Inspection on 01/08/05 for Stokeleigh Residential Home

This inspection was carried out on 1st August 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

Stokeleigh Residential Home 14/01/08

Stokeleigh Residential Home 24/04/07

Stokeleigh Residential Home 30/05/06

Stokeleigh Residential Home 03/12/05

Stokeleigh Residential Home 07/02/05

Stokeleigh Residential Home 24/09/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Stokeleigh Residential Home 19 Stoke Hill Stoke Bishop Bristol BS9 1JN Lead Inspector Sam Fox Unannounced 1 August 2005 09:00 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. Stokeleigh Residential Home D56_D05_S59246_StokeleighRes_V241779_010805_Stage4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Stokeleigh Residential Home Address 19 Stoke Hill Stoke Bishop Bristol BS9 1JN 0117 9684685 0117 9687552 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) Hartford Care Limited Mrs Caroline Cooper PC Care Home only 30 Category(ies) of OP Old Age 30 registration, with number of places Stokeleigh Residential Home D56_D05_S59246_StokeleighRes_V241779_010805_Stage4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 7 February 2005 Unannounced Brief Description of the Service: Stokeleigh Residential Home is registered to accomodate up to 30 residents, aged 65 years and over, who require assistance with their personal care. The home also offers respite care. It is situated close to The Downs in a quiet residential area and benefits from large grounds which are well maintained. Accomodation is provided in single rooms, each with its own ensuite facilities. The upper floors are accessible via two lifts. Stokeleigh Residential Home D56_D05_S59246_StokeleighRes_V241779_010805_Stage4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the purpose of which was to ensure that the environment was well maintained and clean, and to find out if residents were content with the service they received. In addition to this key health and safety records were inspected. Evidence was primarily gained though discussion with residents and the manager and examination of records. Opportunity was also taken to join residents with their lunchtime meal, during which time work practice was observed. What the service does well: What has improved since the last inspection? The home’s protection of vulnerable adults policy has been improved and staff have now received training about this. The home are therefore in a better position to act promptly and appropriately if there are any signs of abuse. Stokeleigh Residential Home D56_D05_S59246_StokeleighRes_V241779_010805_Stage4.doc Version 1.40 Page 6 The home now employs two waking night staff – giving residents greater security and confidence that their needs will be met at night. The home continues to be cleaned a good standard and there is a rolling programme of maintenance which means that residents live in a nice environment. 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. Stokeleigh Residential Home D56_D05_S59246_StokeleighRes_V241779_010805_Stage4.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 Stokeleigh Residential Home D56_D05_S59246_StokeleighRes_V241779_010805_Stage4.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) 2, 3,5 There is effective admissions procedure in place for residents to be confident the home will have the resources and skills to meet their assessed needs. EVIDENCE: The home’s Statement of Purpose and brochure were not looked at in detail at the time of this inspection. It should be noted, however, that they were seen at the last visit and found to be comprehensive and useful documents which were a good source of information for prospective new residents. Personal care files evidenced that the manager conducts an initial assessment prior to new residents moving to the home. This is good practice and meets with the requirements of the legislation. Stokeleigh Residential Home D56_D05_S59246_StokeleighRes_V241779_010805_Stage4.doc Version 1.40 Page 9 Some residents said they had the opportunity to visit the home prior to moving there, others had moved from out of the county and had got their relatives to look for them. All those spoken with said they felt they had the necessary information to make a considered choice about moving into the home and that they did not feel rushed. The manager also confirmed that there is a formal review after one month during which time residents are asked if they wish to take a permanent place. She also said that one resident has been unable to make up their mind so this period of review has been extended. This is good practice. A spot check indicated that residents receive a contract which details some of the facilities and services offered. This was found in two different formats (the newest one being in a more user friendly format). It was recommended that the new owners of the home consider re-issuing their own contracts to those who have not received it. It was noted that residents are informed of increases to their fees via an annual letter. Stokeleigh Residential Home D56_D05_S59246_StokeleighRes_V241779_010805_Stage4.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 Residents can be assured that their health care needs will be acted upon promptly. Action needs to be taken to improve the recording of medication to make the system safer. EVIDENCE: Opportunity was taken to spot check two residents files – one of whom had recently moved to the home. These were found to contain care plans that covered many aspects of support needed, ranging from physical, emotional and social needs. Generally these were found to be well maintained, a recommendation was made, however, that there be clearer guidelines for staff to follow for one resident who was observed to be anxious and in need of constant re-assurance. All staff must ensure that they are consistent in their approach to her. Stokeleigh Residential Home D56_D05_S59246_StokeleighRes_V241779_010805_Stage4.doc Version 1.40 Page 11 Care plans cover health care issues and provide a prompt for staff to ensure that residents have annual check ups. Records provided evidence that all members of the household are supported to see the relevant health care professionals, including district nurses. Residents said they can speak to a GP any time they requested it – the majority said that they receive support from their families to attend appointments. Many have been able to retain GPs that they have known for years and it was clear that they value these relationships. The home operates a monitored dosage system for the administration of medication that is supplied at regular intervals by the local pharmacist. The majority of records held in relation to this were well maintained – all tablets are checked and booked on to the premises and the manager carries out a monthly audit of all stock medication. It was noted, however, that there were three instances when medication had been signed for as given but not administered. All staff trained to give out tablets should be more vigilant and the manager was advised to re- check staff competency. There were certificates available to indicate that they have recently received training. There was a risk assessment for one resident who self medicates – this meets with a requirement made at the last inspection. Stokeleigh Residential Home D56_D05_S59246_StokeleighRes_V241779_010805_Stage4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13,15 There is a relaxed atmosphere in the home, so residents can go about their daily lives in a manner that suits them. They benefit from a wide variety of wholesome and nutritious food. EVIDENCE: Residents were consulted with at length about what it was slike to live in the home. It was apparent that they felt there were no unnecessary rules and that the could dictate their own daily routines. This was observed on the day of the inspection when residents were getting up in their own time. It was clear that they could use communal facilities at any time or go to their bedrooms for some peace and quiet. One resident said that they could have meals in their bedrooms if they wished. A number said that they were pleased to have breakfast in their rooms as it meant that they were not rushed and could get ready in their own time. Residents said that they were satisfied with the amount of formal activities on offer and information about this was clearly displayed on the home’s notice board. There are regular events on a weekly basis. Stokeleigh Residential Home D56_D05_S59246_StokeleighRes_V241779_010805_Stage4.doc Version 1.40 Page 13 Many residents also confirmed that they had regular visits from their family and friends. It was apparent that they are encouraged to maintain these links and any support needed for this is written in care plans. One relative said that she was always made to feel welcome by the staff team. Opportunity was also taken to speak with the friend of one resident who was visiting – she said she could visit the home at any time, the staff were always nice to her and that she was always offered a cup of tea. One resident confirmed that they had their own telephone. In addition to this there is a pay phone available. Opportunity was taken to join residents with their lunchtime meal. The food was tasty, well presented and was enjoyed by residents. Some were unhappy because they had to wait to be served- this was passed on to the manager. It was apparent from menus that residents have a choice of a main meal, omelette or salad. As an additional mark of good practice residents tick what vegetables they like and in what quantity. It was recommended, to fine tune existing good practice, that menus, given to residents to fill out are reformatted as some were difficult to read and poorly photocopied. Stokeleigh Residential Home D56_D05_S59246_StokeleighRes_V241779_010805_Stage4.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, 18 There are a number of different ways for residents to raise concerns – this means they can feel confident that they will be listened to. EVIDENCE: All residents consulted with spoke highly of the manager and it was clear they felt they could turn to her if they had any worries. The complaints procedure is detailed in the home’s brochure and Statement of Purpose – this includes the contact number of the CSCI to whom concerns can also be raised. This meets with requirements of the legislation. The manager said she has not received any complaints since the last inspection and none have been received by the CSCI. It was noted that every six months the manager holds a residents meeting. These provide residents with an additional, more formal forum, through which they can raise concerns and influence the running of the home. In addition to the above residents are given the opportunity to fill out a six monthly survey, which forms part of the home’s quality assurance system. Recent ones were given out in July and these contained positive comments about the home, staff support and food. Stokeleigh Residential Home D56_D05_S59246_StokeleighRes_V241779_010805_Stage4.doc Version 1.40 Page 15 The manager has expanded the home’s protection of vulnerable adults policy – this meets with a requirement made at the last inspection. There was evidence that staff had received training about this. Discussion took place about one resident who could be at risk of bullying from other residents and the manager was asked to keep this situation under review and amend guidelines as necessary. Stokeleigh Residential Home D56_D05_S59246_StokeleighRes_V241779_010805_Stage4.doc Version 1.40 Page 16 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) 19,20,21,23,24,25,26 Residents’ benefit from living in a well-maintained, comfortable and homely environment. They can also be re-assured that good standards of hygiene and cleanliness will be maintained at all times. EVIDENCE: Stokeleigh Residential Home is set in large grounds which have recently been remodelled. These were found to be well maintained and residents expressed their appreciation about having this area to use in the summer months. The premises itself was found to be homely in appearance and comfortably furnished. There are two main lounges on the ground floor and a large conservatory which gives residents plenty of space and choice as to where they wish to spend their time. They were observed having unlimited access to all these areas. Stokeleigh Residential Home D56_D05_S59246_StokeleighRes_V241779_010805_Stage4.doc Version 1.40 Page 17 Opportunity was taken to view a number of bedrooms, all of which have ensuite facilities. These were found to be personalised and to reflect individual choices – indicating that choice and independence are promoted in this respect. Residents also confirmed that they are able to bring in small items of furniture if they wished to do so. They also said they were able to lock their doors to maintain their privacy. There are a number of specialist bathing facilities throughout the premises. All areas of the home were found to be cleaned to a good standard and there were no unpleasant smells. Laundry facilities are sited away from areas were food is stored and the washing machine has a sluicing facility. There were policies available in relation to the control of infection – these were not looked at in detail at the time of this visit. Stokeleigh Residential Home D56_D05_S59246_StokeleighRes_V241779_010805_Stage4.doc Version 1.40 Page 18 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) 27,29 There are sufficient staff on duty so that residents can be confident that their needs will be met. EVIDENCE: Staffing rotas indicated that there are three staff on duty throughout the waking day – these hours occasionally include the manager if there is a shortfall. At night there are two staff who stay awake. At present these levels are adequate to meet with the needs of those residents currently accommodated. Residents spoke warmly about the staff team and the support they give them. Opportunity was taken to view two staff files. These provided evidence that the home has a robust recruitment procedure which involves the completion of an application form, formal interview, the obtaining of references and police checks. Stokeleigh Residential Home D56_D05_S59246_StokeleighRes_V241779_010805_Stage4.doc Version 1.40 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 36,37,38 The home is well run, records are maintained to a high standard and there are effective procedures in place for the maintenance of health and safety. Residents can therefore be reassured that their rights and best interests are being safeguarded. EVIDENCE: The manager has been running the home for a number of years and had many years senior management experience, during which time she has obtained a management qualification. She displayed a commitment to maintaining good standards of care and a good understanding of her responsibilities as a registered manager. All residents consulted with, spoke fondly of her, and it was apparent that they felt at ease to talk with her. The fire logbook evidenced that tests and checks of the system take place at the appropriate intervals. In addition to this all staff receive re-fresher training regularly. Stokeleigh Residential Home D56_D05_S59246_StokeleighRes_V241779_010805_Stage4.doc Version 1.40 Page 20 There were certificates to evidence that staff have received their statutory training in first aid and manual handling. There was information in relation to the Control of Substances Hazardous to Health (COSHH) and chemical data sheets relating to each product used. The manager has developed a number of health and safety risk assessments, all of which are reviewed on an annual basis. These were detailed and met with requirements of the legislation. All portable electrical equipment had been tested in July. The lifts had been serviced on 6\7\0\5 There was a as safety certificate issued on 10\11\04 There is a formal supervision system within the home and a spot check of records of these meetings indicated that this is a useful system designed to support staff and improve work practice. The manager explained that she also supervises via formal observation and works alongside staff, which she records. This is good practice. Stokeleigh Residential Home D56_D05_S59246_StokeleighRes_V241779_010805_Stage4.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 4 4 3 x 3 3 3 3 STAFFING Standard No Score 27 3 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 3 x 3 3 x x x x 3 3 3 Stokeleigh Residential Home D56_D05_S59246_StokeleighRes_V241779_010805_Stage4.doc Version 1.40 Page 22 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard 9 9 Regulation 13(2) 13(2) Requirement Maintain accurate records of all medication administered Re-check staff competencies to give out mediaction Timescale for action 1\07\05 15\09\05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard 6 2 15 Good Practice Recommendations Review and exand care plans as highlighted in standard 6 Re-issue up to date contracts Re format menus Stokeleigh Residential Home D56_D05_S59246_StokeleighRes_V241779_010805_Stage4.doc Version 1.40 Page 23 Commission for Social Care Inspection 300 Aztec West Almondsbury South Gloucestershire BS32 4RG 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 Stokeleigh Residential Home D56_D05_S59246_StokeleighRes_V241779_010805_Stage4.doc Version 1.40 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. 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