Inspection on 19/12/06 for Stone House

This inspection was carried out on 19th December 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.

Other inspections for this house

Stone House 12/11/08

Stone House 29/11/05

Stone House 07/06/05

Stone House 01/12/04

Stone House 25/06/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Stone House 55-57 Cheyney Road Chester Cheshire CH1 4BR Lead Inspector Maureen Brown Key Unannounced Inspection 19 December 2006 08:50 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 Stone House DS0000006672.V317650.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. Stone House DS0000006672.V317650.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stone House Address 55-57 Cheyney Road Chester Cheshire CH1 4BR 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) 01244 375015 F/P 01244 375015 Mr Harry Gerard Keyzor Mrs Jill Keyzor Miss Lisa Jones Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (32), Physical disability (1) of places Stone House DS0000006672.V317650.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 33 service users to include: * Up to 32 service users in the category OP (Old age, not falling within any other category) * One named service user in the category PD (Physical disability aged between 56 and 65 years) Date of last inspection 29th November 2005 Brief Description of the Service: Stone House is a residential care home providing personal care and accommodation for up to 33 older people. It is a family run private business that opened in 1987. The home is located in a residential area near to the centre of Chester, and has been converted from three houses. Many community facilities and shops, pubs and post office are within walking distance. Service user accommodation is on two floors and access between floors is via a passenger lift or the stairs. The home provides accommodation for a total of thirty-three service users in single rooms, thirty of which benefit from en-suite toilet facilities. The remaining bedrooms have wash hand basins fitted. A number of extensions have improved physical standards in the home. An outside garden/courtyard area is available for service users. The registered manager is supported in running the home by the owners, care manager, two deputy managers, two senior care assistants, fifteen care assistants, two cooks, three kitchen assistants and four housekeepers. There are adequate car parking facilities available at the side of the property. The car park is accessible from Garden Lane. The fees at Stone House are between £343.34 and £429.00 per week. Optional extras include hairdressing, chiropody, bingo and newspapers. Stone House DS0000006672.V317650.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit took place on 19 December 2006 and lasted eight hours forty minutes. Maureen Brown carried out the visit. An expert by experience was also present. CSCI are trying to improve the way we engage with people who use services so we gain a real understanding of their views and experiences of social care services. We are currently testing a method of working where “experts by experience” are an important part of the inspection team and help inspectors get a picture of what it is like to live in or use a social care service. The term “expert by experience” used in this report describes people whose knowledge about social care services comes directly from using them. This visit was just one part of the inspection. Before the visit the home was also asked to complete a questionnaire to provide up to date information about services provided. Questionnaires were also made available for service users, relatives and other professionals to find out their views. Other information since the last key inspection was also reviewed. During the visit various records and the premises were looked at. A number of service users, staff and visiting professionals were also spoken with and they gave their views about the service. Twenty-five standards were assessed including all the key standards and most were met. All previous requirements made had been met. Feedback was given to the manager at the end of the visit. What the service does well: The home had an established staff team who were keen for high standards to be maintained. Residents’ plans of care and individual case notes were well documented and reflected each resident’s needs. Supervision of staff was recorded and completed on a regular basis. Meals were varied and reflected each person’s preference. They offered choice and variety. The expert by experience confirmed the meal they shared with the residents was good and well presented. The staff manage daily activities and entertainments well and provide a wide range of choice. Residents said they were pleased with the choices on offer. Stone House DS0000006672.V317650.R01.S.doc Version 5.2 Page 6 A good standard of hygiene was seen throughout the home and the standard of décor was high. The expert by experience also confirmed this. All the relatives commented that they were “more than” satisfied with the overall care provided at the home. What has improved since the last inspection? 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. Stone House DS0000006672.V317650.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 Stone House DS0000006672.V317650.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): 1 & 3. Standard 6 is not applicable. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Clear information is provided for residents to make a decision about moving into the home. A pre-assessment document is available to ensure that the home can meet the residents’ needs. EVIDENCE: Each resident had a copy of the home’s brochure and prospectus. This was produced in a ring bound file and included information about the facilities, services provided, fees, terms and conditions of residence and a copy of the most recent inspection report. Residents and relatives confirmed that they had a copy of this document. Staff said that they sent this out to prospective residents and relatives with an application form for residence. These were reviewed in February 2006 however this information was not recorded on the documents. It is recommended that this be recorded for ease of reference. Prior to this report becoming finalised this recommendation had been met. Stone House DS0000006672.V317650.R01.S.doc Version 5.2 Page 9 A file was kept in the office with each resident’s terms and conditions of residence. This document contained the name of the resident, overall care and services provided, fees payable and the rights and obligations of the proprietors and the resident. The resident or their representative signed this. Stone House DS0000006672.V317650.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 good. This judgement has been made using available evidence including a visit to this service. The residents’ health, personal and social care needs are met by the staff team who enable them to maintain their privacy and dignity. EVIDENCE: A sample of four residents’ care records were seen during this inspection. These were comprehensive and well presented in individual folders. Each contained basic information covering all areas of personal care, risk assessments for falls and moving and handling, social interaction, activities, visiting professionals sheet and a copy of the daily report sheets. The care plans seen were drawn up in consultation with the residents and family and were based on their assessed needs and risks. Care plans were reviewed on a monthly basis, in conjunction with the residents. The residents signed their care plans to show that they agreed with the contents. Daily record sheets seen showed the activities of each resident. Following a previous requirement these are now completed on a daily basis. The records made were written clearly, easy to follow and were signed by carers. Stone House DS0000006672.V317650.R01.S.doc Version 5.2 Page 11 Information regarding bathing and weights were recorded. From a previous requirement there were gaps in the recording of baths being undertaken. Accurate records were now completed. During discussions with the residents it was said that “they were happy at the home” and “they were well cared for” and also “staff were good”. Other comments included “the meals were lovely” and “the home is always clean”. Medication records examined showed that this was recorded and administered appropriately. Medication was kept secure and controlled drugs were stored in line with current regulations. Stone House DS0000006672.V317650.R01.S.doc Version 5.2 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. 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. Residents’ were able to take part in a range of activities of their choosing. Personal and family relationships were encouraged by the home and the staff team supported people with this. EVIDENCE: The residents’ plans reflect the range of activities undertaken which included activities such as reading, bingo, dominoes, sing-a-longs, talking books and watching television. Residents said they particularly enjoyed reading the paper in the mornings and participating in activities during the afternoon. Bingo was a firm favourite. The expert by experience confirmed that the residents spoken with enjoyed the activities on offer. Most service users had family who they went out and about in the community with. Trips to the local town and other local amenities were visited. However the expert by experience raised the question about people who did not have regular family visitors. During discussions with the manager it was agreed this was an area for future development to ensure all residents have the opportunity to go out. Stone House DS0000006672.V317650.R01.S.doc Version 5.2 Page 13 The manager stated that religious services took place monthly within the home and that residents could join in if they wished to do so. Resident’s religious preferences were recorded in their care plans. Residents confirmed they could attend the religious services if they wanted to. The menu was seen and these reflected peoples’ personal choices. Special diets were catered for such as diabetic diets. The expert by experience joined the residents in the main meal of the day and confirmed that meal was good and well presented. An alternative was always available. After the meal residents said that “the meal was lovely” and that “you wouldn’t get better anywhere else”. The kitchen was maintained in a clean and tidy condition. Fridge, freezer and hot food temperatures were recorded and seen by the inspector. The expert by experience confirmed that the kitchen was well run. During discussions between the expert by experience and the cook it was noted that there was a good and varied menu on offer to the residents. Stone House DS0000006672.V317650.R01.S.doc Version 5.2 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. 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. The Protection Of Vulnerable Adults Policy was in line with “No Secrets” guidance and service users are safeguarded from abuse or harm. Arrangements are in place to minimise the risks so that the safety and welfare of the service users are promoted. EVIDENCE: The home’s Protection of Vulnerable Adults Policy was seen and was consistent with the “No Secrets” guidance from the Department of Health. The policy included types of abuse such as physical, verbal, sexual and neglect, signs and symptoms and reporting abuse. A copy of Cheshire’s Social Services policy on Adult Protection was available within the home and was accessible to staff. Staff confirmed that they were aware of the procedures and who to contact with any concerns. Policies on whistle-blowing and challenging behaviour were also seen. Most staff had undertaken training on Adult Protection. The policy on complaints was seen and the commission had received no complaints since the previous inspection. The home had received one complaint, which was resolved. All relevant paperwork was available in the event of a complaint being received. Residents and confirmed that they were aware of the complaints procedure and to whom they would direct their complaint. Residents were confident that any complaint would be dealt with swiftly. Stone House DS0000006672.V317650.R01.S.doc Version 5.2 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. 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 provides a clean and comfortable environment for the people to live in. EVIDENCE: The home was furnished in a domestic style with additional equipment such as grab rails, raised toilet seats and hoists provided as necessary to meet the residents’ needs. A very high standard of décor was evident throughout. All radiators that residents might come into contact with had been provided with protective guards. The heating and lighting was sufficient throughout the home. The home was clean, tidy and free from any unpleasant smells. The expert by experience also confirmed this. Stone House DS0000006672.V317650.R01.S.doc Version 5.2 Page 16 The manager explained that there was a problem with incontinence in one room. On examination with the inspector it was agreed that this was unacceptable and that the carpet must be replaced with an appropriate floor covering. Stone House DS0000006672.V317650.R01.S.doc Version 5.2 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. 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 home makes sure that the right staff are employed to look after vulnerable people. Service users are protected by the robust employment practices of the agency. Staff are supervised on a day-to-day basis, which ensures that the service provided to the service users is acceptable. EVIDENCE: At the time of this inspection the agreed staffing levels were met. On arrival the deputy and three care staff were on duty. The manager was due on duty and the co-owner, cook, kitchen assistant and the housekeeper were also on duty. Eleven of nineteen care staff had obtained NVQ level II or III in care and two staff would be starting NVQ level II in care in January. The registered manager had completed NVQ level IV in care and management. All staff had completed mandatory training, which includes manual handling and first aid courses and most staff had completed food hygiene courses. Staff on duty confirmed they had completed NVQ training in care and mandatory courses. Two members of staff were also NVQ Assessors for the home. It was recommended that specialist training be sought in line with the needs of the current service users. Stone House DS0000006672.V317650.R01.S.doc Version 5.2 Page 18 The recruitment procedure ensures that the staff are suitable to work with vulnerable people. Three staff files were examined and these showed that all relevant pre-employment checks were carried out. This included application forms, two references, Criminal Record Bureau checks and health declarations. Stone House DS0000006672.V317650.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are protected by the health, safety and welfare procedures in place. The views of service users are obtained to influence the running of the home. Service users are fully supported by well supervised staff. EVIDENCE: The manager said that one to one staff supervision was given on a regular basis. Supervision notes were seen and records were up to date. Observed day-to-day supervision of staff was good and the staff team confirmed they were supported by the manager and the senior staff in their delivery of care to residents. The staff said that formal supervision was conducted on a regular basis. Supervision records were kept in a locked cupboard with staff files in the office. Stone House DS0000006672.V317650.R01.S.doc Version 5.2 Page 20 All policies and procedures seen were up to date and accurate. These were kept secure within the home. It was recommended that policies and procedures be reviewed annually. All records seen were kept secure in the one of the offices within the home. Residents and relatives said that they felt the home was well run and that the manager and staff were very welcoming and friendly. This was confirmed during the inspection. Relatives said that the staff worked in a very friendly manner. The expert by experience noted that the manager knew what was required to keep the residents happy and had chosen the staff very carefully and seemed to be a very caring person. Safe working practices include fire safety in which all weekly checks are carried out and recorded, up to date certificates for gas safety, electrical safety, portable appliance testing and tests and servicing for all equipment for moving and handling. These checks ensure that the residents are being protected by the procedures in place. The accident book was seen and it was noted this was a bound book format. It was recommended the Health and Safety Executive book be used in future which has tear out sheets and is therefore in line with the Data Protection Act 1998. The manager said that service users had there own account at the home. Invoices were produced each month or as necessary for personal account funds. The manager completed her Registered Managers Award in March 2005. She has worked at the home for eighteen years, six of which as the manager. Residents’ surveys are conducted on an annual basis and information gathered is used to influence the future service provided. Copies of these were available. On discussion with residents they confirmed that they were aware of the outcomes of the survey. During discussions with the manager it was agreed that the form could be improved and that re-evaluation would be of benefit prior to the next process being undertaken. It was also suggested that other stakeholders be contacted during the quality assurance process. Prior to the final report being produced the manager had re-evaluated the surveys and produced other stakeholder surveys to be used during the next survey process. The inspector saw copies of these. Formal residents meetings do not take place. However good communication was seen between the manager, staff and residents. It was suggested that discussions are noted as further evidence of consultations with residents. Stone House DS0000006672.V317650.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 3 X X X N/A 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 2 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 3 X 2 Stone House DS0000006672.V317650.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No Stone House DS0000006672.V317650.R01.S.doc Version 5.2 Page 23 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 OP26 Regulation 16(2)(k) Requirement The registered person must ensure that the bedroom carpet is replaced with suitable flooring. Timescale for action 31/01/07 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 4 5 6 7 Refer to Standard OP1 OP13 OP30 OP33 OP33 OP33 OP38 Good Practice Recommendations The registered person should ensure that the review dates are included on the brochure and prospectus. The registered person should consider outings into the community for all residents. The registered person should ensure that staff have specialist training in line with current service users needs. The registered person should consider re-evaluation of the service users survey document. The registered person should consider documentation of service users discussions as part of the consultation process. The registered person should review all policies and procedures on an annual basis. The registered person should keep the information stored in the accident book in line with the Data Protection Act 1998. Stone House DS0000006672.V317650.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Stone House DS0000006672.V317650.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!