Inspection on 26/05/06 for Stockingate Nursing Home

This inspection was carried out on 26th May 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 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 23/08/07

Stockingate Nursing Home 22/02/07

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 Gillian Walsh Key Unannounced Inspection 26th May 2006 10:00 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 Stockingate Nursing Home DS0000066612.V291638.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.V291638.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 01977 648683 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 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.V291638.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 9th January 2006 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 has recently been bought from the previous owner by HelpCare Ltd. A new acting manager has been appointed but is not yet registered with the Commission for Social Care Inspection. The 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 on 30/05/06 that fees range from £359 to £467 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.V291638.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. As part of this key inspection two inspectors from the Commission for Social Care inspection (CSCI) undertook a site visit to the home. The visit started at 10am and finished at 5pm. Alongside this, the service provider was asked to complete a pre-inspection questionnaire which was returned prior to the site visit. Questionnaires were sent to service users, their relatives, visiting professionals and GPs. 6 service user, Management/Health & Social Care were received back but these had all been completed by staff as CSCI were informed that none of the service users had capacity to complete them independently. Of the 25 relatives questionnaires sent out, 17 were returned. Of the 11 General practitioner sent, 4 were returned, 1 of the 2 district nurse surveys was returned and 3 of the 11 social worker questionnaires 1 were returned. None of the questionnaires returned gave any comment other than the ticking of the boxes. None of the questionnaires raised any issues with the provision of service and all appeared satisfied. In writing this report, information and evidence was not only obtained by way of visiting the home but information and evidence was obtained from notifications and information obtained by CSCI and from the last CSCI inspection report. In gathering evidence, CSCI undertook case tracking, reviewed documentation, sought feedback from service users and their families, staff, the acting manager and other relevant stakeholders, and undertook relevant observations and discussions appropriate to needs of the service users, taking into account their needs and communication needs. Inspectors would like to thank residents and staff for their time and assistance during this inspection. Stockingate Nursing Home DS0000066612.V291638.R01.S.doc Version 5.2 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. Stockingate Nursing Home DS0000066612.V291638.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.V291638.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3. Standard 6 (intermediate care) is not provided at the home. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. The current Service User Guide and Statement of Purpose do not give prospective residents and their families accurate information about the home although the systems operated by the home ensure that people move into the home after having had their needs assessed and are assured that these will be met. EVIDENCE: Copies of the home’s Statement of Purpose and Service User Guide were seen during the site visit. Both of these documents still contained the details of the previous owner and the previous acting manager. None of the current residents were able to say whether they had received this information. The sample of care records audited confirmed that residents recently admitted to the home had been assessed prior to admission. Discussion took place with the acting manager about how these assessments could be developed to Stockingate Nursing Home DS0000066612.V291638.R01.S.doc Version 5.2 Page 9 include outlines of prospective residents’ abilities as well as their areas of need. Stockingate Nursing Home DS0000066612.V291638.R01.S.doc Version 5.2 Page 10 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, 9 and 10 Quality in this outcome area is poor. This judgement has been made from evidence gathered both during and before the visit to this service. Care plans do not fully reflect residents’ needs although health care needs appear to be met appropriately. Staff are not always respectful of residents’ needs in relation to dignity. Systems in relation to medication are not safe and this has particularly affected the overall judgement. EVIDENCE: The sample of care records audited showed that residents’ health and personal care needs are set out in individual plans of care. Some of the plans seen did not give full detail of how the need could be met. An example of this is where one resident had a care plan detailing their problems with mobility and that they were at risk when mobilising alone. The care plan did not detail how the person could be assisted to mobilise safely and, throughout the day, staff were observed to be sitting this person back in the chair each time they attempted to stand or mobilise. Another care plan described the resident as a “management problem” and stated that behaviour should be controlled by use Stockingate Nursing Home DS0000066612.V291638.R01.S.doc Version 5.2 Page 11 of medication. Care plans are signed as reviewed on a monthly basis although one of the care plans seen, which was signed as reviewed, did not reflect the changing needs of the resident despite a marked deterioration in their physical health and abilities. None of the care plans seen gave detail of residents’ social or spiritual care needs. One of the residents being case tracked said that they very much enjoyed horse racing and football and was looking forward to the World Cup, and had been an active member of an ex-service persons’ club. None of this information had been recorded within the care plan file. Little is documented within the care plans about residents’ choice or their ability to make decisions. Daily records do not support the care plans and gave little idea of the residents’ activities during the day with the statement “all cares given” being made several times by staff. Some risk assessments were seen within the care plan files audited. These were scant and did not appear to be being reviewed. Evidence is available within the care plan files that residents’ health care needs are being met appropriately with visits from GPs, district nurses, chiropodists etc all being documented. Medications are not being managed safely. Out of the five residents’ medications audited, a number of anomalies were found. One resident’s medication had not been booked in correctly at all and therefore could not be audited accurately although it appeared that mistakes had been made with administration. Examples of this are where 14 tablets had been signed as given, only 12 tablets remained in the box. As 28 tablets had been issued, this left 2 tablets unaccounted for. Another resident had been without one of their medications for at least 5 days as this was out of stock and again the amount available did not tally with the amount given. Improvements have been made in the way staff support residents to meet their privacy and dignity needs. All residents now have their own toiletries and appear to be receiving good support with their needs in respect of personal hygiene and dressing. However, staff were observed, on a number of occasions,to be inconsiderate of residents’ dignity in their interactions. This included walking away when a resident was asking a question, speaking about the resident in their presence and not being aware of residents’ needs at mealtimes. Stockingate Nursing Home DS0000066612.V291638.R01.S.doc Version 5.2 Page 12 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, 14 and 15. Quality in this outcome area is adequate. This judgement has been made from evidence gathered during, before and since the visit to this service. There are some improvements in meeting residents’ social, religious and recreational needs although residents could be supported more fully to make choices and decisions within their daily lives. Current arrangements at mealtimes do not fully meet with residents’ needs EVIDENCE: The new acting manager said that a new programme of activities had recently been introduced at the home. This was seen on notice boards and detailed a range of activities for residents to take part in. Some discussion took place with the acting manager about the appropriateness of including in the programme evening activities described as personal care such as bathing. The acting manager said that this programme was in its infancy and was still being changed and developed. Some record had been made of activities held and whether the resident had enjoyed them but this needs to be individualised and developed. Although this programme is available, the activities organiser was not on duty and, other than the television, none of the residents were observed to be taking part in any meaningful activity until this was suggested by the inspector. Stockingate Nursing Home DS0000066612.V291638.R01.S.doc Version 5.2 Page 13 As described in the “health and personal care” section of this report, very little is documented within residents’ care plans about their individual needs and preferences in relation to their social, cultural, religious and recreational needs. When asked about the religious needs of the residents, the acting manager was unaware of any specific need but information received since the site visit indicates that one of the residents may have such needs which, as part of the assessment process, staff should be aware of. All of the relatives’ questionnaires received by the Commission indicated that relatives are made welcome to the home and are able to make their visit in private if they wish. Little evidence is available within documentation to demonstrate that residents are helped to exercise choice and control over their lives. Most of the residents at the home were unable to say whether or not their needs in this area were being met but one person said that what they wanted to do most was go out for a walk. No record was available to show that this had happened but the acting manager said that he was sure that the activities organiser would take this person out for a walk. During the lunchtime meal some residents were asked what they would like to eat, others were not. One person was given a verbal list of the meal options by a carer who said as an aside to the inspector “she won’t remember all this”. The person did not answer immediately so the carer said they would choose for her. When the inspector gave the person the options in a clear and simple way, the person was able to say what they would like to eat. Several residents were struggling to eat without assistance and others were observed to be sitting with their meal in front of them for over 30 minutes before assistance was given. Other residents were observed not to have been provided with the cutlery they needed to meet with their abilities. The mealtime experience was very disorganised and not a pleasant experience for many of the residents. Discussion took place with staff and the acting manager about how mealtimes could be better organised to ensure that residents received the assistance they need in order to enjoy their meals. The lunchtime meal was an option of fish cakes, fish fingers or beef burgers in gravy served with chips, mashed potato, mushy peas and parsley sauce. The meal looked appetising and well cooked. One resident described this as “kiddy food” and was observed not to eat much of the meal. The acting manager said that he was in the process of reviewing the menus with the cook. Stockingate Nursing Home DS0000066612.V291638.R01.S.doc Version 5.2 Page 14 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. Quality in this outcome area is adequate. This judgement has been made from evidence gathered during, before and since the visit to this service. The systems operated by the home ensure that people can raise concerns and complaints although, in order for people to have correct information, the home’s own policy and procedure is in need of updating. Residents may not be fully protected as not all staff are aware of the procedures in place to protect people from abuse. EVIDENCE: No complaints have been received by the home since the last inspection. The complaints procedure needs to be updated to reflect the change in ownership and management of the home and also details of how to make complaints via the Local Authority. Only 3 of the 17 relatives’ feedback cards received indicated that they unaware of the home’s complaints procedure and none said that they had ever had to make a complaint. Certificates were in place for several staff who had received training in Protection of Vulnerable Adults in July of last year. The acting manager was unsure of the local procedures in relation to referring possible vulnerable adult situations although a copy of Wakefield Metropolitan District Council’s vulnerable adult policies and procedures are available in the home. Stockingate Nursing Home DS0000066612.V291638.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 at least once during a 12 month period. 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 from evidence gathered during the visit to this service. Residents live in a safe, well maintained and clean environment. EVIDENCE: Several improvements to the environment have been made recently. Redecoration has taken place in some communal areas of the home and in residents’ bedrooms. The acting manager said that more refurbishment and redecoration is planned to both the interior and exterior of the home. All areas of the home were clean and tidy with no unpleasant odours present. This is a marked improvement and all staff, especially the cleaning staff, should be congratulated on their efforts. Stockingate Nursing Home DS0000066612.V291638.R01.S.doc Version 5.2 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): 27, 28, 29 and 30. Quality in this outcome area is poor. This judgement has been made from evidence gathered during the visit to this service. Residents’ needs are not always being met with current staffing arrangements. Recruitment processes are good but resident care could be adversely affected by the current poor levels of staff training and induction. EVIDENCE: From observing the lunchtime meal, it was evident that there are insufficient staff at this time, with the current organisation of the mealtime, to meet with residents’ needs. The acting manager also said that he had some concerns about only three staff on night duty as bedrooms are situated over two floors. Some training has been organised for staff including health and safety, food hygiene and all of the qualified staff have been enrolled on a vocation related course and safe handling of medications. Only 1 of care staff have NVQ level 2 but the acting manager said that a programme of enrolling care staff onto this course is to begin very shortly. The acting manager is also looking toward introducing the skills for care induction package at the home. Recruitment procedures are good and all relevant documentation was held within staff files. The acting manager was advised to ensure that staff references are from an appropriate source other than just a colleague of the applicant. Stockingate Nursing Home DS0000066612.V291638.R01.S.doc Version 5.2 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): 31, 33, 35, and 38. Quality in this outcome area is good. This judgement has been made from evidence gathered during the visit to this service. A quality assurance programme has been put in place, the outcomes of which should ensure that the home is run in the best interests of the residents. Residents’ financial and health and safety interests are protected by systems operated in the home. EVIDENCE: The acting manager has only been at the home for a number of weeks. He is yet to submit his application to become registered with the Commission for Social Care Inspection. Stockingate Nursing Home DS0000066612.V291638.R01.S.doc Version 5.2 Page 18 The acting manager said that he had started to use a quality assurance system and is already obtaining feedback from staff and visitors to gain their views about the home. He said that, when he had completed this process, he would compile a report and distribute it accordingly, including the Commission. The home holds small amounts of personal allowance on behalf of some of the residents. The amounts of money and relevant documentation were checked and found to be correct. The acting manager said that two members of staff have recently been made health and safety representatives and, on the day of the inspection, a health and safety audit had been organised. Records relating to health and safety, including fire training, risk assessments and certificates relating to servicing of equipment etc, were seen to be in place as required. Systems in place for infection control and dealing with accidents within the home have improved. Stockingate Nursing Home DS0000066612.V291638.R01.S.doc Version 5.2 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 2 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 1 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score N/A X 3 X 3 X X 3 Stockingate Nursing Home DS0000066612.V291638.R01.S.doc Version 5.2 Page 20 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 OP1 Regulation 4, 5. Requirement The registered person must ensure that the Statement of Purpose and Service User Guide are updated to reflect up to date information about the home. A safe system of recording, handling and administration of medication must be followed by staff at the home. (The home has not complied with the previous timescales of 27 May 2005 and 30th November 2005) At all times suitably qualified, competent and experienced persons are working in the care home in such numbers as are appropriate for the health, safety and welfare of service users. The registered person must ensure that staff receive training appropriate to the work they are to perform; (including structured induction training) and the registered person should ensure that a training plan is developed and put in place. (The home has not complied DS0000066612.V291638.R01.S.doc Timescale for action 30/06/06 2 OP9 13(2) 26/05/06 3 OP27 18(1)(a) 30/06/06 4 OP30 18 (1)(c)(i) 30/08/06 Stockingate Nursing Home Version 5.2 Page 21 with the previous timescale of 30th November 2005) 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 OP14 OP12 Good Practice Recommendations Care plans should give good detail in relation to residents needs. This should include social and spiritual needs. And • New care plans should be developed to reflect changing needs. • Should reflect resident’s individual preferences. • Daily records should reflect the care described within the care plan. All staff should be instructed on and reminded that residents must be treated with respect at all times. Mealtimes should be organised to ensure that all residents are given the time and assistance they need to receive and enjoy their meal. Time should be taken to ensure that wherever possible residents are given choice of food, this may be helped by the use of picture menu’s. All staff should be aware, through training, of the homes and local systems for the protection of vulnerable adults. Staff training should continue and should include training to NVQ level 2 for care staff. 2 3 OP10 OP15 4 5 OP18 OP30 Stockingate Nursing Home DS0000066612.V291638.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Brighouse Area Office Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB 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. Extracts may not be used or reproduced without the express permission of CSCI Stockingate Nursing Home DS0000066612.V291638.R01.S.doc Version 5.2 Page 23 - 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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