Inspection on 21/07/05 for Stocks Hall Nursing Home

This inspection was carried out on 21st July 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 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 Nursing Home 08/03/07

Stocks Hall Nursing Home 23/02/06

Stocks Hall Nursing Home 17/02/05

Stocks Hall Nursing Home 04/08/04

Stocks Hall Nursing Home 02/03/04

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 50c Whitemoss Road Skelmersdale Lancashire WN8 8BL Lead Inspector Vivienne Morris Announced 21 July 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 Nursing Home F57 F08 S25581 Stocks Hall (Skelmersdale) V228576 210705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Stocks Hall Nursing Home Address Stocks Hall 50c Whitemoss Road Skelmersdale Lancashire WN8 8BL 01695 555234 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 Limted Mrs Susan King Care Home with Nursing 60 Category(ies) of OP Old Age (24); DE Dementia (36); PD Physical registration, with number Disability (1) of places Stocks Hall Nursing Home F57 F08 S25581 Stocks Hall (Skelmersdale) V228576 210705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1) The home is registrered for a maximum of 60 services users to include: 2) Up to 24 service users in the category of OP (Old age not falling within any other category). 3) Up to 36 service users in the category of DE (Dementia) 4) One named service user in the category PD (Physical Disability under 65 years of age) may be accommodated within the overall number of registered places. 5) Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidelines which may be issued through the Commission for Social Care Inspection regarding staffing levels in care homes. 6) The service should employ a suitable qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection 17 February 2005 Brief Description of the Service: Stocks Hall is a purpose built establishment, providing nursing and personal care for up to 60 elderly persons, including people who’s care needs are associated with Dementia. The home is set in pleasant, well maintained grounds. A patio area with garden furniture is available for those wishing to spend some time outdoors. Private accommodation is located on two levels, the first floor being accessible by passenger lift or stairs. The majority of bedrooms are single with a high percentage having en suite facilities. Two companion rooms are available for married couples, friends or those preferring to share facilities, both having en suite facilities. A number of lounges, quiet rooms and dining areas are available throughout the home, where a variety of activities may take place. Stocks Hall Nursing Home F57 F08 S25581 Stocks Hall (Skelmersdale) V228576 210705 Stage 4.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 July 2005. The inspection looked at 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 selection of private accommodation was viewed and all communal areas and service areas were seen. The Commission for Social Care Inspection had received one complaint about this service since the last inspection, which was in relation to care practices. The complaint was referred back to the provider to be investigated using the home’s complaints procedure. Some elements of the complaint were found to be upheld, others were found to be not upheld and others unresolved. What the service does well: What has improved since the last inspection? Stocks Hall Nursing Home F57 F08 S25581 Stocks Hall (Skelmersdale) V228576 210705 Stage 4.doc Version 1.40 Page 6 The handling and recording of medications had improved since the last inspection. The three requirements made in relation to this standard had been appropriately addressed making the management of medications a safer practice. The policies and procedures of the home in relation to death and dying had been reviewed and updated in accordance with standard 11 of the National Minimum Standards for Care Homes for Older People to ensure that staff respect the privacy of those who are dying and treat them with respect. The information contained in the plans of care was very detailed, providing staff with clear guidance as to how individual needs were to be met. Systems were in place to monitor the quality of service provided. 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 S25581 Stocks Hall (Skelmersdale) V228576 210705 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 S25581 Stocks Hall (Skelmersdale) V228576 210705 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 Sufficient information had been obtained prior to admission to enable the home to determine if individual assessed needs could be adequately met. All the assessed needs of those living at the home were being consistently met. EVIDENCE: The care of four service users’ was ‘tracked’ during the course of the inspection. The information obtained prior to admission was detailed ensuring that the home could provide adequate care for the people admitted. Those people living at the home, whom the local authority funded had been assessed by a social worker prior to admission and a copy of the assessment and care plan had been obtained by the home so that a clear picture of individual needs was available for staff reference. The home had also conducted a detailed assessment before people were admitted to the home, to ensure that the needs of those people coming to live at Stocks Hall Nursing Home could be adequately met by the staff team. The service users’ plans of care had been based on the information obtained prior to admission, therefore documented guidance for staff was provided to Stocks Hall Nursing Home F57 F08 S25581 Stocks Hall (Skelmersdale) V228576 210705 Stage 4.doc Version 1.40 Page 9 ensure that all assessed needs were being consistently met. Those spoken to provided the inspector with positive feedback, including comments such as, ‘the staff, everyone is very kind and helpful’ and ‘the manager was there when I needed so much support when my relative was being admitted to the home’. Stocks Hall Nursing Home F57 F08 S25581 Stocks Hall (Skelmersdale) V228576 210705 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 The health, personal and social care needs of those living at the home were consistently recorded to ensure that staff were able to meet assessed needs adequately. Medication was generally handled and recorded to a good standard. Staff would treat those who are dying with sensitivity and respect. EVIDENCE: The plans of care seen were very well written and individualised to each person receiving care. The assessed needs of those living at the home had been consistently recorded on the plan of care in order to provide staff with clear guidance as to how individual needs were to be met. The care plans had been reviewed on a monthly basis and updated with the involvement of the service user or their relative to reflect changes in service user’s circumstances. One relative confirmed that the staff had discussed the care plan with her. Comments received from those living at the home and their relatives included, ‘I am very happy with the care provided’ and ‘my father receives excellent care, the staff are marvellous’. Stocks Hall Nursing Home F57 F08 S25581 Stocks Hall (Skelmersdale) V228576 210705 Stage 4.doc Version 1.40 Page 11 Full risk assessments had been conducted for those identified as being at risk of falling, to ensure that any potential hazards were minimised or removed. The plans of care seen showed that independence was encouraged wherever possible and that personal care was provided. The psychological health of those living at the home had been assessed and monitored. A variety of risk assessments had been conducted, with specific interventions put in place in order to promote the health and safety of those living at the home. External professional advice had been sought, as required in order to promote the health and welfare of those living at the home. The handling and recording of medications was of a good standard, in accordance with standard 9 of the National Minimum Standards for Care Homes for Older People to ensure that medications were being managed appropriately. The policies and procedures demonstrated that care and comfort would be given to service users who were dying, their death would be handled with dignity and propriety and their spiritual needs would be observed. Stocks Hall Nursing Home F57 F08 S25581 Stocks Hall (Skelmersdale) V228576 210705 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 and 14 Visitors were welcomed to the home and service users were encouraged and supported to maintain contact with family and friends. Service users were able to exercise choice and control over their lives as far as possible. EVIDENCE: Visitors spoken to informed the inspector that they were always made to feel very welcome at the home and were encouraged to participate in the every day life of the service users. The policies and procedures of the home demonstrated that service users were able to receive their visitors in private if they so wished. Those spoken to confirmed this and the inspector saw visiting taking place in private. Strategies were in place to ensure that service users were able to refuse visitors if they so wished. Service users and their relatives had been provided with information about how to contact the local advocacy service if they so wished and access to personal records was facilitated as required in accordance with the Data Protection Act 1998, demonstrating that service users and their relatives were encouraged to be involved in the care provided. Personal possessions were observed in service users’ bedrooms in order to create a homely atmosphere, the extent of which had been recorded on admission to the home in order to protect individual’s personal belongings. Stocks Hall Nursing Home F57 F08 S25581 Stocks Hall (Skelmersdale) V228576 210705 Stage 4.doc Version 1.40 Page 13 Comments received included “the staff are all so friendly, they make me feel very welcome”. Stocks Hall Nursing Home F57 F08 S25581 Stocks Hall (Skelmersdale) V228576 210705 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 seen to be well managed. EVIDENCE: A detailed complaints procedure was in place, which was issued to all service users and their relatives and which included a simple flow chart to show how complaints may be made. The written procedure informed the reader that complaints would be dealt with within five working days and that complainants could refer a complaint to the Commission for Social Care Inspection at any time should they so wish. A record of complaints received by the home was maintained, with well documented details of the internal investigation and outcome. Any correspondence in relation to complaints was also retained on file. Those residents spoken to were aware of the complaints procedure and what they would do if they needed to complain. Stocks Hall Nursing Home F57 F08 S25581 Stocks Hall (Skelmersdale) V228576 210705 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 and 24. Some bedroom furnishings were marked and in need of restoration or replacement in order to enhance the appearance of residents’ private accommodation. The home was maintained to an adequate standard of safety. EVIDENCE: A programme of routine maintenance and renewal of the fabric and decoration of the premises had been produced to ensure that the home, in general was maintained to a satisfactory standard. The corridor carpets had been replaced since the last inspection, which improved the environment for those living at the home. The inspector noted that some bedroom furniture had been replaced. However, some of the remaining items were marked and in need of restoration or replacement and some of the double-glazing units were still in need of repair to ensure that all service users’ private accommodation is well maintained. The grounds of the home were well maintained, providing safe and attractive areas with easy access for service users. Policies and procedures were in place in relation to infection control and relevant training for staff had been provided. Stocks Hall Nursing Home F57 F08 S25581 Stocks Hall (Skelmersdale) V228576 210705 Stage 4.doc Version 1.40 Page 16 A fire procedure and risk assessment was in place at the home to ensure that adequate fire precautions were implemented. The fire alarm systems and fire fighting equipment had been appropriately serviced and tested. Staff had received fire safety training and fire drills had been conducted to ensure the safety of those who live and of those who work at the home. The inspector observed that in the absence of service users’ own provision, furnishings for individual rooms were provided, in general, in accordance with standard 24 of the National Minimum Standards for Care Homes for Older People. However, where specific items of furniture had not been provided, this was due to the safety of service users, in which case a risk assessment had been conducted. Those residents spoken to were content with their own bedrooms. A high percentage of beds were of the adjustable type and specialized mattresses were provided when required to ensure that an adequate standard of nursing care was provided. New bed linen had been provided since the last inspection to ensure comfort for those living at the home. Locks were fitted to bedroom doors on the first floor to protect service user’s privacy and to promote the safety of service users’ personal possessions. Stocks Hall Nursing Home F57 F08 S25581 Stocks Hall (Skelmersdale) V228576 210705 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 numbers and skill mix of staff were adequate to meet the needs of those living at the home. Not all care staff were adequately trained. EVIDENCE: A staff rota was in place at the home, demonstrating which staff were on duty at ant time of the day or night. At the time of the inspection the staffing levels met the minimum requirements of the previous regulating body. Although the dependency levels of individual service users had been determined, these were not routinely utilised when calculating staffing levels. The inspector noted that one service user was receiving continuous 1:1 observation and that additional staff were deployed as required to ensure that service users needs were being met. At the time of the inspection the environment was found to be clean, tidy and pleasant smelling demonstrating that a good standard of hygiene was provided for those living at the home. At the time of the inspection there were 25 care staff employed at the home, of which 8 had achieved a relevant National Vocational Qualification to demonstrate continued personal development and training. A number of other care staff were doing a National Vocational Qualification, which showed that the home was working towards the recommended ratio of 50 of care staff achieving a National Vocational Qualification. All care staff had completed a TOPSS certified training programme4 Stocks Hall Nursing Home F57 F08 S25581 Stocks Hall (Skelmersdale) V228576 210705 Stage 4.doc Version 1.40 Page 18 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 and 33. The registered manager is sufficiently qualified, competent and experienced to run the home. The quality of care provided is effectively monitored. EVIDENCE: Staff spoken to informed the inspector that the manager of the home was supportive and that there were clear lines of accountability in the home. Comments received included “You could not get a more supportive manager, she is always there for us” and “ the manager is marvelous, very caring and supportive”. The registered manager is a first level nurse responsible for the day-to-day operation of Stocks Hall Nursing Home and at the time of the inspection was able to demonstrate that she has undertaken periodic training to update her knowledge, skills and competence. She was also in the process of undertaking a National Vocational Qualification at level 4 and the Registered Managers Award. Stocks Hall Nursing Home F57 F08 S25581 Stocks Hall (Skelmersdale) V228576 210705 Stage 4.doc Version 1.40 Page 19 Staff spoken to confirmed that the registered provider was on site on a day-today basis. Effective quality assurance monitoring systems were in place at the home, which were based upon feedback from those using the service, their relatives, staff and stakeholders within the community. An annual development plan was available, which was linked to a variety of internal audit trails and which reflected the aims and outcomes for those using the service. The home had achieved a variety of recognised external quality assurance awards, demonstrating that the service was independently audited. Service users’ views of the home had been published within the service users’ guide to show the standard of service provided. A variety of meetings were held at regular intervals with minutes being retained, showing that open discussions about the service were encouraged and that views of those using the service, their relatives and staff working at the home were actively sought. Written policies and procedures had been regularly reviewed and updated in light of changing legislation and good practice guidelines. Stocks Hall Nursing Home F57 F08 S25581 Stocks Hall (Skelmersdale) V228576 210705 Stage 4.doc Version 1.40 Page 20 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 3 8 3 9 3 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 x COMPLAINTS AND PROTECTION 3 x x x x 2 x x STAFFING Standard No Score 27 3 28 2 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 2 x 3 x x x x x Stocks Hall Nursing Home F57 F08 S25581 Stocks Hall (Skelmersdale) V228576 210705 Stage 4.doc Version 1.40 Page 21 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 Regulation Requirement Timescale for action 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 24 Good Practice Recommendations Consideration should be given to the replacement or renovation of the bedroom furniture which is in poor condition. The seals in the double-glazing units should be repaired. A minimum ratio of 50 trained members of care staff (NVQ Level 2 or equivalent) should be achieved, including any agency staff working in the home. The registered manager should achieve a National Vocational Qualification at Level 4. 2. 3. 4. 28 31 Stocks Hall Nursing Home F57 F08 S25581 Stocks Hall (Skelmersdale) V228576 210705 Stage 4.doc Version 1.40 Page 22 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 Nursing Home F57 F08 S25581 Stocks Hall (Skelmersdale) V228576 210705 Stage 4.doc Version 1.40 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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