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Inspection on 24/04/07 for Stokeleigh Residential Home

Also see our care home review for Stokeleigh Residential Home for more information

This inspection was carried out on 24th April 2007.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The respect, dignity and privacy of people who use the service is promoted. Meals are well presented and menus verify a healthy, well balanced diet for all residents who benefit from a wide variety of choice. People who use the service are able to express their concerns. Complaints or concerns are documented, dealt with effectively and outcomes are recorded. The home is decorated and furnished to a very good standard and provides a safe, comfortable and peaceful place for people to live in. The home is organised and managed by an effective management team that promotes the views and interests of the residents.

What has improved since the last inspection?

Although residents` daily routines have always been flexible within the home, new documentation is now being used to evidence this. This should ensure more consistency and continuity in ensuring that residents are able to live the lives they choose. It is a comprehensive; person centred account of routines and personal preferences for individual residents over a twenty-four hour period.

What the care home could do better:

Where needs have been identified from the initial assessment a care plan must be developed, giving clear detailed instruction about how staff are to manage the care required. This will make sure that peoples health and welfare is properly maintained and ensure consistency and continuity when delivering the care. Responses received from our surveys and the homes annual quality assurance surveys must be collated and the results must be discussed with the people who use the service. An action plan must be put in place to ensure that people`s wishes are carried out, including more organised trips outside of the home. This will make sure that people have the opportunity to have an enjoyable stimulating lifestyle of their choice.

CARE HOMES FOR OLDER PEOPLE Stokeleigh Residential Home 19 Stoke Hill Stoke Bishop Bristol BS9 1JN Lead Inspector Wendy Kirby Key Unannounced Inspection 24th April 2007 09:00 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 Stokeleigh Residential Home DS0000059246.V339365.R01.S.doc Version 5.2 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. Stokeleigh Residential Home DS0000059246.V339365.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stokeleigh Residential Home Address 19 Stoke Hill Stoke Bishop Bristol BS9 1JN 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) 0117 9684685 0117 9687552 stokeleigh@hartfordcare.co.uk Hartford Care Limited Tracy Bird Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Stokeleigh Residential Home DS0000059246.V339365.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Stokeleigh Residential Home is registered to accommodate 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 that are well maintained. Accommodation is provided in single rooms, each with its own en suite facilities. The upper floors are accessible via two lifts. The cost per week to reside at Stokeleigh Residential Home is between £467.00 and £650.00. Fees are reviewed annually and if care needs increase. This weekly fee does not include provision for items such as hairdressing, chiropody, dental, ophthalmic, or audiology services. Stokeleigh Residential Home DS0000059246.V339365.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced site visit as part of a key inspection carried out over one day. The inspector sent surveys “Have your say” to residents and visitors prior to the inspection and fourteen were completed and returned. Information received from the surveys is detailed throughout the report. Results from the homes annual quality assurance surveys were also looked at and details of the survey are detailed throughout the report. The inspector spent time throughout the visit talking to residents, the manager and staff; a number of records and files were looked at, including care records, staff training records, the complaints log and medication records. The inspector toured the premises accompanied by the manager. Feedback was given on the outcome of the inspection. What the service does well: What has improved since the last inspection? Although residents’ daily routines have always been flexible within the home, new documentation is now being used to evidence this. This should ensure more consistency and continuity in ensuring that residents are able to live the Stokeleigh Residential Home DS0000059246.V339365.R01.S.doc Version 5.2 Page 6 lives they choose. It is a comprehensive; person centred account of routines and personal preferences for individual residents over a twenty-four hour period. 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. The summary of this inspection report can be made available in other formats on request. Stokeleigh Residential Home DS0000059246.V339365.R01.S.doc Version 5.2 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 Stokeleigh Residential Home DS0000059246.V339365.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents needs are assessed prior to admission to determine the suitability of placement. They can be confident that staff will have the resources and skills to meet their assessed needs. EVIDENCE: Pre-admission assessments were comprehensive covering all activities of daily living, a full health screen and personal history background. The prospective resident, family and carers are involved in the pre-assessment and all information is used to determine the suitability of the placement. Stokeleigh Residential Home DS0000059246.V339365.R01.S.doc Version 5.2 Page 9 Information gathered is transferred to a detailed Long Term Assessment record, which is further developed during the initial first four weeks of admission to the home. The records had been signed and dated by the resident/relative. Where possible the manager also obtains comprehensive assessments and care plans from other professionals involved for example, social workers and hospital staff. One relative stated, “ My relative has only been at the home for a short time, however our experience so far is that staff are open and answer questions honestly, which helped us make our decision about requiring long term care.” Through her knowledge and expertise the manager and staff continue to demonstrate a good knowledge of the current residents, their medical history, personal background and their subsequent needs. The information gathered preadmission provides a sound benchmark of the resident’s ability and state of health prior to admission. Stokeleigh Residential Home DS0000059246.V339365.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Because they are consulted about their health and personal care needs residents can be sure their views and expectations will be considered. Further development of care plans is required to ensure that they accurately reflect residents’ needs and provide more instruction to staff on how to deliver the care required. There are safe systems of practice in receiving, storing, administering, and disposing of drugs. Residents can be confident that staff that they will be treated with dignity and respect. EVIDENCE: Stokeleigh Residential Home DS0000059246.V339365.R01.S.doc Version 5.2 Page 11 The home uses the ‘Standex’ system of documentation for assessing, planning and evaluating care based on the activities of living. The documentation available was comprehensive and overall completed to a satisfactory standard. The manager and staff have been working hard to implement this relatively new system for all residents at the home. In house training to help staff develop their skills and confidence when devising care plans and writing the daily records has been introduced. As mentioned previously staff gradually assess the residents needs and complete a long-term assessment plan. Each resident had person centred assessments, which means that staff put the views, wishes, likes and dislikes of each resident at the centre of all care provided. Any needs identified from this assessment are formulated into a care plan detailing how the needs can be met through “Care Instructions”. Care instructions on some plans were sparse in detail and required more instruction on how staff can meet those needs identified. The inspector found that in some cases needs had been identified in the care records, including short-term memory loss; potential risk of falling and episodes of depression but care plans for these had not been developed. Where needs have been identified a care plan must be developed, giving clear detailed instruction about how staff are to manage the care required. This will make sure that peoples health and welfare is properly maintained and ensure consistency and continuity when delivering the care. Whenever possible residents/relatives had signed that the care plans had been discussed and that they agreed with the information, the aims and objectives contained in them. Residents and relatives surveys asked, “Does the home give the care/support that is agreed and expected?” The feedback was positive and comments included, “My relative has settled very quickly and I feel that the staff have been significant in this. My relative has been encouraged to walk using their Zimmer frame and is far less immobile”, “My relatives needs have been largely met” and “Very good, I get all the help and support I need”. Relatives were asked in their surveys “Are you kept up to date with important issues?” comments included, “I am always kept informed on issues such as hospital admissions but not so much if my relative has had a fall or on any medical issues affecting my relatives care” and “At each visit the senior staff comment on my relatives progress, wellbeing and health issues”. Stokeleigh Residential Home DS0000059246.V339365.R01.S.doc Version 5.2 Page 12 With regards to the first response mentioned, the manager explained that it was the policy of the home to inform relatives of any outcomes directly affecting the residents’ health, including chest infections, urinary tract infections and any change in care following a doctor’s visit. The manager stated that usually relatives have not been contacted directly if a resident had fallen particularly when there had been no apparent injuries. In light of the relatives response the manager agreed that this practice should change and that all significant people should be informed. The manager is in the process of arranging annual reviews with residents and their families, which will allow opportunity to discuss and evaluate residents’ care plans and any issues or concerns they may have. Records of the General Practitioner (GP) visits/contact with residents and the outcomes were also available. Specialist referrals and visits from other professionals were evidenced in care files including Community Nurses, Chiropodists, Opticians and Dentists. Results from the residents’ surveys evidenced that they feel that they receive all the medical support they require. The manager stated that each resident was referred to a GP of his or her choice on admission to the home and an initial first visit was then set up. Good working relationships with GP’s and District Nursing teams have been formed and they will visit on request. Policies and procedures for receiving, storing, administering and disposing of medications were examined; systems in place are effective and well managed. The home operates a monitored dosage system for the administration of medication, which is supplied at regular intervals by the local pharmacist. The GP’s conduct a medication review for all residents every six months. There were photographs of each resident on their medication charts to help ensure that medication was dispensed to the correct person. The administration charts were legible and continuity of administration was shown with a signature from the person dispensing. The home promotes privacy and dignity to all people who use the service. Staff receive training on “Promoting Privacy and Dignity” on induction, which covers issues like closing doors and pulling curtains when delivering personal care and knocking on residents doors and waiting for an invitation to enter before going into their rooms. Staff were seen knocking on residents doors before entering confirming respect for the residents individual privacy and dignity at all times. Members of staff spoke respectfully about residents needs and referred to them in the term of address that they preferred, this information was evidenced in the residents care files. Stokeleigh Residential Home DS0000059246.V339365.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Although some support and provision is made to residents with their social opportunities, residents would welcome additional outings to provide daily variation. Encouragement and support from staff enables residents to maintain good contact with family and friends. The home actively promotes residents to exercise choice and control over the lives they choose to live by developing comprehensive daily routines and personal preferences. Residents receive a varied and wholesome diet that they are able to influence. EVIDENCE: Stokeleigh Residential Home DS0000059246.V339365.R01.S.doc Version 5.2 Page 14 There does not appear to be any unnecessary rules in the home and it was evident that the homes philosophy centralises on empowering residents and encourages residents to maintain independence, autonomy and choice. Residents’ daily routines are flexible within the home, residents can get up and go to bed when they like, having their meals in their bedrooms, they can go out when they wish and participate in activities they have a particular interest in. This was confirmed through documentation in residents care files and in discussion and through observation during the inspection. The documentation used is a new initiative to ensure consistency to the residents. It is a comprehensive; person centred account of routines and personal preferences for individual residents over a twenty-four hour period. Activities continue to be organised on a monthly basis, and a copy of the programme is circulated to the residents and visitors. Monthly activities include slide shows, skittles, flower arranging, cooking and exercise classes. The programme for April was looked at and although there were some interesting activities and entertainers arranged it was questionable whether this was enough to meet residents needs. The activities coordinator only works six hours a week and any other time spent stimulating residents is largely down to staff availability on each shift. The manager also participates in cooking activities when time allows, however the consistency of the service offering a varied, stimulating daily programme does seem weak at times. The homes recent annual quality assurance survey asks, “Do you feel we offer enough activities?” Comments included “No”, “Not really but its satisfactory” and “Possibly not”. When asked, “What would you like to see more of?” suggestions provided were, “Talks on interesting subjects”, “Topical discussions” and “Large screen television and DVD’s of classic films”. Since the survey was conducted the home is now in the process of purchasing a new wide screen television for the residents. Residents felt that usually there were activities arranged in the home that they could take part in, however several residents requested more outings. Comments received included, “There should be more frequent, intelligent and varied activities” and “More outings and short trips would be appreciated”. The manager confirmed that for various reasons outings had not been arranged last year and that she and the activities coordinator were addressing this, particularly with the finer months approaching. The manager also explained that she is looking at ways of providing additional hours to allow for more activities within the home. Stokeleigh Residential Home DS0000059246.V339365.R01.S.doc Version 5.2 Page 15 Various entertainers are booked on a regular basis and for special events throughout the year including “Slide show presentations”, “Yesteryears Entertainment” and productions from a travelling theatre company. Residents and relatives commented about occasions when these visits had been cancelled at short notice and how disappointing this can be. The manager explained that entertainers had cancelled at very short notice. On the day of the inspection a guest speaker who was visiting to present a slide show to the residents cancelled that morning. The staff arranged for the residents to participate in a game of Bingo, but the disappointment for all was plain to see. Many residents go out regularly and are encouraged and supported to be actively involved in the local community if they are able and choose to do so. The home operates an open door policy for visitors. Residents are able to see visitors in the privacy of their rooms and there are several semi-private seating areas around the home and in the gardens. Relatives/visitors surveys agreed that they always feel welcome by the staff when visiting. The size and layout of the dining room enables residents to enjoy the social advantages of dining together. Residents enjoy a glass of sherry prior to lunch. The dining room is light, spacious and the tables are attractively laid with tablecloths and napkins. The 4-week menu rota displayed traditional meals and choice was available at each sitting. The menus are reviewed to reflect seasonal trends and availability of produce. Extras are ordered on request for birthdays and special occasions. The kitchen was very clean and spacious and stores exhibited a good range of foods. The inspector spoke briefly with the chef whilst he was preparing lunch. A good variety of fresh vegetables were being prepared as was an array of fruit for the fresh fruit salad which is provided every day as an alternative to the sweet available on the menu. Surveys suggested that the meals provided were good and comments received included, “The chef is excellent and there is always a good choice of food”, “The chef is enthusiastic and tries to accommodate requests” and “I have no complaints about the food and it is always well served by the carers”. Relatives’ comments included, “The menus do not seem to be particularly imaginative, however I appreciate that not all residents may like more Stokeleigh Residential Home DS0000059246.V339365.R01.S.doc Version 5.2 Page 16 adventurous recipes” and “My relative says the food is ok, but finds it a little institutionalised”. The homes annual quality assurance survey asks, “What are your views on the variety of food offered at Stokeleigh?” Comments included, “Improving but more variety of puddings please”, “Could do with more green vegetables”, “Pretty good, quite happy” and “Generally good but could have more variety”. Residents are able to influence the choices on the menus, which is often discussed at residents meetings. Stokeleigh Residential Home DS0000059246.V339365.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are policies in place to ensure that complaints by residents or their families are taken seriously and acted upon. There are good arrangements in place for staff training and awareness of protection of vulnerable adults so that residents are protected from abuse. EVIDENCE: A copy of the complaints procedure is on display in a well-frequented part of the home, which means people will know how to obtain the required information if they want to make a complaint. The complaints policy and procedure is detailed and contains all the required information, which can be found in the service user guide and individual contracts, terms and conditions. There have been three written complaints in the last year, the inspector examined documentation and all details confirmed that policies and procedures Stokeleigh Residential Home DS0000059246.V339365.R01.S.doc Version 5.2 Page 18 were followed and that the complaints were dealt with and resolved effectively and efficiently. It is evident that residents are encouraged to voice their concerns at all times. All residents stated in the surveys that they knew who to talk if they were not happy and how to make a complaint. Comments included, “I am mostly happy and if I wasn’t I would speak to the manager” and “I would speak to some of the staff”. The homes quality assurance survey asks, “Do you feel that you could talk to the manager if you had a problem?” Comments were positive and included, “Yes she is very approachable” and “Yes I’m sure I could”. There are policies and procedures as well as a range of guidance information on the topic of protection of vulnerable adults from abuse. The availability of this information should increase staff awareness and understanding of their role in protecting vulnerable adults who live at the home. The deputy manager is qualified to conduct in house training for all staff in the protection of vulnerable adults, which staff receive annually. A number of staff are undertaking the National Vocational Qualification in care award, and a component of the award addresses issues around the topic of the protection of vulnerable adults from abuse. Stokeleigh Residential Home DS0000059246.V339365.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean, comfortable, well decorated and furnished. It provides a safe, peaceful and well-maintained environment for the residents. The bedrooms, communal rooms and facilities are suitable and well presented for their purpose and meet the residents’ needs. EVIDENCE: Stokeleigh Residential Home DS0000059246.V339365.R01.S.doc Version 5.2 Page 20 Stokeleigh Residential Home is situated in large grounds, which are well maintained, and a source of pleasure for residents, particularly in the summer months. Residents were asked in the homes annual quality assurance surveys “Is there anything that you would like to have included in the gardens?” comments received included “They are delightful and most enjoyable”, “No they are very pretty as they are” and “I think they are excellent”. There are three points of entry to the home to provide access for a range of diverse needs, including wheelchair access and emergency services. Room sizes are adequate for their stated purposes, particularly the lounges, dining room, and conservatory. Residents’ bedrooms are spacious with a sitting room area, which can accommodate their guests when they visit. Some rooms have pretty verandas with planters and bird feeders. Bedrooms also have en suite facilities provided and communal bathing areas and toilet facilities are located throughout the home. Residents are supported to personalise their bedrooms with pictures and ornaments and residents are able to bring items of furniture should they wish. All areas of the home were tastefully decorated, and well maintained. Great attention had been given to ensure that all areas are homely. Residents were making full use of these areas and their bedrooms on the day of the inspection. The home was clean and free from unpleasant odours. The home employs domestic staff on a daily basis. Residents’ surveys confirmed that the home is always fresh and clean and one resident stated, “There are good standards of cleaning in all rooms”. Stokeleigh Residential Home DS0000059246.V339365.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staffing levels are adequate to help ensure that resident’s needs are fully met. Residents are supported and protected by the homes recruitment policy. Staff receive essential training so residents should receive a service from a confident and competent team. EVIDENCE: The manager ensures that staffing levels are indicative of the needs and levels of care required by the residents twenty-four hours a day and confirmed that levels of staff would rise should dependency levels increase. Stokeleigh Residential Home DS0000059246.V339365.R01.S.doc Version 5.2 Page 22 Residents’ surveys agreed that staff were usually always available when they needed them comments included, “I get all the help I need” and “Very good carers always smiling”. Comments received about the staff were positive and included, “The staff always appear to be kind, caring and have appropriate knowledge”, “All staff seem caring and genuinely interested in the clients as individuals” and “They always take time to listen to the residents and their relatives”. A recruitment policy and procedure is in place and the files inspected showed all the appropriate documents and checks were in evidence. CRB disclosures are being retained until the inspector has examined them. The home continues to support staff with NVQ training and the enrolling programme continues. A training matrix has been developed and the inspector was able to see that all mandatory training was undertaken and course dates had been organised for staff for this year. The manager and staff are conscientious in attending training relevant to the care needs of the residents in order to improve the services they are providing. This year the manager is in the process of arranging training in “Caring for people with Parkinson’s Disease”, “Dementia Awareness” and “Infection Control”. Stokeleigh Residential Home DS0000059246.V339365.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ can be confident that their needs and best interests are central to the management approach in the home. Records in the home indicate that the health and safety of residents, staff, and visitors is protected. Stokeleigh Residential Home DS0000059246.V339365.R01.S.doc Version 5.2 Page 24 EVIDENCE: Mrs Bird was appointed as manager of Stokeleigh Residential Home in November 2005. She has fifteen years experience in the care sector and has achieved her Registered Managers Award. It was evident from discussions and observation that the manager and staff are becoming a stable team that supports a commitment to providing quality care for the benefit of the residents. Comments received from relatives’ surveys included, “The home provides a safe, clean, warm, comfortable environment” and “They seem to provide a homely rather than institutionalised atmosphere”. As mentioned throughout the report the home has completed an annual quality assurance audit to assess the satisfaction of residents with regards to the service that the home provides by asking residents to complete surveys. The results and comments from the surveys were generally very positive. Information from the surveys is collated and documented effectively. The results have enabled the home to identify strengths and weaknesses within the service they provide and are acted upon in their development plan for the coming year. Progress of any outcomes are discussed with the residents at their meetings. The manager told the inspector that she likes to visit residents on a daily basis. Conversations include enquiring how residents are, what was their meal like and what are their plans for the day. Residents meetings at present are organised every three months. The residents are informed in advance and asked if there is anything they would like to add to the agenda. Minutes of the meeting were examined and showed that any concerns/issues raised are transferred into an action plan to determine how they can be resolved. Each resident is responsible for his or her own money and a locked safe is provided in each room. Some residents choose to pay for sundries direct for example to the hairdresser and chiropodist, whilst others prefer to be invoiced at the end of each month. The policy of the home is to not hold any amounts of cash for the residents. If residents choose not to keep money in the home other suitable arrangements are made via a representative such as a family member or solicitor. Some of the Health and safety records in the home were examined. Documentation showed that relevant checks were maintained correctly and at the required intervals including all fire alarms and equipment and emergency Stokeleigh Residential Home DS0000059246.V339365.R01.S.doc Version 5.2 Page 25 lighting. The homes records showed all necessary service contracts were up to date including, gas and electrical services, and the passenger lifts. Stokeleigh Residential Home DS0000059246.V339365.R01.S.doc Version 5.2 Page 26 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 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Stokeleigh Residential Home DS0000059246.V339365.R01.S.doc Version 5.2 Page 27 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 OP7 Regulation 12(1) (a) Requirement The registered person shall ensure that the care home is conducted so as to promote and make proper provision for the health and wealth of service users. Timescale for action 13/08/07 2 OP12 16(2) (n) Where needs have been identified from the initial assessment a care plan must be developed, giving clear detailed instruction about how staff are to manage the care required. This will make sure that peoples health and welfare is properly maintained and ensure consistency and continuity when delivering the care. The registered person shall 13/08/07 having regard to the size of the care home and the number and needs of service users, consult service users about the programme of activities arranged by or on behalf of the care home, provide facilities for recreation including, having regard to the needs of service users, activities in relation to recreation, fitness and training. DS0000059246.V339365.R01.S.doc Version 5.2 Page 28 Stokeleigh Residential Home Responses received from our surveys and the homes annual quality assurance surveys must be collated and the results must be discussed with the people who use the service. An action plan must be put in place to ensure that people’s wishes are carried out, including more organised trips outside of the home. This will make sure that people have the opportunity to have an enjoyable stimulating lifestyle of their choice. 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 Stokeleigh Residential Home DS0000059246.V339365.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 DS0000059246.V339365.R01.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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