Inspection on 08/12/05 for Stoke Knoll Rest Home

This inspection was carried out on 8th December 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

Stoke Knoll Rest Home 28/02/08

Stoke Knoll Rest Home 19/07/06

Stoke Knoll Rest Home 04/08/05

Stoke Knoll Rest Home 27/01/05

Stoke Knoll Rest Home 08/07/04

Stoke Knoll Rest Home 13/01/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Stoke Knoll Rest Home 142 Church Road Bishopstoke Hampshire SO50 6DS Lead Inspector Mrs Michelle Presdee Unannounced Inspection 8th December 2005 10:00a X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Stoke Knoll Rest Home DS0000012401.V272097.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 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. Stoke Knoll Rest Home DS0000012401.V272097.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Stoke Knoll Rest Home Address 142 Church Road Bishopstoke Hampshire SO50 6DS 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) 023 8061 2402 Mr Roy Northover Mrs Heather Northover Care Home 24 Category(ies) of Dementia (3), Dementia - over 65 years of age registration, with number (24), Mental disorder, excluding learning of places disability or dementia (3), Mental Disorder, excluding learning disability or dementia - over 65 years of age (24), Old age, not falling within any other category (24) Stoke Knoll Rest Home DS0000012401.V272097.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. A maximum of 3 service users in the categories DE and MD may be accommodated between the age of 55-65 years at any time. 4th August 2005 Date of last inspection Brief Description of the Service: Stoke Knoll is a rest home providing care and support to 24 elderly men and women with age related conditions such as dementia and mental illness. Mr & Mrs Northover who are the registered persons for two other rest homes in the Southampton Locality own the home. The home is an old Victorian house built over three floors with an adjoining two-bedroom cottage and large enclosed garden. The home has undergone renovation of its heating system and safety valves on service users sinks, and further improvements have been made to the bathroom facilities and the home in general. The home is situated in the locality of Bishopstoke on the outskirts of Eastleigh shopping centre and train station. The area offers pleasant walks, public houses, local shops and small rivers where people can be observed fishing. Stoke Knoll Rest Home DS0000012401.V272097.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection started at 10.00am and was completed by 2.20pm. Twenty-four service users were being accommodated, the majority of service users were spoken to and three visitors to the home were also spoken to. The manager whose application for registration is being processed assisted the inspector. The inspector was shown around the home and randomly chose several bedrooms to view. Records were viewed on this inspection. The manager had not completed the pre- inspection questionnaire. Two relative/visitors comment cards and one-service users comment cards have been received, which gave positive feedback. What the service does well: What has improved since the last inspection? What they could do better: Stoke Knoll Rest Home DS0000012401.V272097.R01.S.doc Version 5.0 Page 6 The assessment and care planning process still needs to improve to ensure all service users needs are documented to enable staff to have sufficient information to meet their needs. The kitchen area in the home needs attention to ensure all safety and hygiene measures can be adhered to. 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. Stoke Knoll Rest Home DS0000012401.V272097.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Stoke Knoll Rest Home DS0000012401.V272097.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Pre-admission assessments and assessments need to be carried out for all service users, ensuring the home can meet the needs of service users. EVIDENCE: The assessments of four service users who had recently moved into the home were examined. Two of these admissions had been on an emergency basis. It was noted for both of these service users assessments had not been completed at any stage of their admission. For one of these service users good daily notes had been maintained but no entry had been made for the last eight days. For the other two assessments looked at, one had had a pre-admission assessment completed, which gave a clear picture of the service users needs before entering the home. No assessment had been completed. For the last assessment looked at it was found no pre- admission assessment had been completed, but an assessment had been completed. Discussions were held on the need to ensure a pre-admission assessment, assessment and care plan were produced for each service user. The content of what each should include was discussed. The importance of including night-time assessments for service users who are disruptive at night was discussed. Stoke Knoll Rest Home DS0000012401.V272097.R01.S.doc Version 5.0 Page 9 Stoke Knoll Rest Home DS0000012401.V272097.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,9,10 Care plans need to be carried out for all service users and the information recorded needs to be more detailed to ensure care staff have the necessary information to meet service users needs. Medication procedures in the home are adequate to ensure the safety of service users. Staff have the core training to ensure service users are treated with respect. EVIDENCE: The care plans of the four service users who had recently moved into the home were looked at. It was found three service users had care plans and one service user had no care plan. All service users had basic information recorded on their care plan including name, address, next of kin, GP and date of admission to the home. One family member for one service user had done a detailed plan of “who am I”, which gave an extensive picture of the service user. The care plans gave little information on how the carers where to meet the service users needs. In one example under the heading of metal abilities the care plan just stated “Alzheimer’s”. Discussions were held on how this did not belong in the care plan but belonged in the assessment process and the care plan should be stating how the care should be given with this diagnosis. In another example under social activities a list was provided it did not state Stoke Knoll Rest Home DS0000012401.V272097.R01.S.doc Version 5.0 Page 11 how the home or carers where to meet these social needs. Risk assessments had been completed and now included ways to minimise the risk. The home has a medication procedure, which details the receipt, recording, storage, handling, administration and disposal of medicines. Medication is ordered and collected from the pharmacist on a monthly basis. All medication is checked and recorded when it enters the home. On arrival to the home the manager had just popped out to return some medication to the pharmacist, which had been incorrectly provided. Medication is put in a box with a photograph of the service user in the trolley in the box or container it comes from the pharmacist in. All extra medication is stored in a locked filing cabinet in the locked room. At each time the drugs need to be administered two carers take the trolley around the home. The two carers sign to take the trolley and then individual records are signed as the medication is administered. From the records seen only one error was found when it was apparent medication had been administered but no signature had been made. The records of controlled medication were checked and it was found these were was being stored and recorded appropriately. The records held matched the stocks in the home. Staff do receive training on the administration of medication, however no record could be found as to when staff last received training. The inspector was advised the core standards of privacy and respect are covered on staffs induction programme. It was difficult to gage from discussions with service users due to their communication difficulties if they felt they were treated with respect and dignity. Three comment cards had stated they felt service users were treated with respect and dignity and the visitors to the home felt service users were treated with respect. Service users can see visitors in their own rooms. Stoke Knoll Rest Home DS0000012401.V272097.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14,15 Choice is promoted in the home for service users to live as independently as possible. A varied diet is provided, which service users enjoy but planned menus must be produced and displayed in the home. EVIDENCE: It was clear from observations on the day service users are encouraged to exercise choice and control over their lives. One service user enjoyed walking to the very near local pub on a regular basis. Four service users had recently enjoyed shopping visits to local shopping centres, accompanied by staff members. Service users have freedom of movement around the home and enjoy the activities around the home. One visitor commented on the fact that there is always something going on in the home and how much the service users had enjoyed helping decorate the Christmas cake. Service users are encouraged to have their meals in the dining room. At the present time there are no planned menus and menus are not displayed but there are plans to introduce both of these. A record is maintained of all meals provided. Service users spoken to confirmed they enjoyed their meals and they could always have an alternative if they did not like the main meal. Staff and service users confirmed they have fresh vegetables the majority of the time. Stoke Knoll Rest Home DS0000012401.V272097.R01.S.doc Version 5.0 Page 13 On the day pork casserole, runner beans, swede, mashed potatoes and gravy was served with apple sponge and custard for pudding. The home is currently without a cook and trying to recruit another one. Stoke Knoll Rest Home DS0000012401.V272097.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These standards were not assessed on this occasion. Stoke Knoll Rest Home DS0000012401.V272097.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These standards were not inspected on this occasion. Whilst walking around the home it was noted all areas were clean and no offensive odours were detected Stoke Knoll Rest Home DS0000012401.V272097.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 The home has adequate staffing levels to ensure service users needs can be met. EVIDENCE: The home employs fourteen care staff; two housekeepers, a gardener and two maintenance men cover this and other homes. The duty rotas for two weeks were seen. It was noted the home has adequate staff on duty to meet the needs of service users, who five are considered as having high care needs, fourteen as medium and five as low care needs. Two housekeepers work five mornings a week and one works on a Saturday morning. The homes laundry is done by care staff during the night and day. Two members of staff work a waking night duty. One comment card had been received stating they thought the home was short staffed at weekends; from the rotas seen it was clear there were adequate staff on duty. Stoke Knoll Rest Home DS0000012401.V272097.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33,35,38 The home is well managed and seeks the views of the users ensuring their needs are met. Finances are well managed in the home ensuring service users are protected. The kitchen and practices in this room need to be improved to ensure all health and safety issues are followed. EVIDENCE: Since the inspection the acting manager of the home has become registered with the Commission. The manager has had many years experience and is going to start a National Vocational Qualification Level 4 in care and Management. The home has an annual development plan, which is organised by Mr and Mrs Northover. Mr and Mrs Northover carry out monthly visits and reports. Mrs Johansson stated she felt service users and visitors views were gained on an individual and informal basis. A suggestion box is provided in the home, which anyone can cut put their views into. The home has a policies and procedures file, which is kept up-to-date. Stoke Knoll Rest Home DS0000012401.V272097.R01.S.doc Version 5.0 Page 18 The home does not manage any of the service users finances, but does keep and manage the personal allowance for some service users. The records held matched the money held and all receipts were available. The finances were individually stored and kept in a secure place. The home has a risk assessment completed on the building. Staff receive regular training which covers moving and handling, fire safety, first aid, food hygiene and staff are currently undertaking training on infection control. Certificates were seen for the gas, electrical system, fire alarms, fire extinguishers and bath hoist which were all recent. A record is maintained of fire checks in the home, it was noted the weekly checks had been missed for the last five weeks. The kitchen area, which includes the small cooking area and the large room next door, where food, crockery and pans are stored, is in need of some attention. It was noted the cupboards in the large room were in need of cleaning. One large cupboard had no door; two other cupboard doors did not close properly. It was noted in one cupboard checked; two items of food stored were out of date and were immediately thrown in the bin. Fresh vegetables were being stored in bags in as corner of the kitchen. It was clear the temperature of the fridge and freezers were not being maintained. It was agreed this was an area in the home, which could be improved. Stoke Knoll Rest Home DS0000012401.V272097.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 2 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 3 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Stoke Knoll Rest Home DS0000012401.V272097.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. Standard OP3 OP7 OP38 Regulation 14(1)(a) 15 16 (2) (g) Requirement Assessments must be completed for all new service users. Care plans must be completed in detail for all new service users. The kitchen area and the storage of food needs to be improved. Timescale for action 01/02/06 01/02/06 01/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Stoke Knoll Rest Home DS0000012401.V272097.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Stoke Knoll Rest Home DS0000012401.V272097.R01.S.doc Version 5.0 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. 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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