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Inspection on 30/05/06 for Stokeleigh Residential Home

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

This inspection was carried out on 30th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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

Staff provide a standard of care that, is individualised and person centred and work hard to ensure that residents needs and wishes are met. The service was proactive in monitoring residents` care needs and in ensuring health needs were being met. The home`s environment and its surroundings meets the residents` needs and provides great pleasure and enjoyment to them. The activities provide a regular, varied and stimulating programme to suit individual preferences. Meals were well presented and menus verify a healthy well balanced diet for all residents. Through dedication of existing staff members and the new management team the home has worked hard to improve, raise and maintain standards, which are detailed throughout the report.All requirements have been addressed since the last inspection and will require ongoing development, the inspector is confident that this will continue and will look forward to reviewing their progress at the next inspection.

What has improved since the last inspection?

The statement of purpose and service user guide has been updated to reflect changes of management and ownership of the home. A new pre assessment form has been implemented to determine the suitability of placement for prospective residents, to ensure that their needs can be met. A new care plan system has been initiated to ensure that residents` care is monitored, evaluated and updated on a monthly basis. All staff have received training via supervision on dispensing, administration of medicines and accurate recording on the MAR sheets. A new medicines trolley has been obtained which has improved the effectiveness of storage and administration. The deputy manager now has responsibility for the ordering, storage, stocktaking and disposing of medication and is currently developing medication profiles for all residents. Plans are being developed with regards to residents` wishes when dealing with acute illness and making plans for end of life. The carpeting in the lounge has been replaced, and the corridors are being redecorated. New shelving and flooring has been provided in the larder. Staff are now receiving supervision and a plan has been developed which should help ensure that staff receive this regularly. The manager has recently attended a course on "Fire Risk Assessment" and has written a Fire Safety Risk Assessment for the home. Arrangement for serving meals has been reviewed to make provision for residents to eat at their own pace without feeling pressured to finish.

What the care home could do better:

Provision to supply a portable telephone for staff will ensure that people will be able to get through to the home at all times. Risk assess the front access to the home and discuss any adaptations required with the area manager, including adequate lighting and handrail facilities.

CARE HOMES FOR OLDER PEOPLE Stokeleigh Residential Home 19 Stoke Hill Stoke Bishop Bristol BS9 1JN Lead Inspector Wendy Kirby Key Unannounced Inspection 30th May 2006 09:30 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.V292700.R01.S.doc Version 5.1 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.V292700.R01.S.doc Version 5.1 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 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.V292700.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd December 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 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 will cost 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.V292700.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection conducted as part of the annual inspection process. The inspection lasted one day. During the inspection the inspector spent time in discussions with the manager and deputy manager. A number of records were examined, including four residents’ care plans, and records relating to the day-to-day running and management of the home. The inspector took a tour of the premises. Time was spent observing the residents in the home throughout the course of the visit and six were spoken with at length and one visitor. Members of staff were observed on duty and two were consulted individually. The inspector sent questionnaires “Have your say” to all thirty residents in the home prior to the inspection and thirteen were returned. Comments received from the residents and their families have been included within this report. What the service does well: Staff provide a standard of care that, is individualised and person centred and work hard to ensure that residents needs and wishes are met. The service was proactive in monitoring residents’ care needs and in ensuring health needs were being met. The home’s environment and its surroundings meets the residents’ needs and provides great pleasure and enjoyment to them. The activities provide a regular, varied and stimulating programme to suit individual preferences. Meals were well presented and menus verify a healthy well balanced diet for all residents. Through dedication of existing staff members and the new management team the home has worked hard to improve, raise and maintain standards, which are detailed throughout the report. Stokeleigh Residential Home DS0000059246.V292700.R01.S.doc Version 5.1 Page 6 All requirements have been addressed since the last inspection and will require ongoing development, the inspector is confident that this will continue and will look forward to reviewing their progress at the next inspection. What has improved since the last inspection? The statement of purpose and service user guide has been updated to reflect changes of management and ownership of the home. A new pre assessment form has been implemented to determine the suitability of placement for prospective residents, to ensure that their needs can be met. A new care plan system has been initiated to ensure that residents’ care is monitored, evaluated and updated on a monthly basis. All staff have received training via supervision on dispensing, administration of medicines and accurate recording on the MAR sheets. A new medicines trolley has been obtained which has improved the effectiveness of storage and administration. The deputy manager now has responsibility for the ordering, storage, stocktaking and disposing of medication and is currently developing medication profiles for all residents. Plans are being developed with regards to residents’ wishes when dealing with acute illness and making plans for end of life. The carpeting in the lounge has been replaced, and the corridors are being redecorated. New shelving and flooring has been provided in the larder. Staff are now receiving supervision and a plan has been developed which should help ensure that staff receive this regularly. The manager has recently attended a course on “Fire Risk Assessment” and has written a Fire Safety Risk Assessment for the home. Arrangement for serving meals has been reviewed to make provision for residents to eat at their own pace without feeling pressured to finish. Stokeleigh Residential Home DS0000059246.V292700.R01.S.doc Version 5.1 Page 7 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.V292700.R01.S.doc Version 5.1 Page 8 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.V292700.R01.S.doc Version 5.1 Page 9 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 Quality in this outcome area is good. Prospective residents or their families receive relevant information to make a decision about the nature of the home. Prospective residents’ needs are assessed prior to admission to determine the suitability of placement to ensure that their needs can be met. Trial visits give prospective residents an opportunity to assess the nature of the home. EVIDENCE: A statement of purpose and service user guide is made available at the initial stage of enquiry to prospective residents/families. Following a requirement from the previous inspection, the statement of purpose and residents contracts have been reviewed and updated to reflect managerial changes and the change in the ownership of the home. Stokeleigh Residential Home DS0000059246.V292700.R01.S.doc Version 5.1 Page 10 Thirteen residents stated in their surveys that they had received a contract and that they had enough information given to them to assist them in deciding if the home was the right place for them to live. The service user guide includes valuable information on the facilities and services available to them within the home. Since the previous inspection the manager has been auditing a new tool for the pre-admission assessments, which 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. The manager has worked previously in a care home with nursing and has an NVQ4 and her Registered Managers Award. Through her knowledge and expertise she is able 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. Prospective residents are encouraged to visit the home either for the day or perhaps for lunch dependent on their wishes. A month’s trial period on both sides is usually undertaken to ensure that everyone is happy with the arrangements and to ensure that the placement is suitable. One new resident in the home was spoken to as part of the inspection and confirmed that they had received relevant information prior to admission and had made a visit to the home before making a decision about where to live. Stokeleigh Residential Home DS0000059246.V292700.R01.S.doc Version 5.1 Page 11 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): 7,8,9,10 Quality in this outcome area is good. The service had good systems for meeting and monitoring residents’ health and personal care needs in consultation with residents. There are safe systems of practice in receiving, storing, administering, and disposing of drugs. Staff have a good awareness of individuals’ needs and treat the residents in a warm and respectful manner, which means that they can expect to receive care and support in a sensitive way. EVIDENCE: 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. Stokeleigh Residential Home DS0000059246.V292700.R01.S.doc Version 5.1 Page 12 This is a new system of documentation and in its early stages. The manager and her staff have been working hard to implement this system for all residents at the home. The manager is developing some in house training to help staff develop their skills and confidence when devising care plans and writing the daily records. Following admission to the home, the staff gradually assess the residents needs and complete a long-term assessment plan. Each resident had comprehensive person centred assessments, which means that staff put the views, wishes, likes and dislikes of each resident at the centre of all care provided. 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 inspector was informed 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. During the inspection it was observed and noted that staff on duty had identified that one resident was poorly and that their health was deteriorating. The resident was immediately referred to the GP who paid a visit and subsequently admitted the resident to hospital. This indicates an efficient process whereby residents’ needs are continually monitored, assessed and managed. Several requirements were made at the previous inspection with regards to medication procedures, storage and recording. The manager and her deputy were able to demonstrate that they had addressed the requirements and the inspector was confident that they would continue to work hard towards maintaining and raising the standards around medication policies and procedures. Further developments will be followed up at the next inspection. The policy and procedure for ordering, storage, administration and disposing of medication were correct and written in August 2005. The manager stated that she was in the process of reviewing the information. A new medicines trolley has been obtained which has improved the effectiveness of storage and administration. Following previous requirements made, the deputy manager has now taken full responsibility for the ordering, storage, stocktaking and disposing of medication and is currently developing medication profiles for all residents. One resident stated in their survey that they “receive their medication promptly”. Stokeleigh Residential Home DS0000059246.V292700.R01.S.doc Version 5.1 Page 13 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. Two residents stated that obtaining medication from the pharmacy can be delayed following a GP visit. This has been addressed by the manager with the pharmacy and will be monitored in the future. The manager has made arrangements for all staff to receive Medication Competency training and has given staff some in house training via supervision in the interim. Although this was not looked at in great detail during the inspection, the manager and her staff are continuing to make every effort to establish resident’s wishes concerning palliative care and any provision residents and their families would wish for by developing end of life care plans. The atmosphere in the home on the day of the inspection was relaxed. Staff, the manager and residents were observed to have good relationships. Staff responded to residents in a sensitive and professional manner. All residents’ rooms have a lock on their door. Staff were witnessed knocking on residents doors before entering confirming respect for the residents individual privacy and dignity at all times. Stokeleigh Residential Home DS0000059246.V292700.R01.S.doc Version 5.1 Page 14 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): 12,13,14,15 Quality in this outcome area is good. Residents benefit from a varied activities programme, which is both enjoyable, stimulating and meets individual preferences and expectations. Residents maintain family contact and staff encourage family and friends to join in with household activities. Relatives feel they can advocate openly on behalf of their relative. Residents receive a varied and wholesome diet that they are able to influence. EVIDENCE: Many activities continue to be organised on a monthly basis, and a copy of this is circulated to the residents and visitors. The activities arranged for the month of June were examined and included a slide show, skittles and flower arranging. It was noted that various entertainers have been booked for the month including “Danny Entertains” and “Keyboard with Colin”. Stokeleigh Residential Home DS0000059246.V292700.R01.S.doc Version 5.1 Page 15 On the day of inspection an entertainer was visiting to play songs to the residents on his keyboard. There was a positive interest shown and many residents attended. Residents were singing and toe tapping to the music. After the show the inspector spoke to the entertainer who said that he had been visiting the home for several years. He stated that “staff were always very welcoming and the residents seemed very happy and relaxed during his visits”. Nine residents stated in their surveys that “There are activities arranged by the home that I can take part in” and one resident said “There is always a good range and different types of activities”. Some choose not to participate according to how they feel and they are not pressurised to do so. Some residents go out regularly and it was apparent that they continue to be encouraged to be actively involved in the local community if they are able and choose to do so. One resident who was local to the area said that she was fortunate to have many friends available whom she relies upon to take her to church and visit local areas of interest to her. The residents have a monthly meeting to discuss any concerns, items of interest and any other issues. The inspector looked at the minutes of the last meeting which covered many areas including a new laundry system which had been instigated and residents felt that this had helped the problem of missing laundry, an interest was expressed with regards to a trip to the Zoo, and the possibility of organising a musical afternoon in the grounds. The size and layout of the dining room made it possible for all residents to enjoy the social advantages of dining together. Staff had used their expertise and knowledge of the residents, personalities, preferences and ability to eat independently, when seating them for lunch. Residents were witnessed enjoying a glass of sherry prior to lunch. The dining room was light, spacious and the tables were attractively laid with tablecloths and napkins. The inspector spent time with the chef and his assistant. The cook was able to demonstrate an awareness of individual requirements and needs of the residents, including special dietary requirements and personal preferences. The chef explained that he would talk with the residents on a daily basis to obtain feedback about the meal served. 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. Stokeleigh Residential Home DS0000059246.V292700.R01.S.doc Version 5.1 Page 16 Documentation was provided to show the inspector that required temperature checks were being carried out on fridges and freezers and that food was also being probed after being cooked before serving. Risk assessments were in place and up to date. Residents’ surveys suggested that the meals provided were very satisfactory, with adequate portions. One resident stated, “Some meals tend not to be in a style I like, for example, chicken in a white wine sauce.” Residents are able to influence the choices on the menus, which is often discussed at residents meetings. An alternative choice is always available for residents on a daily basis. At the last residents’ meeting many residents said that they enjoyed the baked potato evening and requested that ham salad be offered as an alternative on the supper menu. Stokeleigh Residential Home DS0000059246.V292700.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. There are robust and comprehensive policies in place to manage complaints and residents can be confident that their concerns will be listened to and acted upon. There are good arrangements in place for staff training and awareness of protection of vulnerable adults. 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 two written complaints in the last year, the inspector examined documentation and all details confirmed that policies and procedures were followed and that the complaints were dealt with and resolved effectively and efficiently. Stokeleigh Residential Home DS0000059246.V292700.R01.S.doc Version 5.1 Page 18 Evidence from the residents’ surveys showed that eleven residents knew how to make a complaint. One resident said, “I have no complaints, I am very happy and content”. During the inspection two residents stated, “if they had any concerns they can always speak to Tracy the manager”. One resident said “I do not know how to complain, but I always talk to my daughter if I am not happy and she will sort it out”. 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 now qualified to start in house training for all staff in the protection of vulnerable adults and an enrolment programme is under way. The inspector will examine the effectiveness of the training at the next inspection. 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.V292700.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26. Quality in this outcome area is good. 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 is situated in large grounds, which are well maintained, and a source of pleasure for residents, particularly in the summer months. New garden furniture has recently been purchased. One resident asked in his survey for the provision of sun screening. The manager confirmed with the inspector that new garden umbrellas had been purchased. The residents spoken with were very complimentary about the home and the garden areas. Stokeleigh Residential Home DS0000059246.V292700.R01.S.doc Version 5.1 Page 20 There are three points of entry to the home to provide access for a range of diverse needs, including wheelchair access and emergency services. One residents survey stated that access to the front of the house was not satisfactory. Some of the points raised included that the steps to the front entrance were “poorly lit” and that “handrail facilities were obstructed by planters”. This was discussed with the manager during the inspection and it was recommended that the front access to the home was risk assessed and discuss any adaptations required with the area manager. The manager contacted the inspector shortly after the inspection to confirm that the following provisions were to be made; the steps were to be repaired, each step would be painted with a white strip to assist those people who are visually impaired, better lighting facilities were to be installed and the planters were to be removed to give full access to handrail facilities. The efficiency of the home in addressing this issue is commendable and will greatly benefit residents and visitors to the home. 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 had pretty verandas with plants and bird feeders. Bedrooms also have en suite facilities provided and communal bathing areas and toilet facilities are located throughout the home. Residents had been 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. One resident said how much she enjoyed her own company and the sanctuary in her own room and that she also had the opportunity to meet up with fellow residents in various lounge areas throughout the home when she so desired. Since the last inspection one lounge has had a new carpet. The corridors have been redecorated and new flooring and shelving has been provided in the larder. The home was clean and free from unpleasant odours. The home employs domestic staff on a daily basis. Stokeleigh Residential Home DS0000059246.V292700.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. Adequate staffing levels help to ensure that resident’s needs are met. Residents are supported and protected by the homes recruitment policy. The residents are cared for by skilled staff that are trained and supported by management. EVIDENCE: A robust 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. Following the previous inspection the manager said that she was going to undertake a review of the rotas. The staffing levels are well supported by the manager and are indicative of the needs and levels of care required by the residents. If levels of dependence were to increase, then staffing levels would need to be increased. The inspector examined staffing rotas. Some staff were on sick leave and replacement staff names had been inserted to keep the required levels. The manager uses her own staff group to cover any staff absences and makes good use of agency staff. This is good practice and provides a consistent care service to the residents. Stokeleigh Residential Home DS0000059246.V292700.R01.S.doc Version 5.1 Page 22 Eight residents stated in their surveys that staff are usually available when you need them, and six felt that staff were always available. Two residents said that “sometimes there is a wait”. The manager is aware of this and will continue to monitor staffing levels. Nine residents felt that staff listen to them and act appropriately. Two residents had had experiences where information had not been passed on, and felt communication amongst staff could be improved. Some relatives and visitors to the home had found it difficult when contacting the home by telephone, whereby there may be no answer for long periods, particularly on weekends and evenings. The manager explained to the inspector that whilst she was on duty and supernumerary she was always available to answer the phone. Unfortunately on the evenings and weekends the staff do not have access to a mobile phone and are not able to hear the phone ring whilst delivering care to the residents. It is recommended therefore that the manager make provision for a mobile phone to alleviate the anxiety and the frustration it is causing to family and friends. There is an induction programme, which covers all mandatory training, including Fire, Manual Handling, and Health and Safety. The home continues to support their staff with NVQ training and the enrolling programme continues. The manager and her staff are conscientious in attending training relevant to the care needs of the residents. 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 any remaining staff. The inspector spent some time throughout the day observing staff carrying out their duties and assisting residents. Staff were respectful, warm in manner, good humoured and sensitive towards the residents within a relaxed, calm environment. Stokeleigh Residential Home DS0000059246.V292700.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36,37,38 Quality in this outcome area is good. Residents’ needs and best interests are central to the management approach in the home. Staff receive appropriate supervision. The homes record keeping policies and procedures safeguard residents. The health and safety of residents, staff, and visitors is protected. EVIDENCE: Tracy Bird was appointed as manager at Stokeleigh Residential Home in November 2005. She has fourteen years experience in the care sector and has achieved her Registered Managers Award. Stokeleigh Residential Home DS0000059246.V292700.R01.S.doc Version 5.1 Page 24 In February this year Tracy appointed a new Deputy manager, it was evident in conversations that both were dynamic in their roles and enjoying the new challenges that faced them. They shared various initiatives with the inspector to further develop standards and procedures in the home and both expressed how they were fully supported and encouraged by the staff in the home. There was a degree of satisfaction expressed by all of the residents spoken with. Based on the comments made and through the inspectors observation it is evident that the home is run in their best interests and to ensure their needs are being met. 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. Policies and procedures for the home were examined and are currently being reviewed and where necessary updated. New policies and procedures for storage and administration of oxygen, and evacuation in the event of a fire were well written. A plan has been developed to ensure staff receive supervision once every six to eight weeks. Arrangements in place confirm that individual supervision is based on an agreement between the manager and staff member. A plan is devised for discussion relating to key residents, work issues, staff issues, personal development and training. The recorded outcomes of the supervision need to be more comprehensive to help evidence the effectiveness of the sessions. Staff meetings are held on a monthly basis and the minutes for these were examined. The attendance of staff was good and the agenda was informative and useful ensuring that staff were kept up to date with new initiatives and issues within the home. Staff are given the opportunity to express their ideas and any concerns they may have during the meeting. The home has a part time maintenance man who will undertake maintenance and repair tasks or arrange for the appropriate tradesman. All electrical items are PAT tested annually by an outside contractor, who is contacted if any new electrical items come into the home. 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 lighting. Stokeleigh Residential Home DS0000059246.V292700.R01.S.doc Version 5.1 Page 25 The homes records showed all necessary service contracts were up to date including, gas, electrical and lift services. Fire safety training for staff is given on induction and then at the recommended given intervals, as recommended by the Fire Prevention Officer. All night staff undertake this on a three-monthly basis, and day staff sixmonthly. The provider is completing monthly visits and copies of the reports are being sent to the Commission for Social Care Inspection. Stokeleigh Residential Home DS0000059246.V292700.R01.S.doc Version 5.1 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 3 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 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 3 3 3 Stokeleigh Residential Home DS0000059246.V292700.R01.S.doc Version 5.1 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. Standard Regulation Requirement Timescale for action 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 Refer to Standard OP10 Good Practice Recommendations Making provision for a portable phone will relieve frustration and anxieties for families and friends who on evenings and weekends find it difficult to get through to the home. Risk assess the front access to the home and discuss any adaptations required with the area manager, including adequate lighting and handrail facilities. 2 OP22 Stokeleigh Residential Home DS0000059246.V292700.R01.S.doc Version 5.1 Page 28 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.V292700.R01.S.doc Version 5.1 Page 29 - 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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