Inspection on 21/06/07 for Stone House

This inspection was carried out on 21st June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 24/08/06

Stone House 05/01/06

Stone House 15/06/05

Stone House 04/10/04

Stone House 15/04/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Stone House Union Street Bishops Castle Shropshire SY9 5AJ Lead Inspector Keith Salmon Key Unannounced Inspection 21st June 2007 09:45 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 Stone House DS0000020656.V341602.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 DS0000020656.V341602.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stone House Address Union Street Bishops Castle Shropshire SY9 5AJ 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) 01588 638487 01588 638582 www.coveragecareservices.co.uk Coverage Care Services Ltd Edna May Jones Care Home 40 Category(ies) of Dementia (9), Learning disability over 65 years registration, with number of age (3), Old age, not falling within any other of places category (28) Stone House DS0000020656.V341602.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The number of persons for whom personal care is provided shall not exceed 40. The number of adults with a learning disability over 65 years of age may not exceed 3. The number of older persons accommodated in the home shall not exceed 40 of whom up to 9 may have dementia. 24th August 2006 Date of last inspection Brief Description of the Service: Stone House care home is managed as a non-profit making venture by Coverage Care Limited, and registered to provide personal care and accommodation for up-to 40 older people with a range of needs. Situated near the centre of Bishops Castle, the home is adjacent to the Community Hospital. Accommodation is arranged over five separate units each comprising single bedrooms, toilet and bathing facilities, lounge/dining area, and a small kitchen facility for provision of beverages. There is a main kitchen, supplying meals to all five units, within the home, and a laundry facility, both of which service the requirements of the adjacent Community Hospital. Well decorated with comfortable furnishings, Stone House presents a homely atmosphere. There is also an active day centre, which adds to the air of community involvement. Weekly fees for Stone House, reviewed annually on 1st April each year currently range from £414 for ‘Residential’ clients to £435 for ‘EMI’ clients. Additional charges are made for toiletries, hairdressing, newspapers, and escort to hospital for routine appointments. Stone House DS0000020656.V341602.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Unannounced ‘Key’ Inspection commenced at 9.45am, concluded at 2.30pm, and was conducted by Mr Keith Salmon. Present on behalf of the Home was Mrs. Edna Jones (Registered Manager). With no requirements from the previous inspection, held in August 2006, this inspection focussed on the home’s performance, relative to all ‘Key’ Standards, with judgements based on observations made during a tour of the premises, a review of care related documentation, staff duty rotas and staff files, plus a range of other documents/records reflecting the general operation of the home. The Inspector also held individual discussions with the Manager, 6 Residents, 1 Visitor, and several members of Staff. What the service does well: What has improved since the last inspection? What they could do better: The Inspector can specify no area of care provision, which requires improvement, and is assured the home will continue to monitor and re-assess its performance to sustain their high level of service provision, and to build on any aspect of care if, and where, possible. Stone House DS0000020656.V341602.R01.S.doc Version 5.2 Page 6 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 DS0000020656.V341602.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 DS0000020656.V341602.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Processes to ensure appropriate and thorough care needs assessment, prior to admission, are effectively undertaken. The findings are applied to ensure appropriate placement. EVIDENCE: Review of care plans, and related documentation, provided evidence that appropriate and thorough care needs assessment is undertaken by the Manager, or Deputy Manager prior to admission. Information gathered is utilised in enabling an informed decision regarding the Home’s capability of meeting the individual care needs of each prospective Resident. Stone House DS0000020656.V341602.R01.S.doc Version 5.2 Page 9 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 excellent. This judgement has been made using available evidence including a visit to this service. The model of Care Plan utilised by the Home is comprehensive, easy to follow and current. Care provided by the Home is very effective in meeting the Residents’ assessed care needs, and is delivered considerately. Residents are treated with respect, their privacy and dignity upheld. The storage, administration, and disposal of medicines are in accordance with accepted good practice. EVIDENCE: Review of care related documentation relating to four ‘case tracked’ (i.e. all aspects of care examined in detail) residents demonstrated that Care Plans are very well organised, easy to understand and up-to-date. Stone House DS0000020656.V341602.R01.S.doc Version 5.2 Page 10 The high level of detail included in Care Plans relating to residents’ individual needs, together with clear statements of care to be provided, is commendable. This detail ensures Carers are enabled to fully meet those needs in an informed and safe manner, regardless of who is providing direct care at any given time, and this was confirmed by discussions with ‘case tracked’ Residents. It was ‘Recommended’, at the previous Inspection, that risk assessments should be undertaken, and documented, for the use of bed rails. Evidence of this having been completed was observed in care plans sampled. Evidence was also observed confirming a regular care needs review by the Manager on at least a monthly basis. Inspection of medicine storage provision, and administration records, demonstrated the home’s practices meet the guidelines of the Royal Pharmaceutical Society. Staff were seen and heard to respect Service Users’ privacy and dignity, including knocking on Service Users’ bedroom doors prior to entering, referring to Residents in a respectful, yet friendly manner. Residents are encouraged to undertake their own personal daily routines as they wish, and consistent with their capabilities. Staff were observed to interact well with Service Users, and it was evident relationships are close but still professional. One notable area of good practice is that many Residents are able to have consultations with their General Practitioner at the local surgery courtesy of transport via the Home’s minibus and, although the Home is to lose that facility in the near future the Manager has already made arrangements for a replacement service with the local ‘Dial-a-Ride’. Stone House DS0000020656.V341602.R01.S.doc Version 5.2 Page 11 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 excellent. This judgement has been made using available evidence including a visit to this service. Staff have an excellent understanding of the service users support and leisure needs and use this to assist them to exercise choice and control in their lives. Service users have many opportunities for community/family contact which enables them to make a choice about who they see and when and where they see them. Dietary needs of service users are very well catered for with a balanced and varied selection of food available that meets service users tastes and choices. EVIDENCE: A senior member of staff has responsibility for leading and planning leisure/social activities. Activity preferences are discussed at Residents’ Meetings, and Residents confirmed to the Inspector they participate in any activity as and when they wish, including attending the day centre. Alternatively, if they choose, they simply spend time in their own room or in one of the lounge areas. Stone House DS0000020656.V341602.R01.S.doc Version 5.2 Page 12 Examples of activities were seen in notices for May and June 2007, which showed evidence of many, and varied, activities on offer including; group activities such as reminiscence sessions, bingo, yoga, traditional board games, dominoes, cards, exercise classes, and videos, visiting musicians/entertainers at the Day Centre. Residents who wish to are also enabled to assist with maintenance of the Gardens. A number of Residents are due to take a holiday in Llandudno during the coming weeks. On display in the entrance lobby corridor were many photographs of ‘days gone by’, featuring mainly agricultural activities around Bishops Castle, including photographs of relatives of many current Residents. Every Wednesday local clergy provide a Church of England Service, with provision, separately, of Holy Communion once a month, and on the third Wednesday of the month there is a Service by the local Methodist Minister. Residents of other denominations also receive pastoral care as they wish. Residents were very complimentary, both directly to the Inspector and in the minutes of their formal meetings, as to the range and quality of food provided. They were able to relate what they had chosen for lunch and informed the Inspector that the staff come round and ask them their preference from the menu each day, which are also displayed on the dining room tables. Stone House DS0000020656.V341602.R01.S.doc Version 5.2 Page 13 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 home has a satisfactory complaints system with evidence that service users feel that their views are listened to and acted upon. Staff have the relevant knowledge through well-planned induction and on going training to safeguard service users from abuse. Service users are provided with up to date information about adult protection. EVIDENCE: CSCI has received no complaints about the home since the previous Inspection, held in August 2006, and past experience has been that homes within the ‘Coverage Care’ Group respond quickly to complaints, with full records kept of any action needed as a result of investigations. Residents spoken with stated they had no complaints, but would feel very comfortable to speak with the Manager or Staff at any time. Information regarding adult protection/ ‘whistle-blowing’ from various authorities is on display on a notice board within each of the five units within the Home. Accident Records were reviewed and found to be current, presenting no areas for concern. The activity board displayed arrangements for the visit to the home of Age Concern to provide confidential advice to Service Users. Stone House DS0000020656.V341602.R01.S.doc Version 5.2 Page 14 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, 20, & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Stone House is decoratively of a good standard, providing Residents with a safe, well furnished, homely, comfortable, and clean place in which to live. EVIDENCE: Accommodation is arranged into five individual units each comprising single bedrooms, toilet and bathing facilities, lounge/dining area, and a small kitchen facility for the provision of beverages. The Units are well decorated, comfortably furnished and provide a warm, homely atmosphere. The main kitchen provides meals for all five Units. There is also a day centre, access to which adds to the air of community involvement. Stone House DS0000020656.V341602.R01.S.doc Version 5.2 Page 15 The Inspector observed a ‘Recommendation’ from the previous Inspection, had been actioned, i.e. Floor coverings in two ground floor communal bathrooms, which were previously carpeted, have been replaced with more appropriate impermeable, non-slip material. The attractive, well-maintained gardens are a credit to the Home, being generously planted with colourful flower borders and mature shrubs, and including a dedicated ‘safe’ garden for Residents with confusional disorders. A tour of the Home showed the standard of cleanliness in the Home to be excellent. Stone House DS0000020656.V341602.R01.S.doc Version 5.2 Page 16 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. Staff numbers on duty and skill-mix were sufficient to meet the assessed care needs of current Residents. There is a committed, effective, and well-supported staff group, with the skills and knowledge to ensure Residents enjoy a quality of life, which meets their individual requirements and aspirations. Recruitment and employment practices, and the provision of training for Staff are consistent with the safeguarding of Residents. EVIDENCE: A review of duty rosters, and discussions with Staff, confirmed staffing numbers and skill-mix enable a service provision which meets the care needs of the Service Users. Staff were observed to carry out their duties in an enthusiastic and professional manner. Staff are subject to a thorough, and relevant, orientation/induction programme with evidence of on-going training including a very high proportion having attained relevant NVQ qualifications. Stone House DS0000020656.V341602.R01.S.doc Version 5.2 Page 17 The home has continued to maintain its well-organised systems and detailed records for staff. Records examined evidenced all the necessary information demonstrating potential staff are appropriately screened before they are deemed suitable to start work at the home. All were in accordance with the requirements of the Standard. Stone House DS0000020656.V341602.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 25, & 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is managed by an experienced well-qualified individual, who possesses sound leadership skills, carries out her responsibilities to the full, and promotes a professional ethos. The systems for consultation with Residents are excellent with evidence suggesting their views are acted upon. The organisation continues to improve and make progress towards raising the standards in all areas for the benefit of its service users. Service Users are safeguarded by the financial procedures operated in the home. Health, safety, and welfare of service users and staff are promoted fully by safe working systems in place. Stone House DS0000020656.V341602.R01.S.doc Version 5.2 Page 19 EVIDENCE: Through conversation with Residents and Staff, plus observation of staff practice, there is strong evidence the ethos of the home is open and transparent, with the views of Staff and Service Users sought, listened to, and valued. Staff appeared involved and happy in their work. Promotion of ‘quality assurance’ is evident within the Home’s management practices, and was seen through reports/minutes of meetings, satisfaction surveys, and observed contact between Staff and Residents. In turn, this ‘inhouse’ quality assurance is effectively supported through monthly ‘Regulation 26’ visits by the Operations Manager. This involves full audit with regard to the state of the building/decoration/furnishings, operational systems, and practices related to the administration of medicines. Reports of this activity are forwarded direct to CSCI each month. A review of staff personnel files, and related records, demonstrated that staff are subject to regular supervision. In conversation with the Inspector, staff confirmed they are well supported by the Manager, and consider their training opportunities to be good and appropriate to their needs. The financial management of small amounts of cash, for a few Residents, covering incidental items, is conducted in accordance with the Standard, including records/cash amounts being subject to audit on a regular basis. All other records were seen to be secure and well maintained. Observation and review of relevant records provided evidence that Health and Safety Policies/Procedures/Practices are satisfactory, maintenance and servicing of equipment regularly undertaken, and appropriately documented, and all COSHH requirements met. Records are maintained for hot water supply to outlets accessible to Residents. Water temperatures tested during the Inspection were found to be satisfactory, and in accordance with accepted levels. Stone House DS0000020656.V341602.R01.S.doc Version 5.2 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 4 X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 3 Stone House DS0000020656.V341602.R01.S.doc Version 5.2 Page 21 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. Refer to Standard Good Practice Recommendations Stone House DS0000020656.V341602.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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 DS0000020656.V341602.R01.S.doc Version 5.2 Page 23 - 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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