Inspection on 23/08/07 for Stockingate Nursing Home

This inspection was carried out on 23rd August 2007.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Stockingate Nursing Home 10/04/08

Stockingate Nursing Home 15/11/07

Stockingate Nursing Home 22/02/07

Stockingate Nursing Home 26/05/06

Similar services:

Whiteley House

Tyndale Avenue

2-10 Norfolk Road

Bennfield House Nursing Home

Eastfield Residential Home

Sign Health

Springwood

Fairburn Mews

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

CARE HOMES FOR OLDER PEOPLE Stockingate Nursing Home Stockingate South Kirkby Pontefract W Yorks WF9 3QX Lead Inspector Tony Brindle Key Unannounced Inspection 23rd August 2007 3.30pm 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 Stockingate Nursing Home DS0000066612.V340227.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. Stockingate Nursing Home DS0000066612.V340227.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stockingate Nursing Home Address Stockingate South Kirkby Pontefract W Yorks WF9 3QX 01977 648683 F/P 01977 648683 janet.db@btconnect.com 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) Helpcare Ltd vacant post Care Home 25 Category(ies) of Dementia - over 65 years of age (25), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (25) Stockingate Nursing Home DS0000066612.V340227.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd February 2007 Brief Description of the Service: Stockingate Nursing Home is registered to provide care for 25 elderly people who may have a diagnosis of dementia or other mental health problems. The home was bought from the previous owner by HelpCare Ltd in 2006. A new acting manager has been appointed but is not yet registered with the Commission for Social Care Inspection. The acting manager is supported by qualified nurses as well as care assistants. Bedrooms are mostly single, although a few double rooms remain, and are beginning to be personalised. The home does not provide en-suite facilities and, as an existing provider, is exempted from any requirement to do so. The communal facilities consist of 2 lounges, a dining room and, to the back of the home, there is an enclosed garden. The provider informed the Commission for Social Care Inspection in August 2007 that fees range from £359 to £492 per week. Additional charges include hairdressing, private chiropody and newspapers. Information about the home and the services provided are available from the home in the Statement of Purpose and Service User Guide. A copy of the most recent inspection report is available in the entrance hall. Stockingate Nursing Home DS0000066612.V340227.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit started at 3.30 pm and ended at approximately 7 pm. This was a very positive and enjoyable visit. There was the opportunity to speak to people living at the home as well as the operations manager, care staff, kitchen, office and domestic staff and the handyman. Four people’s records were seen and included assessments, care plans, daily and medical records and the record of activities. Six staff records were also seen and included application forms, references, police checks, training and supervision records. A sample of people’s medications and finances were checked and a tour of the home was undertaken. Other information considered was the home’s returned Annual Quality Assurance Assessment and returned Commission for Social Care Inspection surveys. Two people living at the home responded to our survey as well as 3 relatives and 1 healthcare professional. The feedback received was positive. The inspector would like to take the opportunity to thank the manager and her staff team for their hospitality, and people using the service and their relatives for their patience and co-operation throughout the visit. What the service does well: What has improved since the last inspection? The redecoration of parts of the home has enhanced the living conditions within the home. The cleanliness of the home has got better. Stockingate Nursing Home DS0000066612.V340227.R01.S.doc Version 5.2 Page 6 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. Stockingate Nursing Home DS0000066612.V340227.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Stockingate Nursing Home DS0000066612.V340227.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. New people are not admitted to the home without first receiving satisfactory levels of information about the home and having their needs assessed to ensure that the home is able to meet with their needs. EVIDENCE: All of the files seen contained completed pre-admission assessments and the nurse on duty explained that, wherever possible, the acting manager does the assessments herself. The files included a basic pre-admission assessment based on activities of daily living, which included past medical history as well as current needs. Feedback from people who completed our survey indicated that they were satisfied with the information they had been given about the home prior to moving in and happy about the way their move had been carried out. The home does not provide intermediate care. Stockingate Nursing Home DS0000066612.V340227.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 10 Quality in this outcome area is poor. This judgment has been made using available evidence including a visit to this service. Although the information held within assessments and care plans is satisfactory, the needs of some people have not been properly assessed, and the care plans do not sufficiently show how a person’s needs, in respect of their health and welfare, are to be met. The recording of the support people receive would enhance the ways in which care and support is offered and provided. The systems in relation to medication are not safe and this has particularly affected the overall judgment. EVIDENCE: The records show that the ways that the staff complete care plans and risk assessments is not always consistent, as some of the plans clearly identify the ways in which people need to be supported, and others do not. The plans are put together following a basic assessment and provide the basis for the care to Stockingate Nursing Home DS0000066612.V340227.R01.S.doc Version 5.2 Page 10 be delivered. Some of the plans do not set out in detail the action that needs to be taken by the care staff to make sure all aspects of people’s health, personal and social care needs are met. One person who is a diabetic did not have a risk assessment and full plan of care to show staff how to support this person with this condition. One person, who uses a frame to get around the home, did not have a complete falls risk assessment and mobility assessment. The daily records were seen to contain some good information about what people had done during the day, and information about how decisions had been made about how to spend their time. However, many did not give a full picture of the support people had received, or information about decisions that had been made by them or on their behalf. Feedback from people who completed our survey indicated that they were happy with the way their care was arranged, and one person living at the home said that the staff talk to them about their care. Feedback from people who completed our survey indicated that they were satisfied with the ways in which their healthcare needs were supported; one person living at the home said that the staff are very caring and always ask them how they would like to be looked after. The records show that the staff do make sure that doctors’ appointments and district nurse visits are arranged. The nurse on duty confirmed that this is always completed. The records show that the acting manager has in place a policy and procedure relating to the receipt, recording, storage, handling, administration and disposal of medicines. However, this is not always followed. On checking a sample of the medication, not all the records and quantities were found to be in order, with people having more medication than they should. Regular checks on the numbers of medications held by the home are not carried out, and the acting manager does not have a satisfactory system for counting loose tablets. Stockingate Nursing Home DS0000066612.V340227.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The ways in which people’s social and recreational needs are identified and met remain the same as at the last inspection. People could be supported more fully to make choices and decisions about their daily lives. EVIDENCE: A full time activities organiser is employed at the home and a programme of activities is available. The activities organiser was not on duty during the visit but care staff were seen to engage a small number of people in an activity. Photographs of a recent event held at the home were on display. The record of the various activities that people had been involved in was seen, and contained some good information. The work on developing life histories of people continues which look into their interests, hobbies and social preferences. The records show that people’s social and recreational preferences need to be included in their care plans. Stockingate Nursing Home DS0000066612.V340227.R01.S.doc Version 5.2 Page 12 Staff were seen to interact with the service users in positive ways. Staff were seen to talk to people in pleasant ways, offering them drinks and talking to them about their day. No relatives visited the home while the site visit took place. There have been some improvements in the way meals are organised with the introduction of two sittings so that staff can be available to offer assistance as needed. The lounge is now being used as the dining room, and vice versa. People living and working in the home said that this was a change for the better as the rooms are better suited to this activity, and the staff have a noticed a positive change in the way people engage with each other, both during meal times and while sitting in the new lounge. Unfortunately, due to the time that the site visit took place, meal times were not observed. Some people living at the home said that the food was good, and the menus were seen to offer people choices and variety. One staff member said that there is always enough food on the premises and a look at the pantry confirmed this. The staff member explained that food and supplies are usually ordered online via a local supermarket, and delivered twice a week. Stockingate Nursing Home DS0000066612.V340227.R01.S.doc Version 5.2 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. 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. Complaints are managed appropriately. Staff have had training on safeguarding issues, to ensure that allegations of or suspicions of abuse are reported to the manager, in order that people’s best interests promoted and their well-being are protected. EVIDENCE: The records show that there is a simple and clear complaints procedure that which includes the stages and timescales for the process. The Commission recently received an anonymous complaint, which was passed onto the service provider to investigate. The complaint centered on the following: • when people get up and go to bed; • the activities program; • the deployment of the cook to provide personal care; • meals; • an allegation that the manager left the home unattended. The acting manager undertook the investigation on behalf of the provider, and could not find any ground to substantiate any of the issues raised by the anonymous complainant. As the complaint was anonymous, the Commission was unable to go back to the complainant with the findings of the acting manager’s investigation. The records show that complaints are usually responded to and dealt with, within the appropriate timescales. The records show that there are appropriate Stockingate Nursing Home DS0000066612.V340227.R01.S.doc Version 5.2 Page 14 procedures for responding to the suspicion of, or evidence of abuse or neglect. One member of staff said that all allegations and incidents of abuse are followed up promptly and the action taken by the staff is recorded. The records confirmed this. The records held by the Commission show that since the last inspection, an allegation of abuse was made against a staff member. The allegation was that the staff member had slapped three different people in the home. The staff member has been suspended. A safeguarding meeting took place following this meeting, and the police were informed of the allegation. The Commission records show that the police are taking action against action this staff member, and a court hearing regarding this matter has been opened and adjourned in order that further evidence could be sought. Feedback from people who completed our survey indicated that they were satisfied that the staff at the home were aware of how to respond to incidents of alleged abuse. People living at the home said that felt safe and comfortable and knew who to speak to if they were unsure about a situation or the way someone was behaving. The training records show that staff have had satisfactory training in the area of safeguarding vulnerable people. Stockingate Nursing Home DS0000066612.V340227.R01.S.doc Version 5.2 Page 15 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 good. This judgement has been made using available evidence including a visit to this service. Generally, the home is clean and comfortable. EVIDENCE: Some areas of the home have been refurbished such as the dining room. The nurse on duty said that there are plans to get new furniture and the development of a sensory garden. Both of these will enhance the present environment of the home. A tour of the home was undertaken and, generally, maintenance and levels of hygiene were of an acceptable level. The lounges were clean and tidy. People living at the home said that it is easy to get round. Feedback from people who completed our survey indicated that they believed that the home is kept clean and hygienic. Laundry facilities are sited so that soiled articles, Stockingate Nursing Home DS0000066612.V340227.R01.S.doc Version 5.2 Page 16 clothing and infected linen are not carried through areas where food is stored, prepared, cooked or eaten. Appropriate hand washing facilities are available; the records show that there is an appropriate infection control policy and procedure in place. Stockingate Nursing Home DS0000066612.V340227.R01.S.doc Version 5.2 Page 17 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. Some improvement is needed to ensure that a well trained staff team supports people living in the home. EVIDENCE: Staff rotas showed that staffing levels are appropriate to meet the needs of the people living at Stockingate. A programme for staff training is in place. The records show that some staff are in need of refresher training. Induction procedures are in place and any new staff should receive the new induction in common standards in line with the Skills for Care Council. The records show that some of the induction documentation seen for staff already working in the home had not been completed. National Vocational Qualification (NVQ) training has been arranged for care staff but the target of 50 of staff holding the level 2 award is yet to be achieved. Recruitment policies and procedures are generally being followed, with three of the four staff files seen holding all of the documentation required by regulation to protect people. Stockingate Nursing Home DS0000066612.V340227.R01.S.doc Version 5.2 Page 18 On arriving at the home, the cabinet that holds all the confidential recruitment information was seen to be open. This cabinet remained open throughout the site visit, at times it was unattended. Two written references are obtained before appointing a member of staff, and any gaps in employment records are explored. The records show that new staff are confirmed in post only following completion of a satisfactory police check, and satisfactory check of the Protection of Vulnerable Adults register and Nursing register. Feedback from people who completed our survey indicated that they believed that the staff were well trained. Some of the records confirmed that staff receive training in areas such as health and safety, fire safety, movement and handling, safeguarding, and food hygiene, however, not all staff have received refresher training. Stockingate Nursing Home DS0000066612.V340227.R01.S.doc Version 5.2 Page 19 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 37 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Some good management systems are now in place at the home but this judgement is particularly affected by the potential risk to people’s safety caused by poor risk assessments, medication auditing and recording, issues surrounding confidentiality and a lack of security of people’s monies. EVIDENCE: The acting manager has been at the home for nearly 12 months but is yet to submit her application to become registered with the Commission for Social Care Inspection. There is written evidence to show that the acting manager has started to use a quality assurance system and feedback from relatives and Stockingate Nursing Home DS0000066612.V340227.R01.S.doc Version 5.2 Page 20 visiting healthcare professionals gathered during January 2007 was seen. The acting manager is yet to compile a report detailing the outcomes of the survey. Feedback from people who completed our survey indicated that they feel safe living in the home, and that they believe it is well run. The home holds small amounts of personal allowance on behalf of some of the people living in the home. The amounts of money and relevant documentation were checked and found to be correct. However, it was noted that the money tin was in the recruitment cabinet, which had been left unlocked and, at times, unattended. It is also noted here, that the safe operation of the medication system is the responsibility of the acting manager. and as errors were found when the medication was checked. Some records relating to health and safety, risk assessments and certificates relating to servicing of equipment etc, were seen during the visit. Records relating to fire safety checks had been completed. Stockingate Nursing Home DS0000066612.V340227.R01.S.doc Version 5.2 Page 21 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 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 1 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 1 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 2 x 1 1 Stockingate Nursing Home DS0000066612.V340227.R01.S.doc Version 5.2 Page 22 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 OP7 OP38 Regulation 13 Requirement Risk assessments must be properly completed. The registered person must ensure that any activities that people take part are so far as reasonably practicable free from hazards to their safety, free from avoidable risks, and that any risks to their health and safety are identified and eliminated as far as possible. Appropriate plans of care must be completed based on properly completed risk assessments. People living at the home must have a written plan showing how their needs in respect of their health and welfare are to be met. A safe system of recording, handling and administration of medication must be followed by staff at the home. Previous timescale for compliance 22/02/07. The acting manager must submit an application for registered manager, to the Commission for Social Care Inspection without DS0000066612.V340227.R01.S.doc Timescale for action 01/10/07 2 OP7 OP38 15 01/10/07 3 OP9 13(2) 01/10/07 4 OP31 9 31/10/07 Stockingate Nursing Home Version 5.2 Page 23 6 OP35 16 (2) (l) further delay. Secure facilities should be provided for the safe-keeping of money on behalf of the service user. 01/10/07 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 OP7 Good Practice Recommendations The way that the daily records are completed should be improved to make sure that a full picture is given of the support people are given, and the ways people are supported to make day to day decisions. Training should continue until at least 50 of care staff have achieved level 2 NVQ in care. Individual records and home records should be secure, and should be maintained in accordance with the Data Protection Act 1998 and other statutory requirements. 2 3 OP28 OP37 Stockingate Nursing Home DS0000066612.V340227.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Brighouse Area Team First Floor St Pauls House 23 Park Square Leeds LS1 2ND 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 Stockingate Nursing Home DS0000066612.V340227.R01.S.doc Version 5.2 Page 25 - 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. 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