Inspection on 03/12/05 for Stokeleigh Residential Home

This inspection was carried out on 3rd December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Stokeleigh Residential Home 14/01/08

Stokeleigh Residential Home 24/04/07

Stokeleigh Residential Home 30/05/06

Stokeleigh Residential Home 01/08/05

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 Inspection 3rd December 2005 08:45 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.V268625.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. Stokeleigh Residential Home DS0000059246.V268625.R01.S.doc Version 5.0 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 Hartford Care Limited Mrs Caroline Cooper Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Stokeleigh Residential Home DS0000059246.V268625.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st August 2005 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, which are well maintained. Accommodation is provided in single rooms, each with its own ensuite facilities. The upper floors are accessible via two lifts. The home has recently employed a new manager who has successfully passed a “fit persons” interview to become registered under the Care Standards Act. One reference is outstanding; once received, a new certificate will be issued. Stokeleigh Residential Home DS0000059246.V268625.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the home’s second unannounced inspection this year and took place on a Saturday over six hours. The focus of this inspection was to check staffing levels, to look at arrangements for health and safety and to examine careplanning processes. Evidence was gathered through discussion with the manager and staff, observation and consultation with residents. In addition to this key records were examined. What the service does well: What has improved since the last inspection? The home continues to maintain many of the good standards highlighted at the last inspection. Residents are encouraged to speak their minds and their concerns are taken seriously. The menus have been re-formatted so that they are easier to read and new contracts have been issued. Stokeleigh Residential Home DS0000059246.V268625.R01.S.doc Version 5.0 Page 6 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 DS0000059246.V268625.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 Stokeleigh Residential Home DS0000059246.V268625.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): 1,2,3,4,5 Residents are given enough information to make an informed decision about moving to the home. Some of this, however, needs updating and the home should more fully record initial assessments so that they can be sure they will be able to meet individual needs. EVIDENCE: Stokeleigh Residential home has a Statement of Purpose and residents guide which are made available for all new prospective residents. This should be reviewed annually and will need to be altered to reflect the managerial changes within the home. The CSCI would be pleased to receive copies of these when complete. Residents confirmed that they received a copy of guide before moving in. All new residents are asked to sign a contract and it was understood that these have been updated to reflect a change in the ownership of the home. Stokeleigh Residential Home DS0000059246.V268625.R01.S.doc Version 5.0 Page 9 The admissions process includes a home assessment by the manager who discusses with residents their individual needs. A number of residents confirmed that they had been visited in their home prior to moving to Stokeleigh Residential Home. Record keeping in this respect, however, was inadequate and those files seen at the time of this visit did not demonstrate that full assessments had taken place. This was discussed with the new manager who undertook to improve this. National Minimum Standard three provides a checklist of all issues that should be discussed and may help with this process. The new manager displayed a good understanding of the scope of the services available at the home and about specialist support that was available. At the time of this visit there were no residents observed to be accommodated out of the home’s registration category and their needs were being met. Residents confirmed that they, or their family, were able to visit the home prior to moving there and said that the staff were very welcoming and answered any questions they had. Stokeleigh Residential Home DS0000059246.V268625.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): 7,8, 9, 11 Care plans need to be more detailed so the home can more clearly demonstrate it is providing residents with an individualised service. These should include wishes in the event of their death. Residents’ are well supported with their health care needs. The medication system, however, needs to be improved so that it is safer. EVIDENCE: Each resident has a care plan, which identifies any physical, emotional and social support needed. The two seen at the inspection were limited in detail and did not clearly demonstrate individual needs and preferences. These should be improved, particularly in relation to emotional and social needs. This was a recommendation made at the last visit and now becomes a requirement. During this process the manager should also focus on whether risk assessments need to be in place. This will be a focus of the next inspection. Records continue to provide evidence that residents are supported to see the relevant health professionals and to have annual check ups. Residents said they could ask a GP to visit at any time and some were re-assured by the fact that they have been able to retain Doctors who they have known for years. Stokeleigh Residential Home DS0000059246.V268625.R01.S.doc Version 5.0 Page 11 The home operates a monitored dosage system for the administration of medication that is supplied at regular intervals by the local pharmacist. On inspection, there were several errors which were as follows: • • • • The medication was not being booked on the premises in the appropriate manner Tablets were being signed for as given but they were not actually available on the premises. Tablets were being dispensed from one container to another - thus increasing the risk of errors being made There were some tablets unaccounted for. A series of immediate requirements were issued about this and the home will be the subject of an additional visits to ensure they have been achieved. Two requirements made in relation to medication at the last visit have not been met and consideration to further enforcement action will be given if these are not actioned promptly. In addition to the above the manager was asked to develop individual medication profiles – this should enable staff to become more familiar with prescribed medication and enable them to more easily spot mistakes. It was not clear on care plans what residents’ wishes were in the event of their death. Whilst it is acknowledged that this is a sensitive issue, it is important that the home gathers this information, this should also include spiritual requirements. Stokeleigh Residential Home DS0000059246.V268625.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): 12,13,15 Residents are supported to dictate their own routines and are encouraged to remain active members of the community. The serving of meals should be reviewed to make the process more relaxed for residents. EVIDENCE: This inspection took place on a Saturday morning and it was observed that there was a relaxed atmosphere and residents were getting up in their own time. All those consulted with said they felt there were no unnecessary rules and that they could come and go as they pleased. It was apparent that they felt confident that they could dictate their own routines. Many activities continue to be organised on a monthly basis and it was noted that throughout December a number of entertainers have been booked for the festive season. In addition to this there is regular Holy Communion and armchair exercises. Once again all residents spoken with said there was plenty to do if they wanted to, although some choose not to participate according to how they feel and they are not pressurised to do so. Stokeleigh Residential Home DS0000059246.V268625.R01.S.doc Version 5.0 Page 13 It was observed that family and friends are made welcome at any time. The manager explained she is due to have a social evening in the near future to introduce herself to all the relatives. Some residents go out regularly and it was apparent that they continue to be encouraged to be actively involved in the local community of they are able and choose to do so. Opportunity was taken to join residents with their lunchtime meal. This generally appeared to be enjoyed by all members of the household and most residents spoke positively about the choice and quality of the food. It was noted, however, that the some residents were waiting a considerable time for their food and this led to issues for one resident who eats slowly. This has been the subject of discussion with the manager. The home should review practices in this respect. Menus provided evidence that residents benefit from having a varied, nutritious and wholesome diet. They confirmed that they receive breakfast in their bedrooms, which gave them the opportunity to start the day in their own time. They also said that they could choose to eat all their meals in their bedrooms if they wished. Stokeleigh Residential Home DS0000059246.V268625.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): 16 Residents can be confident that their concerns will be listened to and acted upon. EVIDENCE: The home has a formal complaints procedure, which is displayed on the notice board and included in the guide that is given to all new residents. This was confirmed through discussion at the time of this visit. Residents continue to speak honestly about what life is like within the home and there was an open atmosphere. They did not appear to be afraid to speak their minds. They said that the staff were kind and approachable and that initially they would talk with their key worker of they had a concern. They said that they would speak with the manager if it were more serious. Stokeleigh Residential Home DS0000059246.V268625.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): 19,20,21,23, 24 Residents continue to benefit from a homely, comfortably furnished and well maintained environment. It is cleaned to a good standard. EVIDENCE: Stokeleigh Residential Home is situated in large grounds, which are well maintained, and a source of pleasure for residents, particularly in the summer months. The premises itself continues to be well maintained, comfortably furnished and homely. Residents bedrooms are personalised and reflect individual tastes – a number commented that they were able to bring in their own furniture which they were pleased to do. All bedroom doors can be locked and each room has a safe that residents can use to keep their personal possessions secure. Stokeleigh Residential Home DS0000059246.V268625.R01.S.doc Version 5.0 Page 16 There are a number of communal areas for residents use – it was noted that the carpet in one lounge requires stretching. In addition to this the flooring in the lift is “bubbling” up and this is a tripping hazard. The home continues to be cleaned to a high standard and there were no unpleasant smells. One senior care assistant said that she was currently undertaking an infection control course which she was enjoying. The home has a number of up to date policies available in relation to this although they were not looked at in detail at the time of this visit. Stokeleigh Residential Home DS0000059246.V268625.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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): 27,28,29 There is a robust recruitment procedure in place that is designed to protect vulnerable adults. Staffing levels should be kept under review. EVIDENCE: At the time of the inspection there were three care assistants on duty. At present this appears to be sufficient to meet the needs of those residents currently accommodated. If levels of dependence were to increase, or if the home were to fill their vacancies, then staffing levels would need to be increased. The new manager said that she was going to undertake a review of the rotas. This will continue to be a focus of the next inspection. One member of staff spoken with said she was pleased with the amount of training she had received and she confirmed that she had successfully passed her National Vocational Qualification – level 2. She also said that she had and first aid, manual handling and fire training. Training records indicted that staff have been encouraged to participate in short training course and to utilise long distance learning packages. Opportunity was taken to view the personal files of the newest staff, these contained completed application forms, references and CRB checks. This meets with the requirements of the legislation. It was noted that the application form did not give scope for staff to put their full employment history and it is recommended that the format of this is reviewed. Stokeleigh Residential Home DS0000059246.V268625.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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): 36,38 There are adequate systems in place for the maintenance of health and safety so residents can be confident that the environment is safe. EVIDENCE: The manager is new so a number of these standards were not inspected and will be a focus of future visits. Whilst it was noted that staff receive some formal supervision it appeared that this is sporadic and action should be taken to ensure that this is more consistent. The manager has recently recruited for a deputy, which should enable her to have the support to achieve this. Stokeleigh Residential Home DS0000059246.V268625.R01.S.doc Version 5.0 Page 19 The last recorded staff meeting was in July, the manager should ensure that these are carried out more regularly as these provide an important, more formal forum, through which staff can be involved in the running of the home. The home had an up to date insurance certificate. The fire logbook provided evidence that the home tests and checks the fire system at the appropriate intervals and that staff receive regular training. A workplace fire risk assessment was unavailable. This needs to be developed and updated annually. A certificate was seen to confirm that the home had the electrical wiring checked last year and that there were no significant faults. In addition to this all electrical appliances had been tested in July of this year. The home receives a visit from an external manager who is appointed to oversee the running of the home. Reports of these visits are sent to the CSCI. This meets with requirements of the legislation. It was noted, however, that these did not include much detail and it is recommended that more in-depth records be kept. Stokeleigh Residential Home DS0000059246.V268625.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 3 3 2 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 x 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 x 4 3 3 X 3 3 x x STAFFING Standard No Score 27 3 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x x 2 x 2 Stokeleigh Residential Home DS0000059246.V268625.R01.S.doc Version 5.0 Page 21 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 4 5 6 Standard OP1 OP3 OP7 OP9 OP9 OP9 Regulation 6 14 15 13(2) 13(2) 13(2) Requirement Update Statement of purpose and service user guide Ensure that an assessment is obtained for all new residents prior to them moving in Review and expand care plans Maintain accurate records of all medication administered Repeated requirement Re-check staff competencies to give out medication Repeated requirement Ensure that all medication given on an as and when basis is checked monthly and that accurate stock checks are maintained Develop medication profiles for all residents Ensure that residents wishes in the event of their death are included in care plans Repair or replace flooring in lounge and in the lift Ensure staff are supervised at regular intervals Ensure there is an up to date workplace fire risk assessment Timescale for action 28/02/06 03/12/05 30/03/06 03/12/05 03/01/06 03/12/05 7 8 9 10 11 OP9 OP11 OP20 OP36 OP38 13(2) 12(1)(a) 23(2)(b) 18(2) 23(4)(a) 03/01/06 30/01/06 30/12/05 03/01/06 30/01/06 Stokeleigh Residential Home DS0000059246.V268625.R01.S.doc Version 5.0 Page 22 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 OP15 OP36 OP33 Good Practice Recommendations Review arrangements for serving meals Ensure staff meetings take place at regular intervals Regulation 26 reports to be more detailed Stokeleigh Residential Home DS0000059246.V268625.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos 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 DS0000059246.V268625.R01.S.doc Version 5.0 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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