and surveys returned spoke positively on how the home is managed. Comments included “A good level of
Stockdove House DS0000009711.V343061.R01.S.doc Version 5.2 Page 21 care”. And, “It’s clear the folk who reside there are well looked after”. A resident spoken to said, “Yes the manager is very nice and caring”. We looked at records and found regular tests to emergency lighting, fire procedures, electrical appliances and fire extinguishers had been carried out ensuring the safety of residents and staff is maintained. This is a small family run home and views are sought from residents and staff of how the home could be improved mainly on an informal basis, through discussion and visiting relatives. However feedback from relatives and friends should be sought on how the home is achieving its goals for the residents and how they feel the home could be improved. Stockdove House DS0000009711.V343061.R01.S.doc Version 5.2 Page 22 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 X X X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 3 Stockdove House DS0000009711.V343061.R01.S.doc Version 5.2 Page 23 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 OP29 Regulation 19 schedule( 2) Requirement People living at the home must feel safe and staff employed must have all recruitment checks required by legislation in place. (Timescale of 30/08/06 not met) 2 OP9 13 and 17 Only care staff that have received suitable training must administer medication to ensure that this procedure is carried out by skilled and competent staff. 30/11/07 Timescale for action 30/11/07 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 OP31 Good Practice Recommendations The registered person should complete level 4 National Vocational Qualification (NVQ) or equivalent in management and care. Stockdove House DS0000009711.V343061.R01.S.doc Version 5.2 Page 24 2 3 4 5 OP33 OP19 OP9 The views of families and friends should be sought on how the home is achieving its goals for the residents. The premises should be maintained, refurbished and redecorated for the comfort of the residents. The manager should seek advice from a pharmacist in relation to medicine policies and medication administered to residents living at the home. Resident’s interests should be recorded and they are given opportunities for stimulation, which suits their preferences. OP12 Stockdove House DS0000009711.V343061.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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
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