Inspection on 16/06/05 for Stocks Hall Nursing Home

This inspection was carried out on 16th June 2005.

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

Stocks Hall Nursing Home 05/12/06

Stocks Hall Nursing Home 06/12/05

Stocks Hall Nursing Home 16/11/04

Stocks Hall Nursing Home 16/06/04

Stocks Hall Nursing Home 25/02/04

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 Nursing Home Stocks Hall 249-251 Liverpool Road South Burscough Ormskirk, Lancashire, Lead Inspector Vivienne Morris Unannounced 16 June 2005 09:30 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 Nursing Home F57 F08 S25578 Stocks Hall (Burscough) V235144 160605 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Stocks Hall Nursing Home Address Stocks Hall 249-251 Liverpool Road South Burscough Ormskirk Lancs 01704 895667 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 Mrs Janet Molyneux Care Home 52 Category(ies) of DE Dementia - over 65 (7) registration, with number OP - Old Age (52) of places PD - Physical Disability (4) Stocks Hall Nursing Home F57 F08 S25578 Stocks Hall (Burscough) V235144 160605 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Up to 52 service users in the category of OP who need nursing care. 2. Up to 8 service users in the category of OP who need personal care only. 3. Up to 7 service users in the category of DE(E) who need nursing care. 4. Up to 4 service users in the category PD. 5. The service should, at all times, employ a suitably qualified and experienced manager who is registered with the National Care Standards Commission. Date of last inspection 16.11.04 Brief Description of the Service: Stocks Hall Care Home is located in a residential area of Burscough, within walking distance of the village centre. The home is registered to accommodate up to 52 elderly service users requiring personal or nursing care. There are also a number of places available for those service users who have care needs associated with a diagnosis of Dementia. Accommodation is situated on two floors, serviced by a passenger lift, enabling access to all areas of the home for those who are less mobile. A 4-bedded rehabilitation unit is located on the first floor. Lounge areas and dining facilities are provided on both floors of the home. Service users’ private accommodation is provided mainly in single rooms. However, two shared rooms are available for married couples, companions or those who prefer to share facilities. Although en-suite facilities are not provided at Stocks Hall, toilets and bathing facilities are located at convenient intervals throughout the home. Stocks Hall Nursing Home F57 F08 S25578 Stocks Hall (Burscough) V235144 160605 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted over one day during June 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 Commission for Social Care Inspection had not received any complaints about this service since the last inspection. What the service does well: What has improved since the last inspection? The policies and procedures of the home in relation to death and dying had been reviewed and improved since the last inspection. The dignity of residents has improved by the removal of notices displayed in their bedrooms in relation to personal care. The storage of external preparations has improved, as at the time of the inspection they were stored securely. Stocks Hall Nursing Home F57 F08 S25578 Stocks Hall (Burscough) V235144 160605 Stage 4.doc Version 1.40 Page 6 The system for the collection of clinical waste has improved as the amount of waste collected was being recorded. 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. Stocks Hall Nursing Home F57 F08 S25578 Stocks Hall (Burscough) V235144 160605 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Stocks Hall Nursing Home F57 F08 S25578 Stocks Hall (Burscough) V235144 160605 Stage 4.doc Version 1.40 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 standard(s) 3 and 6 The residents’ needs had been well assessed before admission to ensure that staff were able to give appropriate care and support. Those admitted for intermediate care were encouraged to maintain their independence to enable them to return home. EVIDENCE: The care of four people living at the home was ‘tracked’ during the course of the inspection, so that the inspector could determine if service users needs had been assessed prior to admission and if appropriate care was being delivered to meet these needs. The information obtained by the home prior to admission involved the resident and was detailed, providing staff with a clear picture of individual assessed needs so that the resident could be assured that the home was able to appropriately meet their needs. One service user stated “I am very content living here’. The service user accommodated on the rehabilitation unit had also been assessed by the social worker prior to admission, a copy of which was in the Stocks Hall Nursing Home F57 F08 S25578 Stocks Hall (Burscough) V235144 160605 Stage 4.doc Version 1.40 Page 9 care records. This resident’s plan of care was based on the combined information obtained from the two assessments. Assessments from the social worker had not been obtained for the other two residents whose records were seen, therefore the needs of these people had not been established prior to the home conducting their own assessment, although their plans of care had been based on the information obtained by the home prior to admission. For those receiving nursing care an NHS registered nurse had conducted an assessment to determine the level of funding required. Dedicated accommodation is provided for those requiring rehabilitation so that their programmes are individualised and undisturbed. The rehabilitation unit includes a lounge and dining area, bathroom, shower and toilet to allow privacy and dignity. Identified staff were allocated to this four bedded unit, who had received specific training in relation to rehabilitation so that these people received the care they required. Appropriate equipment for rehabilitation purposes was available for service users to aid in their rehabilitation programmes. Qualified nurses were always on duty at Stocks Hall, allowing rehabilitation staff to seek professional advice, as required. The occupational therapist and physiotherapist provided specific training for staff working on the rehabilitation unit, which involved appropriate supervision and competence monitoring to ensure that staff had the ability to use techniques for rehabilitation including the promotion of mobility, continence and self-care, and programmes to reestablish community living. Staff spoken to informed the inspector that they had a good rapport with external professionals who visited the home. The physiotherapist, occupational therapist and district nurse were on the rehabilitation unit at the time of the inspection. One resident informed the inspector that those accommodated on the rehabilitation unit were able to visit friends on the other units within the home as they wished. Stocks Hall Nursing Home F57 F08 S25578 Stocks Hall (Burscough) V235144 160605 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, 8, 9 and 11. Clear guidance was provided for staff to ensure that the health, personal and social care needs of those living at Stocks Hall was fully met. The residents were not protected by the medication procedures in place at the home. EVIDENCE: The plans of care for all four residents were very informative, providing staff with a clear picture of the individual health, personal and social care needs of those living at the home and how these assessed needs were to be met, including supporting independence where possible. The plans of care were regularly reviewed and updated to ensure that changing needs of residents were also met. There was no evidence available to demonstrate that the resident or their representative had been involved in the care planning process, therefore they had not been offered the opportunity to have some input into the care they were receiving. One resident was seen to be asleep at the dining table at 2.20pm, with an apron on and an empty dish on the table. This did not promote the dignity of this particular resident. At the time of the inspection there were two residents with pressure wounds. Wound care was found to be well managed and external professional advice had been sought to promote healing. Appropriate equipment had been Stocks Hall Nursing Home F57 F08 S25578 Stocks Hall (Burscough) V235144 160605 Stage 4.doc Version 1.40 Page 11 provided in accordance with the plan of care in order to promote pressure relief. The registered manager had sought advice from a variety of external professionals and a wide range of risk assessments had been conducted in order to improve the quality of care for those living at the home and to ensure their continued health and safety. One resident stated “they(the staff) do their best for you”. At the time of the inspection there were no residents who were managing their own medications, although a system was in place to safeguard those who preferred to self-medicate, should the need arise. The system in place for the management of medications needs to be improved. Any hand written transcriptions should be signed, checked and countersigned by a second staff member in order to reduce the risk of medications being wrongly administered. The medication administration records should be signed when topical preparations, such as prescribed creams and ointments are applied to ensure that residents receive prescribed treatments. Records must be maintained of medications returned to the supplier, to reduce the possibility of any mishandling. Care staff working on the rehabilitation unit had received medicines management training to ensure their competence in the control of medicines on the unit. The policies and procedures in relation to death and dying had been reviewed since the previous inspection and now demonstrated that care and comfort would be given to a resident who is at the end of their life and that their death would be handled with dignity. Stocks Hall Nursing Home F57 F08 S25578 Stocks Hall (Burscough) V235144 160605 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) 13. Those living at the home were encouraged and supported to maintain contact with relatives, friends and the local community. EVIDENCE: The inspector observed that visitors were made welcome to the home and those visiting at the time of the inspection confirmed this. A detailed visitors policy was in place, a summary of which was included in the service users’ guide, identifying that residents could entertain their visitors in the privacy of their own room, if they preferred and that visiting was unrestricted unless the resident wished otherwise. The involvement of local groups and outside entertainers was detailed in the service users’ guide. One resident discussed the care provided with the inspector. The care received by this resident on the day of the inspection did not allow for choices being made in relation to activities of daily living and did not respect the wishes and feelings of this particular individual. This issue was discussed with the manager at the time of the inspection. One relative commented, “my relative loves the food and is very happy here. I have no complaints”. Stocks Hall Nursing Home F57 F08 S25578 Stocks Hall (Burscough) V235144 160605 Stage 4.doc Version 1.40 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 Service users were adequately protected from abusive situations through the home’s policies and procedures. EVIDENCE: Detailed policies and procedures were in place at the home in relation to the protection of vulnerable adults, which were found to be in line with the Department of Health guidance ‘No Secrets’, which was readily available for staff, to provide them with guidance should any allegations be received. A separate whistle blowing policy was in place for staff reference explaining their responsibilities should they have any concerns about actual or suspected abuse of a resident. Appropriate action was seen to have been taken, in accordance with relevant guidelines following a reported allegation of abuse. Policies and procedures were also in place in relation to verbal or physical aggression displayed by residents so that staff would be aware of the management framework of such situations. The policies and procedures of the home protected residents’ money and valuables from any mishandling. Stocks Hall Nursing Home F57 F08 S25578 Stocks Hall (Burscough) V235144 160605 Stage 4.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 26 An infection control policy was in place, which provided staff with clear guidance in relation to the control of infection within the home. EVIDENCE: Appropriately equipped laundry facilities are located within the basement, to which those living at the home do not have access and soiled linen is not carried through food preparation areas. Evidence was obtained to demonstrate that the home complied with the Water Supply (Water Fittings) Regulations 1999. At the time of the inspection the home was clean, hygienic and pleasant smelling. Stocks Hall Nursing Home F57 F08 S25578 Stocks Hall (Burscough) V235144 160605 Stage 4.doc Version 1.40 Page 15 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 29. The skills of staff and the number of staff on duty was sufficient to ensure the needs of residents were met. Adequate recruitment procedures were employed to protect and support those living in the home. EVIDENCE: A recorded staff rota was in place, which showed that, at the time of the inspection the staffing levels met the minimum requirements of the previous regulating bodies. Although dependency assessments had been conducted, these were not used to calculate the ratio of staff to residents, in order to ensure that sufficient staff were deployed to meet the needs of those living at the home. The records of two staff members were examined at the time of the inspection, which were found to contain all required information and documents to demonstrate that a thorough recruitment procedure had be conducted in order to protect residents. Staff spoken to confirmed that they had been thoroughly inducted into their roles and that a lot of training was offered. One service user commented “I hope they don’t move me, I am very settled and trust the staff”. Stocks Hall Nursing Home F57 F08 S25578 Stocks Hall (Burscough) V235144 160605 Stage 4.doc Version 1.40 Page 16 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) 38 Systems were in place for the protection of the health, safety and welfare of those who lived at the home and those who worked at the home. EVIDENCE: Relevant records and service certificates were examined which demonstrated that the systems and equipment within the home had been appropriately serviced to ensure safe working practices and the health and safety of those living and those working at the home. A variety of risk assessments had been conducted in relation to safe working practices to minimise any risks factors that had been identified and the recording of accidents was satisfactory. Staff had received induction and foundation training to meet TOPSS specification on safe working practice topics to ensure the health and safety of Stocks Hall Nursing Home F57 F08 S25578 Stocks Hall (Burscough) V235144 160605 Stage 4.doc Version 1.40 Page 17 the residents. Staff spoken to stated that they felt well supported by the management framework and that they enjoyed working at the home. Stocks Hall Nursing Home F57 F08 S25578 Stocks Hall (Burscough) V235144 160605 Stage 4.doc Version 1.40 Page 18 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 2 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 x COMPLAINTS AND PROTECTION x x x x x x x 3 STAFFING Standard No Score 27 2 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 x x x x x x x 3 Stocks Hall Nursing Home F57 F08 S25578 Stocks Hall (Burscough) V235144 160605 Stage 4.doc Version 1.40 Page 19 YES 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 Timescale for action 15(1) Unless it is impracticable to carry 30.09.05 out such consultation, the registered person must prepare the written plan of care in consultation with the service user or their representative. 13(2) The registered person must 31.07.05 make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. 12(4) The registered person shall make 10.07.05 suitable arrangements to ensure the care home is conducted in a manner which respects the privacy and dignity of service users. 12(3) The registered person shall, for 10.07.05 the purpose of providing care to service users, and making proper provision for their health and welfare, so far as practicable ascertain and take into account their wishes and feelings. 13(4)(a)(c The registered person must 31.10.05 ) implement a programme to replace the locks on bedroom doors with a more suitable design, which can be opened from the inside. (Timescale of F57 F08 S25578 Stocks Hall (Burscough) V235144 160605 Stage 4.doc Version 1.40 Page 20 Regulation Requirement 2. 9 3. 10 4. 14 5. 24 Stocks Hall Nursing Home 31.03.05 not met). 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. Refer to Standard 3 27 36 Good Practice Recommendations The registered person should obtain copies of all assessments conducted by other professionals to determine the level of care required by residents. The registered manager should consider calculating care staffing needs in accordance with guidance recommended by the Department of Health. Formal supervision should incorporate all aspects of practice and the philosophy of care in the home. Stocks Hall Nursing Home F57 F08 S25578 Stocks Hall (Burscough) V235144 160605 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Levens House Ackhurst Business Park Foxhole Road Chorley, Lancashire 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 Nursing Home F57 F08 S25578 Stocks Hall (Burscough) V235144 160605 Stage 4.doc Version 1.40 Page 22 - 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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