Inspection on 02/02/06 for Stocksbridge Neuro-Rehabilitation Centre

This inspection was carried out on 2nd February 2006.

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 no outstanding requirements from the previous inspection report, but made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Stocksbridge... 12/08/08

Stocksbridge... 31/07/07

Stocksbridge... 02/08/06

Stocksbridge... 08/07/05

Stocksbridge... 11/01/05

Stocksbridge... 29/06/04

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Snydale Care Home

Staveley Birk Leas Nursing Home

Fairmount Nursing Home

Currergate Nursing Home

Brookfield

Castlethorpe Care Home

Elmleigh Convent

Woodlands Respite Care Centre

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

CARE HOME ADULTS 18-65 Stocksbridge Neuro-Rehabilitation Centre 2a Haywood Lane Stocksbridge Sheffield South Yorkshire S36 2QE Lead Inspector Mrs Sue Stephens Unannounced Inspection 13:55 2 February 2006 nd Stocksbridge Neuro-Rehabilitation Centre DS0000048612.V268822.R01.S.doc Version 5.0 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 Stocksbridge Neuro-Rehabilitation Centre DS0000048612.V268822.R01.S.doc Version 5.0 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 Adults 18-65. 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. Stocksbridge Neuro-Rehabilitation Centre DS0000048612.V268822.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Stocksbridge Neuro-Rehabilitation Centre Address 2a Haywood Lane Stocksbridge Sheffield South Yorkshire S36 2QE 0114 2837200 0114 2887736 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) Active Care Partnerships Ltd Kathryn Sandra Oakley Care Home 24 Category(ies) of Physical disability (24) registration, with number of places Stocksbridge Neuro-Rehabilitation Centre DS0000048612.V268822.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home is for service users who require neurological care. The minimum numbers of staff on duty must comply with the staffing notice dated 6/3/00 and attached (referring to previous name of home; Holly Lodge). 8th July 2005 Date of last inspection Brief Description of the Service: Stocksbridge Neuro-Rehabilitation centre is a purpose built residence for people requiring neurological care. The building has therapy rooms, an independent living skills kitchen, lounges for relaxation and paved access to the gardens. The centre overlooks Stocksbridge and is near to a bus route and some shops; and is within easy reach of Sheffield and the motorway network. The building has two levels, with a passenger lift providing access to both levels; there is level access is to the gardens. Rooms and corridors are designed to accommodate wheelchairs. Nurses, psychologist, physiotherapist, occupational therapist, speech and language therapist, carers and assistants are employed to form a multidisciplinary care team. Stocksbridge Neuro-Rehabilitation Centre DS0000048612.V268822.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over a period of 4 hours 20 minutes between 1:55pm and 18:15pm. During this time the inspector spoke to service users, staff, and the manager. A sample of documentation, which included service users assessments and care, plans and staff recruitment files was checked. Service users were observed using the homes facilities and relaxing around the home. Some people were out with staff as part of their programme of rehabilitation. The manager Kathryn Oakley assisted in the inspection. The inspector thanks the service users, staff and manager for their welcome at the home and their helpful assistance during this inspection. What the service does well: Service users said they were satisfied with the care they received. They said the home met their health and personal care needs. Staff were attentive and professional towards service users and service users made positive comments about the staff team. Service users needs were regularly assessed, and their care plans reflected the care they needed, the plans gave staff instruction how to deliver care. Service users received care from a multi professional team. Service users said the meals were well cooked and enjoyable. The managers and staff team focussed on the care and recovery of the service users. Staff received good training, which provided them with good knowledge and skills. The home carried out audits to check how it was performing, and recruitment checks were in the main robust. Stocksbridge Neuro-Rehabilitation Centre DS0000048612.V268822.R01.S.doc Version 5.0 Page 6 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. Stocksbridge Neuro-Rehabilitation Centre DS0000048612.V268822.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Stocksbridge Neuro-Rehabilitation Centre DS0000048612.V268822.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 3 The home assesses the needs of service users prior to, and after admission. The staff and the manager have a good awareness of people’s individual needs. EVIDENCE: The two care plans checked contained the service users’ full needs assessments. The multi disciplinary team all had input into the assessments, including physiotherapy and occupational therapy. The team continually reassessed the service users needs. The manager was very knowledgeable about individuals assessed needs, and had a good awareness of people whose needs were changing. The inspector noted that staff were calm and relaxed when dealing with service users. Staff were aware of individuals preferences and understood their communication difficulties. Stocksbridge Neuro-Rehabilitation Centre DS0000048612.V268822.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8 and 9 The care plans reflect service users assessed needs; they are informative and instruct staff about how to provide care. This gives service users consistent care. Service users receive assertive guidance to help them maintain their recovery programme. The manager needs to look at how she could help some individuals feel more involved in the day-to-day running of the home. EVIDENCE: The care plans were informative and included the action staff had to take to meet individual needs. There was a lot of detail in the plans and very thorough daily records about the person’s progress. All members of the multi disciplinary team had contributed to the plans. The plans set out specialist needs, for example, psychology, physiotherapy, speech and language and occupational therapy. Service users could participate in their plans, when this was appropriate for them. Stocksbridge Neuro-Rehabilitation Centre DS0000048612.V268822.R01.S.doc Version 5.0 Page 10 Care packages included the rehabilitation and development of the individual; this sometimes conflicted with the service users daily decisions and choices, for example going out and participating in more active activities. Two service users expressed their frustration about this. The manager said she did consult with individuals, about their choices; however it was important for some individuals to keep to strict routines (for example rest and limited stimulation) whilst they are recovering and gaining their health. Five service users discussed with the inspector about how they felt the home helped them participate in the day-to-day running of the home. Some service users gave good feed back, they said they were satisfied; one person gave examples of how staff, including domestics were very helpful in helping the service user to maintain her room and laundry in the way she preferred. Two service users said they had been disappointed in service user meetings, they had turned up to these but staff had not. Stocksbridge Neuro-Rehabilitation Centre DS0000048612.V268822.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 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 17 The last inspection covered the personal development, education, occupation, community links, leisure, and relationships standards. The home met these standards. Service users still experience disturbed nights because of the noise; this can affect their health, wellbeing and recovery. Service users at the home enjoy the meals but would like more choice. EVIDENCE: On the previous inspection service users said the noise level at night was unacceptable, it disturbed them and kept them awake. The inspector consulted service users again. Most said the situation had not improved very much. The service users said they felt night staff were sometimes noisy, they could hear them laughing and talking and some wore noisy shoes. The service users and manager recognised that the atrium at the centre of the home increased this problem because it caused increased volume and echoes. Stocksbridge Neuro-Rehabilitation Centre DS0000048612.V268822.R01.S.doc Version 5.0 Page 12 The commission had received an anonymous complaint about the homes meals and mealtimes. The complainant had concerns that care, therapy and domestic staff were used to cover when the cook was on leave. The complainant was concerned that the staff did not have the training, or skills to prepare the food in order to meet service users needs and preferences. The manager and service manager said that they did use the homes staff when the cook was not available. The managers did not feel that using agency staff met the service users needs. Instead they asked staff at the home that were willing to cook. They said the advantage of this was that existing staff had good knowledge of the service users needs and preferences. The manager confirmed all staff received food hygiene training. On the inspection day an occupational therapy assistant was preparing the evening meal. The inspector spoke to the staff member at length, and checked the food and the kitchen. The staff said she was happy to stand in for the cook and enjoyed doing so. She said she felt she had enough skills to prepare the meal and often prepared meals with service users as part of her therapist role. The staff member had a good understanding of people’s individual needs; this included soft and nutritional diets. During the inspection the main meal was served; this was stew and dumplings followed by pear sponge and custard. The meal was freshly prepared using fresh meat and vegetables. The meal was served on time. The service users said the meals were good. One resident said, “The meals are beautiful”. The service users did say however that there was only a limited choice of meals. At lunch the same menu was always available, it did include choices for example sandwiches, jacket potatoes or brunch. Some service users said they would prefer something different sometimes. For the main meals there was only one choice on the menu. The staff who was cooking said if a service user asked for something different she would be able to provide it. Information about service users dietary needs was available and the manager was updating information about service users preferences. The kitchen was clean and orderly and food was correctly stored. Stocksbridge Neuro-Rehabilitation Centre DS0000048612.V268822.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 and 19 Service users were satisfied with the health care and personal care they received at the home. EVIDENCE: Service users said they felt the home met their health and personal support needs. One person discussed how impressed they were with the care at the home and said this had improved their health a lot. The person made positive comments, which included: Staff are “very respectful, they know how I like my things” “I can’t say enough about them, nothing is too much for them”. And “I’ve never felt as relaxed and well looked after”. Staff were attentive to the service users and sensitive in their approach. Service users said they could have access to a G.P if they needed, and said they had assistance to attend other health appointments. Care plans documented service users health care needs. Stocksbridge Neuro-Rehabilitation Centre DS0000048612.V268822.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 The home needs to give service users better assurance that the home will listen and act upon their concerns and complaints. EVIDENCE: Service users said they were able to raise concerns. They said they could go to staff and alternatively they could go to the manager or service manager. Two service users said the staff and managers did listen to them about most of their concerns. But the home did not take enough action about the noise level at night and sometimes during the day. The manager said all staff had received adult protection training. The service manager had delivered this. Stocksbridge Neuro-Rehabilitation Centre DS0000048612.V268822.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25 and 30 Service users felt warm and comfortable in the home, and the facilities met their disability needs. EVIDENCE: The building was clean, warm and accessible for people with disabilities. The lighting and ventilation was good; and there was a variety of good quality furnishing and fittings; for example, in the dining area there was a worktop and cupboards for service users and visitors to make drinks. See standard 16 for service users views about the Atrium. The atrium is noisy and does not benefit service users who want rest and quiet. The manager confirmed that improvement work was finished on the patio areas outside. One patio area was still waiting for completion. The inspector visited a number of bedrooms on individual service users approval. The rooms were personalised, well equipped and furnished. Service users said their beds were comfortable and they were warm at night. Stocksbridge Neuro-Rehabilitation Centre DS0000048612.V268822.R01.S.doc Version 5.0 Page 16 One service user said the home had good laundry facilities and staff handled laundry and clothes respectfully. The laundry facilities were suitable for the home. Stocksbridge Neuro-Rehabilitation Centre DS0000048612.V268822.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. The home carried out good employment and training procedures; this helped safeguard service users and provided them with consistent and professional care. Better checks on employment histories will enhance the service users safety. EVIDENCE: Less than 50 of staff had a National Vocational Qualification in care. However the home had enrolled staff onto training and this was due to commence. The manager said this was because they had experienced difficulties in finding suitable training support; the manager said this problem had now been resolved. The inspector checked two recruitment files. The files were up to date and orderly; thorough recruitment checks were in place. The files did not contain the employees’ full employment histories. Staff said the training was good, and they received training on a regular basis. On display there were future training events, these included crisis intervention and safe working practice training. Stocksbridge Neuro-Rehabilitation Centre DS0000048612.V268822.R01.S.doc Version 5.0 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 and 42 The home carried out self-monitoring processes, which identified service users opinions and areas for improvement. The home had improved its health and safety practices. EVIDENCE: The manager discussed some of the homes quality assurance measures. These included service user and family questionnaires. The manager was also reviewing service users dietary needs and preferences. There had been regular provider visits and the service manager also carried out audits on the home. The inspector checked the previous requirements relating to fire drills, fire risk assessments and first aid qualifications. Fire drills now included using different exits and a fire risk assessment was in place and up to date. Stocksbridge Neuro-Rehabilitation Centre DS0000048612.V268822.R01.S.doc Version 5.0 Page 19 The manager had arranged for all staff to receive first aid training. When the training is completed, this requirement will be removed. The manager had planned safe practice training for the year ahead. Stocksbridge Neuro-Rehabilitation Centre DS0000048612.V268822.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 3 X X Standard No 22 23 Score 2 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 2 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 2 17 Standard No 31 32 33 34 35 36 Score X 2 X 2 3 X CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X Standard No 37 38 39 40 41 42 43 Score X X 3 X X 2 X Stocksbridge Neuro-Rehabilitation Centre DS0000048612.V268822.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? No 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 YA8 Regulation 12 Requirement Service users must be consulted about how the home can improve meetings and service user consultation about the home. Action must be taken to reduce the noise levels at night and clients must be consulted regularly about whether the situation has improved. Previous action date 30.08.05 Better choice must be provided on menus, this must be done in consultation with service users. Service users must be consulted about the noise levels, how this affects them. This must be treated as a formal complaint using the homes own complaints procedure. 5. YA24 13,23 The external patio areas and dwarf walls must be repaired to enable safe client access. (Previous action date 01.12.05 and 30.09.05) 30/06/06 Timescale for action 31/03/06 2. YA16 12 31/03/06 3. 4. YA17 YA22 16 12 and 22 31/03/06 31/03/06 Stocksbridge Neuro-Rehabilitation Centre DS0000048612.V268822.R01.S.doc Version 5.0 Page 22 6 6. 7 YA32 YA34 YA42 18 19 18 Ways of reducing noise levels from the atrium must be sought. 50 of staff must have a national vocational qualification in care at level 2 or better. Full employment histories must be taken for all new recruited staff. A qualified first aider must be rostered to work at all times. (Previous action date 30.08.06 30/09/06 31/03/06 30/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 4. Refer to Standard YA37 Good Practice Recommendations The registered manager should aim to a level 4 NVQ qualification in management or equivalent. Stocksbridge Neuro-Rehabilitation Centre DS0000048612.V268822.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR 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 Stocksbridge Neuro-Rehabilitation Centre DS0000048612.V268822.R01.S.doc Version 5.0 Page 24 - 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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