Inspection on 19/10/05 for Stocks Hall

This inspection was carried out on 19th October 2005.

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

Stocks Hall 11/12/07

Stocks Hall 26/01/07

Stocks Hall 24/03/06

Stocks Hall 24/02/05

Stocks Hall 13/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE STOCKS HALL 76A Nursery Avenue Nursery Lane Ormskirk L39 2DZ Lead Inspector Vivienne Morris Announced 19 October 2005 09:30am 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 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. STOCKS HALL F57 F08 S5909 Stocks Hall (Ormskirk) V246146 191005 Stage 0.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Stocks Hall Address 76a Nursery Avenue Nursery Lane Ormskirk Lancashire L39 2DZ 01695 579842 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Stocks Hall Care Homes Limited Mrs Ann Williams Care Home 45 Category(ies) of DE(E) Dementia - over 65 (27) registration, with number OP Old Age (18) of places STOCKS HALL F57 F08 S5909 Stocks Hall (Ormskirk) V246146 191005 Stage 0.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: This home is registered for a maximum of 45 service users to include: Up to 18 service users in the category OP (Old age, not falling within any other category) needing personal care only. Up to 27 service users in the category DE(E) Dementia (service users who are over 65 years of age) needing personal care only. The registered person must at all times, employ a suitably qualified and experienced manager who is registered with the National Care Standards Commission. Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any which may be issued through the National Care Standards Commission regarding staffing levels in care homes. Date of last inspection 24 February 2005 Brief Description of the Service: Stocks Hall care home provides 24-hour personal care and accommodation for the elderly and people who have care needs associated with dementia. Stocks Hall is owned by Stocks Hall Care Homes Limited and is one of four homes managed by the company. The home is situated in a quiet area of Ormskirk, close to the town centre, near to shops, pubs and post office. Ample car parking is available at the front entrance with garden areas and a larger garden at the rear of the home. The premises is a two storey “purpose-built” property. Bedroom accommodation is on both floors. All bedrooms are single and several of these rooms have an en-suite facility. Lounge and dining rooms are also located on both floors. There is a passenger lift. Accessible toilets and bathrooms are located on both floors near to bedroom and living rooms. STOCKS HALL F57 F08 S5909 Stocks Hall (Ormskirk) V246146 191005 Stage 0.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was conducted over one day during October 2005. The inspection process focused on the outcomes for people living at the home. During the course of the inspection service users, relatives and staff were spoken to, relevant records and documents were examined and a tour of the premises took place, when a random selection of private accommodation was viewed and all communal areas and service areas were seen. The registered person had addressed all the requirements and recommendations from the previous inspection and only one requirement was made at this inspection, which is commendable. The Commission for Social Care Inspection had received one complaint just prior to this inspection, which was investigated during the inspection process. One family raised some concerns with the inspector at the time of the inspection, which were discussed with the registered manager, who will look into the concerns raised and respond in writing to the family and the Commission for Social Care Inspection. What the service does well: Service users had been appropriately assessed prior to admission in order to establish the level of care required and to determine if the home could adequately meet the assessed needs. Those living at the home had access to external professionals as required, who were involved in the care of the resident to ensure that health care needs were being met. Mealtimes were generally well managed and service users spoken to confirmed that the food was always enjoyable. The home was being well managed and complaints were appropriately addressed in accordance with the policies and procedures of the home. Service users were living in a safe, well-maintained environment. The grounds of the home were pleasant and kept in a tidy manner. The ratio of care staff to service users was being calculated in accordance with the dependency levels of those living at the home to ensure that a sufficient number of staff were on duty to meet the needs of the service users. The views of service users, family and stakeholders in the community had been sought to establish how the service was achieving its goals for service users.. STOCKS HALL F57 F08 S5909 Stocks Hall (Ormskirk) V246146 191005 Stage 0.doc Version 1.40 Page 6 The registered manager ensured safe working practices within the home and ensured the health and safety of service users and staff. What has improved since the last inspection? What they could do better: The plans of care must be more detailed, providing staff with clear guidance as to how individual assessed needs are to be met, including personal and social care needs. The plans of care should be reviewed on a monthly basis or more often if required to ensure that changing needs of those living at the home are consistently met. Risk assessments should be more detailed so that staff are aware of action required to reduce or eliminate any risk factors. Liquidised diets should be presented in a more appealing manner in order to maintain appetite and nutrition and staff should offer assistance with eating in a discreet and sensitive manner. The registered person should address the outstanding recommendation made by the Environmental Health Officer to promote good practice policies. The registered person should further develop monitoring of the quality of service provided, including internal audit control and the implementation of an annual development plan. STOCKS HALL F57 F08 S5909 Stocks Hall (Ormskirk) V246146 191005 Stage 4.doc Version 1.40 Page 7 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. STOCKS HALL F57 F08 S5909 Stocks Hall (Ormskirk) V246146 191005 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection STOCKS HALL F57 F08 S5909 Stocks Hall (Ormskirk) V246146 191005 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 Service users had been appropriately assessed prior to admission to ensure that the home could adequately meet individual needs. EVIDENCE: The inspector ‘tracked’ the care of three service users during the course of the inspection. Service users had been appropriately assessed by the home prior to admission to ensure their needs could be fully met, in accordance with standard 3.3 of the National Minimum Standards for Care Homes for Older People. One service user who was funded by the local authority and whose file was examined, showed that the registered person had obtained a Care Management assessment and care plan to determine the level of care required and to establish how assessed needs could be met. Plans of care had been developed for each service user, which had been generated from the information obtained through the pre-admission assessment process. STOCKS HALL F57 F08 S5909 Stocks Hall (Ormskirk) V246146 191005 Stage 4.doc Version 1.40 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 standard(s) 7 and 8 Staff had not been provided with sufficient information as to how personal and social care needs were to be met. Service users’ health care needs were being fully met. EVIDENCE: Plans of care had been developed for all three residents whose care was ‘tracked’ at the time of the inspection. However, more specific details must be provided to ensure that staff are aware of exactly how to support service users in meeting their individual assessed needs, in relation to personal and social care. Although the plans of care had been spasmodically reviewed, this process had not been conducted at monthly intervals or more often if required to ensure that changing needs of residents were being adequately met. The resident or their representative had been involved in the care planning process, therefore they had been offered the opportunity to have some input into the care provided. A variety of risk assessments had been conducted. However, these should be more detailed in relation to the action, which staff need to take in order to reduce or eliminate the potential risk factor. STOCKS HALL F57 F08 S5909 Stocks Hall (Ormskirk) V246146 191005 Stage 4.doc Version 1.40 Page 11 The care records of one service user with a pressure wound were examined. Wound care was being carried out by the District Nursing Services, which was referred to in the plan of care and appropriate pressure relieving equipment had been provided in order to promote the healing process. The registered manager had sought advice from a variety of external professionals and the plans of care incorporated individual health needs to ensure that health care needs were being fully met. Staff were seen to be attending to service users needs in a professional and competent manner. STOCKS HALL F57 F08 S5909 Stocks Hall (Ormskirk) V246146 191005 Stage 4.doc Version 1.40 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 standard(s) 12 and 15 The plans of care did not demonstrate that those living at the home were supported to continue their interests and hobbies. Mealtimes were generally well managed, providing a relaxed environment for service users to enjoy their meals. EVIDENCE: The care records for individuals were well written and although these included specific interests and preferences of people living at the home, this information had not been transferred onto the plans of care to ensure that residents were supported to continue with their interests and hobbies. The routines of daily living were evidently as flexible as possible and freedom\of movement within the home was noted. One service user commented ‘I can get up and go to bed when I want to, I just need to ring my bell and the staff will come straight away to help me.’ The plan of care for one service user with religious needs did not demonstrate that this person was being supported to continue with their religious observance. However, the service user confirmed that their religious needs were being fully met. Social relationships were recorded in the care files and the service users’ guide informed readers that service users were encouraged and supported to STOCKS HALL F57 F08 S5909 Stocks Hall (Ormskirk) V246146 191005 Stage 4.doc Version 1.40 Page 13 maintain social relationships. Service users were able to entertain visitors in their own rooms if they so wished, promoting privacy for those concerned. An activities co-ordinator was employed at the home and a routine programme of activities was in place to ensure that those living at the home were stimulated, although participation in activities was not compulsory. Trips out were arranged, using the company mini bus and records of participation were retained to monitor the success of events and to ensure that people did not become isolated. One person living at the home said ‘the activities girl is very good, there is plenty going on and there are regular trips out.’ The inspector observed meals being served at lunchtime. Specialised aids to help individuals eat their meals were provided therefore independence with meals was being encouraged. The service users spoken to confirmed that the food was always enjoyable and the menu showed that a variety of meals were served. Records were available about individual diets and staff were seen to be aware of residents’ dietary needs and preferences, which ensured that service users received a nutritional diet in accordance to their needs. One service user stated ‘ the food is always very good. We get plenty to eat.’ Nutritional risk assessments had been conducted in conjunction with the dietician and dietetic advice had been sought as required. The inspector noted that the liquidised diets were not presented in a manner which was attractive and appealing in terms of appearance in order to maintain appetite and nutrition. The registered manager informed the inspector that individual food moulds had been ordered to promote the appearance of the liquidised diets. Staff were seen to be offering assistance in eating where necessary, although it would be more relaxing for those needing assistance if staff were to sit with the service user, whilst assisting to eat, rather that standing next to them. STOCKS HALL F57 F08 S5909 Stocks Hall (Ormskirk) V246146 191005 Stage 4.doc Version 1.40 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 standard(s) 16 Complaints were being well managed. EVIDENCE: There was a simple, clear complaints procedure in place, telling people of how they could make a complaint should they wish to do so. This procedure also told people that they could make a complaint to the Commission for Social Care Inspection at any stage, should they wish to do so. A record had been retained of complaints made to the home and the investigation conducted was clearly documented. Complainants had been responded to within appropriate timescales, as indicated in the home’s written procedure. STOCKS HALL F57 F08 S5909 Stocks Hall (Ormskirk) V246146 191005 Stage 4.doc Version 1.40 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 standard(s) 19 Service users live in a safe, well-maintained environment. EVIDENCE: STOCKS HALL F57 F08 S5909 Stocks Hall (Ormskirk) V246146 191005 Stage 4.doc Version 1.40 Page 16 The inspector toured the premises during the course of the inspection, viewing the communal areas of the home and a number of randomly selected service users’ bedrooms. The registered person had developed an up to date programme of routine maintenance for the home to demonstrate future planning for the renewal of the fabric and decoration of the premises. The grounds of the home were maintained in a tidy, safe and attractive manner, which allowed access to sunlight and were accessible to service users. The home was designed in a comfortable and homely way and service users confirmed that they were happy with the environment and their surroundings, one service user stating’ I like my room, it is very cosy.’ The fire officer had not visited the home since the previous inspection. However, fire records examined were found to be satisfactory. The Environmental Heath Officer had inspected the premises since the previous inspection and had made two recommendations, one of which had been addressed, the other of which was in the process of being addressed. STOCKS HALL F57 F08 S5909 Stocks Hall (Ormskirk) V246146 191005 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 28. The skill mix of staff was appropriate to the needs of those living at the home. Service users felt safe and secure at all times. EVIDENCE: The inspector examined the staff rotas, which demonstrated that a range of staff with mixed skills and qualifications were employed at the home and the staff rota showed which staff were on duty at any one time and in what capacity each was employed to ensure that the needs of service users were being met by appropriately trained care staff. The ratios of care staff to service users were being determined according to the assessed needs of service users and a system was operated for calculating staff numbers required, in accordance with guidance recommended by the Department of Health. All night staff were on waking watch and staff providing personal care to service users were all above the age of 18years. Staff left in charge of the home were all above the age of 21years. At the time of the inspection the home was clean, tidy and pleasant smelling. There were sufficient ancillary staff identified on the duty rota. At the time of the inspection there were 25 care staff employed at the home, with 52 having completed a National Vocational Qualification at level 2 or STOCKS HALL F57 F08 S5909 Stocks Hall (Ormskirk) V246146 191005 Stage 4.doc Version 1.40 Page 18 above. One service user stated ‘the staff are very friendly and will do anything for me.’ STOCKS HALL F57 F08 S5909 Stocks Hall (Ormskirk) V246146 191005 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33 and 38 The home was being well managed by an appropriately qualified person. The quality of service provided was regularly monitored. The health, safety and welfare of service users and staff was protected and promoted. EVIDENCE: The registered manager had been in post for a period of five years, during which time it was evident that she had undertaken a variety of relevant training courses, including a National Vocational Qualification at level 4 and the Registered Managers Award, demonstrating that she is competent to manage the care home. Discussion with the manager and staff demonstrated a clear commitment to health and safety issues and a number of safe working practices were verified at the time of inspection, which demonstrated that people living and working at the home were adequately protected. The home had achieved the Investors in People award and was therefore STOCKS HALL F57 F08 S5909 Stocks Hall (Ormskirk) V246146 191005 Stage 4.doc Version 1.40 Page 20 checked by an independent body to show how the service was meeting its goals. The registered person had developed a system to formally obtain the views of service users, relatives and stakeholders in the community about the quality of service provided, the results of which were published in the home’s newsletters. The registered manager had commenced some audits to show that the quality of service was being regularly monitored. However, the auditing process should be further developed to ensure that the service is of a satisfactory standard for those living at the home. The written policies and procedures of the home had been reviewed regularly and updated as needed in accordance with changing legislation and good practice guidelines. An annual development plan should be implemented, reflecting the outcomes for those who live at Stocks Hall to ensure that to demonstrate that forward planning has been taken into consideration. The inspector found that all required checks and services had been conducted on equipment and systems demonstrating that the registered manager ensured safe working practices within the home and ensured the health and safety of service users and staff. All accidents and injuries were appropriately recorded. RIDDOR incidents were reported to the Health and Safety Executive. However, although the accident book complied with the Data Protection Act 1998, it was not being used in the appropriate manner to ensure confidentiality of personal data. STOCKS HALL F57 F08 S5909 Stocks Hall (Ormskirk) V246146 191005 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 2 COMPLAINTS AND PROTECTION 2 x x x x x x x STAFFING Standard No Score 27 3 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 x 2 x x x x 2 STOCKS HALL F57 F08 S5909 Stocks Hall (Ormskirk) V246146 191005 Stage 4.doc Version 1.40 Page 22 NO 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 7, 12 Regulation 15(1) Requirement More specific details must be provided within the plans of care to ensure that staff are aware of exactly how to support service users in meeting their individual needs, including personal and social care needs. Timescale for action 15.12.05 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. 2. 3. 4. 5. 6. Refer to Standard 7 7 15 15 19 33 Good Practice Recommendations The plans of care should be reviewed at monthly intervals or more often if required to ensure that changing needs of residents are being adequately met. Risk assessments should be more detailed in relation to the action which staff need to take in order to reduce or eliminate the potential risk factor. Liquidised diets should be presented in an attractive manner to maintain appetite and nutrition. Staff should offer assistance with eating in a discreet and sensitive manner. The registered person should address the outstanding recommendation made by the Environmental Health Officer in February 2005. The registered person should implement an annual F57 F08 S5909 Stocks Hall (Ormskirk) V246146 191005 Stage 4.doc Version 1.40 Page 23 STOCKS HALL 7. 8. 33 38 development plan, based on a systematic cycle of planning, action and review, reflecting the aims and outcomes for service users. Audits for monitoring the quality of service provided should be further developed. The accident records should be used in accordance with the Data Protection Act 1998. STOCKS HALL F57 F08 S5909 Stocks Hall (Ormskirk) V246146 191005 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Levens House Ackhurst Business Park Foxhole Road Chorley PR7 1NW 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 STOCKS HALL F57 F08 S5909 Stocks Hall (Ormskirk) V246146 191005 Stage 4.doc Version 1.40 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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