Inspection on 21/09/06 for Stone House Nursing Home

This inspection was carried out on 21st September 2006.

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

The inspector 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 Nursing Home 20/03/08

Stone House Nursing Home 09/02/06

Stone House Nursing Home 22/09/05

Stone House Nursing Home 22/02/05

Stone House Nursing Home 05/07/04

Stone House Nursing Home 06/01/04

Stone House Nursing Home 14/10/03

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

CARE HOMES FOR OLDER PEOPLE Stone House Nursing Home Bishopstone Road Stone Aylesbury Buckinghamshire HP17 8BX Lead Inspector Barbara Mulligan Unannounced Inspection 11:30 18 September 2006 th 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 Nursing Home DS0000019253.V304585.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 Nursing Home DS0000019253.V304585.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stone House Nursing Home Address Bishopstone Road Stone Aylesbury Buckinghamshire HP17 8BX 01296 747122 01296 747 007 stonehousehome@aol.com 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) Mr Dhanani Mrs Dhanani Philomena Heritage Care Home 31 Category(ies) of Dementia (31), Old age, not falling within any registration, with number other category (0) of places Stone House Nursing Home DS0000019253.V304585.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Elderly Physically Frail Elderly Mentally Impaired Date of last inspection 9th February 2006 Brief Description of the Service: Stone House Nursing Home is situated in a country road, within 20 minutes drive from the main Aylesbury town. The Home is a large older House set in well-kept, large gardens. The Home is able to provide nursing accommodation for 31 Service Users with an additional category for Service Users diagnosed with Dementia. A Registered Nurse who has also achieved the Registered Managers Award efficiently manages the Home. The fees range from £550 to £900 per week. Stone House Nursing Home DS0000019253.V304585.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 was undertaken on Monday 21st September at 11.30am. The visit consisted of discussions with the Registered Manager, care staff, service users and relatives, a tour of the premises and an examination of the homes records, policies and procedures. The inspection officer was Barbara Mulligan. The Registered Manager is Philomena Heritage. Twenty-four of the National Minimum Standards were assessed during this visit. Twenty-one of these are fully met, one was not applicable as the home does not provide intermediate care and two were almost met. As a result of the inspection the home has received two requirements. Eight comment cards were received from service users, relatives and/or representatives; one was received from a care manager and another from a general practitioner. Comments received, both from people interviewed and those who responded to the survey, expressed a high level of satisfaction with the care received from support staff. Some positive comments received include “My wife would not be here today if it was not for the high standard of care given by the home” and “ excellent communication with staff who are always helpful” and “patients are extremely well tended and cared for, with every attempt to meet their needs”. One comment cards received identifies one area of dissatisfaction with the service and this is regarding the cleanliness and hygiene of the home. “Toilets are not cleaned or the yellow bags emptied regularly and we do this ourselves”. Visiting relatives spoken to on the day of the day of inspection conveyed their satisfaction with the care and the environment. The evidence seen and comments received indicate that this service meets the diverse needs [e.g. religious, racial, cultural, disability] of individuals within the limits of its Statement of Purpose. The inspector would like to thank the registered manager, the staff team and service users and relatives for their cooperation and assistance during this inspection. What the service does well: Stone House Nursing Home DS0000019253.V304585.R01.S.doc Version 5.2 Page 6 Service users are assessed prior to moving into the home, giving both staff and service users the confidence that their needs will be met. Medication procedures in the Home are of a high standard and in line with current guidance. Care is implemented in a sensitive and professional manner, ensuring the privacy and dignity of Service Users is maintained. Staff receive training appropriate to their roles. The Manager and Proprietor have an open dialogue to ensure the welfare of Service Users is maintained and the environment is able to meet current legislation and guidance. The activities provided give service users variety and diversion during the day. Service users are encouraged and supported to maintain links with family and friends. Individuals are encouraged to personalise their rooms with their own furniture and personal belongings. There is a motivated and established staff team that consists of nursing and care/support staff. There is an effective complaints procedure with all complaints and concerns being acted upon promptly, within stated time scales. There is an extensive range of policies and procedures, providing care staff with relevant information about all aspects of care and the home/organisation. What has improved since the last inspection? What they could do better: Stone House Nursing Home DS0000019253.V304585.R01.S.doc Version 5.2 Page 7 During a tour of the premises it was noticed that the carpet outside the kitchen door has started to gather up and was becoming a possible trip hazard to both staff and service users. This needs to be addressed to ensure the carpet is made safe. Records demonstrate that the fire alarm system is not being checked weekly and this will be a requirement of the report. It is recommended that information regarding advocacy services is displayed in a prominent area within the home so service users can access it independently. It is recommended that the full choice of menu is recorded on the written menu so service users are aware what the alternative is. 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. Stone House Nursing Home DS0000019253.V304585.R01.S.doc Version 5.2 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 Stone House Nursing Home DS0000019253.V304585.R01.S.doc Version 5.2 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): 3 and 6 Quality in this outcome is good. This judgement has been made using available evidence including a visit to this service. Potential service users receive a needs assessment undertaken by staff trained to do so, ensuring that the home can meet the care needs requirements of service users. The Home does not provide intermediate Care Services therefore this standard does not apply to the Home. EVIDENCE: Stone House Nursing Home DS0000019253.V304585.R01.S.doc Version 5.2 Page 10 It is the responsibility of the registered manager or a registered nurse to carry out the initial assessment of need. The manager stated that they would visit a potential service user either in the hospital or in their own home to undertake the initial assessment. The home uses its own assessment tool and this covers medical history, mental health, self help, communication, social needs, nursing needs, pressure area care, nutritional status, personal hygiene needs, continence needs and mental health needs. Pre-admission assessments for recent admissions to the home were assessed; these are completed to a high standard, dated and signed by the author. Service Users admitted from an out of county placement are only accepted to the Home with a full Social Services report and where necessary hospital discharge summaries. These are received by the Home prior to any decision for admission being made. In addition the Home will gain information from relatives or significant others prior to admission. The assessment demonstrates that prospective service users, family members or representatives are included in the assessment process if this is appropriate. This was confirmed during a discussion held two relatives during the visit. A review with the service user, family/relatives and the placing care manager is held following a one-month probationary period. The home does not admit service users for intermediate care so this standard was not assessed during the inspection. Stone House Nursing Home DS0000019253.V304585.R01.S.doc Version 5.2 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 and 10 Quality in this outcome is good. This judgement has been made using available evidence including a visit to this service. The care planning system adequately provides staff with the information they need to meet the service users needs. Healthcare support for service users is good, which means that their health and well-being is promoted and protected. Medication procedures within the home are clear and there is consistent implementation resulting in safe working practices. The manner in which personal care is delivered ensures service users are treated with respect and dignity and that their right to privacy is upheld. EVIDENCE: The home uses the Standex system. A random selection of care plans were examined. These are completed fully, dated and signed. Care plans looked at are detailed and informative and reflect the changing needs of the individual. Care needs are identified with a comprehensive action plan detailing how staff will meet those needs. All care plans observed contain evidence of regular review. Stone House Nursing Home DS0000019253.V304585.R01.S.doc Version 5.2 Page 12 Risk assessments are in place for pressure area care, falls, nutrition and moving and handling. There are risk assessments in place for the use of protective bedsides. There is evidence that risk assessments are reviewed on a regular basis and updated as necessary. The registered manager said that the General Practitioner visits the home on a weekly basis but will also attend when required. The home is able to access health care advice via the Vale of Aylesbury Care Homes Team. Advice can be sought regarding nutrition, tissue viability and physiotherapy. Each service user is seen by an optician and the manager said that an optical domiciliary service visits the home two to three times a year. Referrals for hearing tests are via service users G.P. Chiropody services visit the home on a six weekly basis. Dental screening is accessed on a needs only basis via a local domiciliary dental service. The manager informed the inspector that the home tries hard to promote continence. At the time of the inspection there was one service user who has recently been admitted to the home with a pressure sore. The registered manager assured the inspector that this was healing well and there is a detailed plan of care in place providing guidelines for staff. Comments received both from service users interviewed and from comment cards received indicate that there is a high level of satisfaction with the standard of care received. Medication is kept in one mobile, lockable trolley and surplus medication is kept in a secure metal cupboard attached to the wall. Medication is administered via a monitored dosage system and the home uses a local pharmacy. An inspection of the MAR charts shows no signature omissions. Several N.M.C. booklets were observed regarding the administration of medicines. There is a medication policy in place and this covers all areas detailed in standard 9. Records of all medication received and returned are accurate and well maintained. The home uses controlled drugs and these are stored in a metal cupboard, which complies with the Misuse of Drugs Regulations 1973. There is a register in place to record all administrations of controlled drugs and the signatures of two staff are recorded in the register. The manager is aware of the need to retain medication for a period of seven days after a service user has died. Single rooms ensure service users receive care from staff and health care professionals in complete privacy. Adequate screening in shared rooms Stone House Nursing Home DS0000019253.V304585.R01.S.doc Version 5.2 Page 13 ensures complete privacy for the service user. Staff were observed during the inspection to knock on service users bedroom doors before entering. The home’s Statement of Purpose includes information about maintaining the privacy of service user’s. If service users wish to have a key to their room then this can be facilitated. Preferred terms of address are recorded in service users care plans and likes and dislikes are recorded in most service users plans. Stone House Nursing Home DS0000019253.V304585.R01.S.doc Version 5.2 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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems in the home ensure that where appropriate service users are supported to exercise choice and control over their lives. Individuals are able to receive visitors at the home and there are no restrictions imposed on visiting unless requested by the service user. Service users are encouraged to bring personal possessions in with them allowing personal space to reflect the character and interests of its occupant. The presentation and standard of food is good and meets the nutritional needs of service users. However, the menu needs to offer a choice of meals to service users. EVIDENCE: There is some information available in care plans regarding service users interests. The daily activities are posted in the main entrance to the home. Service users spoken to on the day of the inspection were positive about the activities available. The only criticism conveyed was that there should be more of them. An activities coordinator visits the home five afternoons a week. She was in the home on the day of the inspection and hosting a quiz in the larger of the two lounges. Service users appeared to be enjoying this. The inspector spoke Stone House Nursing Home DS0000019253.V304585.R01.S.doc Version 5.2 Page 15 to the activities coordinator. She said she carries out quizzes, craft sessions, music sessions, reminiscence sessions, invites entertainers to the home and arranges trips out to places of interests. Photographs were displayed showing the most recent trip out. Examples of other trips out include the local Garden Centre, Waddesdon Manor and the home is visiting the Bucks Goats farm on the following Monday. The activities coordinator is in the process of drafting the homes first newsletter and the inspector saw evidence of this. A further project that she wishes to undertake is to develop a sensory garden. Records are maintained by the activities coordinator of who undertakes each activity. She has photographs of different events and maintains a folder of comments made by service users following each activity. This is to be commended. Comments received via discussions held with service users and relatives and via comment cards are positive. Service users are able to receive visitors in the privacy of their own rooms, and are able to choose whom they see and do not see. There are no restrictions on visiting, and this is documented in the Service Users Guide. Involvement by the local community includes a regular church service in the home, regular visits by the hairdressers and barbers, a theatre company and visiting musician. Service users are encouraged to look after their own financial affairs whenever possible. However families, or on occasions a chosen solicitor will be responsible for an individuals financial dealings. The registered manager said she has information available for service users regarding advocacy groups if it is required. It is recommended that this information is displayed in a prominent area where service users can access it independently. An invitation to bring in personal items of furniture and other belongings is included in the Service Users Guide and evidence of this was seen during a tour of the premises. The inspector was told that service users can have access to their personal records if they wish. Service users are offered three meals a day. The main meal is served at lunchtime and there is a written menu. However, this menu does not record the choice available to service uses and just states that an alternative can be provided. It is a recommendation that the menu records what the choice is and service users are made aware of this. The menu is rotated on a four weekly cycle. The inspector had the opportunity to observe a lunchtime meal. This was relaxed, unrushed and well organised. Where service users require help to eat this is done discreetly. Comments received by service users indicate a varying level of satisfaction with the meals on offer. Some were pleased with the standard of food and others were dissatisfied with the choices available. Stone House Nursing Home DS0000019253.V304585.R01.S.doc Version 5.2 Page 16 The inspector was told that service users can take their meals in their rooms or the lounge if they wish. The nutritional needs of the service users are assessed and regularly reviewed and the inspector saw evidence of this in the care plans. Stone House Nursing Home DS0000019253.V304585.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are systems in place that enable service users, staff and stakeholders to make comments about the quality of the service in a non-judgemental manner. Policies and procedures to protect service users from abuse are in place, including financial protection. Care workers have a good knowledge and understanding of Adult Protection issues that protect service users from abuse. EVIDENCE: There is a complaints procedure and this informs the complainant who to approach with their complaint. Copies of the complaints procedure are included in the Statement of Purpose and the Service Users Guide and this gives guidance about referring a complaint to the Commission for Social Care Inspection. The home has a dedicated book for the recording of complaints. The home has received one complaint since the previous inspection. This was responded to within stated timescales and is well recorded. The inspector looked at an Adult Protection Policy and within this there are guidelines for staff about the responsibilities of the staff, types and signs of abuse and what to do if you suspect abuse. Training records demonstrate that most care staff have completed POVA training. There remains five newly employed care staff to undertake this training. Discussions with ancillary staff confirm that they are included in POVA training. Stone House Nursing Home DS0000019253.V304585.R01.S.doc Version 5.2 Page 18 The inspector looked at the homes policies and procedures regarding service users money and financial affairs. This policy ensures service users have access to their money, valuables and safe storage of valuables. Stone House Nursing Home DS0000019253.V304585.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment within the home is good, providing service users with an attractive and homely place to live. The overall quality of the furnishings and fittings is good ensuring the safety and comfort of service users. Standards of cleanliness at the home appear to be good meaning that service users live in an environment that is clean and hygienic, protecting their health, safety and welfare. EVIDENCE: Stone House provides 24hr-nursing care for frail elderly people. The home is situated in the quiet village of Stone. Bedrooms are situated on the ground and first floor and access to the upper floor is via a passenger and stair lift. Stone House Nursing Home DS0000019253.V304585.R01.S.doc Version 5.2 Page 20 The internal decoration of the home is in good repair, however some carpets were noted to be stained and would benefit from cleaning. The carpet outside the kitchen door has started to gather and this could soon become a trip hazard. This needs to be addressed and will be a requirement of the report. The kitchen is clean, spacious and well looked after. The home has a large garden that is well-maintained and accessible to service users. There are no CCTV cameras in use within the home at the time of the inspection. There is one small dining room. Other service users eat their meals either in their rooms or in the lounges where they have been sitting throughout the day. Small tables are brought into the lounges at lunchtime for service users to eat their meals from. The lounges are adequately decorated and there are personal touches around the home such as flowers, plants, books and pictures. Lighting in communal areas is domestic in character and sufficient to facilitate reading and other activities. There are quiet areas around the home where service users can meet visitors in private. A church service is held in the home on a monthly basis. The furnishings observed in communal areas are of good quality and suitable for the range of interests and activities preferred by service users. Following the previous inspection a requirement was issued for the repairs to bedrooms doors identified in Standard 19 of the main body of the report are completed. This remains within the stated timescale of 30/09/06. Concerns were raised via a comment card from a relative regarding the lack of cleanliness and hygiene within the home. However a tour of the home showed that the home was clean and free from offensive odours. The registered manager must ensure that a high standard of hygiene is maintained at all times. The laundry room is sited so that soiled articles, clothing and infected linen do not have to be carried through areas where food is stored, prepared cooked or eaten. The floors in the laundry are washable and the walls easily cleanable. Instructions were observed in the laundry regarding the washing of foul linen. Policies and procedures were observed by the inspector for the control of infection, which includes the safe handling and disposal of clinical waste. Stone House Nursing Home DS0000019253.V304585.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing numbers are appropriate to meet the assessed needs of the service users. Staff have clearly defined job descriptions and understand their own and others roles and responsibilities. Service users benefit from a staff team who are appropriately trained to ensure that service users are cared for by skilled staff at all times. There are effective recruitment procedures in place to ensure service users are protected from harm. EVIDENCE: The home employs a mixture of registered nurses, care assistants, ancillary staff and an activities coordinator. Rotas demonstrate that appropriate levels of staff are on duty across a twenty-four hour period. There are seven care staff and two registered nurses on duty on a morning shift, four carers, two registered nurses and an activities coordinator on an afternoon shift. At night there are two carers and one registered nurse. The duty rota identifies staff by name and their role in the home. Ancillary staff are recruited in sufficient numbers to meet the needs of the home. There are no staff working in the home who are aged under 18 years of age. Stone House Nursing Home DS0000019253.V304585.R01.S.doc Version 5.2 Page 22 Progress is being made with NVQ training. At the time of the inspection there were two staff who had completed NVQ level 2 and 3 and another senior carer has completed NVQ level 2. Following the previous inspection it was identified that CRB disclosures with POVA clearance were not applied for prior to the appointment of the staff member. A requirement was issued for a POVA first to be received at the Home prior to any staff member working in the Home. A selection of five staff files were examined and found to contain the necessary documentation as detailed in schedule 2. However the home needs to obtain photographic proof of ID of all staff. There is evidence that all staff POVA and CRB checks have been obtained prior to employment. The home does not employ any volunteers. There is a policy regarding staff recruitment and this was found to cover all areas as detailed in standard 29. There is evidence of a staff induction programme and these were observed during the inspection. This is a book produced by an outside company. This covers health and safety training, fire safety, accident reporting, safe food handling, infection control, COSHH, emergency first aid and confidentiality. Training records show that staff are up to date with mandatory training. Staff spoken to stated that the range of training was good and all care staff are encouraged to undertake all areas of training. Stone House Nursing Home DS0000019253.V304585.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is supported well by the staff team in providing clear leadership and demonstrating an awareness of their roles and responsibilities to the benefit of service users. The home operates a consistent approach to quality assurance resulting in the home being proactive in identifying issues that may effect the well being of services users. Protocols and systems are in place to ensure service users financial interests are safeguarded. Health and Safety procedures are in place ensuring the safety of service users, staff and visitors to the home. EVIDENCE: The registered manager continues to work hard to ensure the home is meeting the current minimum standards and is complying with relevant legislation. The Stone House Nursing Home DS0000019253.V304585.R01.S.doc Version 5.2 Page 24 registered proprietor and manager meet regularly to ensure any issues of concern can be raised in an open and productive manner. The Manager of the home has completed the Registered Managers Award. Further training undertaken by the registered manager in the last twelve months includes dementia mapping, POVA update and mentorship update. The Home does not take responsibility for the maintenance of Service Users finances. A billing system is in place which ensures Service Users maintain control of their finances or appointed persons are able to ensure the safe management of personal accounts. All purchases on behalf of Service Users are added to a monthly bill with receipts held and open to inspection. The home operates regular committee meetings and minutes are kept of these. This was confirmed through discussions held with relatives. One relative spoken to said “ I attend the relatives meetings regularly, but I find the management of the home is very approachable and if I have a problem I will talk to the manager”. The manager informed the inspector that a service satisfaction questionnaire is sent out to service users and relatives on an annual basis. The registered manager said that these have just recently been sent out and are slowly being returned. Staff meetings are held on a monthly basis and staff are able to provide feedback during these. The proprietor regularly sends Regulation 26 visit reports to the Commission. Records were seen for fire safety. These are comprehensive and up to date. However, testing of the fire alarm needs to be undertaken weekly and is requirement of the report. A fire manual covers the homes fire procedures, practice fire drills, fire prevention, maintenance of escape routes, fire alarm testing, emergency lighting testing and door maintenance. A generic fire risk assessment for the home is in place. Service reports are in place for the maintenance of the lifts and hoists. PAT testing certificates are in place dated 16/02/05, electrical installation 17/03/06 and the oil burning boiler certificate is dated April 2006. COSHH sheets are up to date and accurate. Risk assessments for the use of cot sides are in place. The inspector looked at Infection Control guidelines that are available for all staff. The homes incident and accident book is completed legibly. Stone House Nursing Home DS0000019253.V304585.R01.S.doc Version 5.2 Page 25 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 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 2 3 X X X X 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 X X 2 Stone House Nursing Home DS0000019253.V304585.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP19 Regulation 23 Requirement The registered manager is required to ensure that the carpet outside the kitchen door is made safe. The registered manager is required to ensure that the fire alarm system is checked in house on a weekly basis and the results are recorded. Timescale for action 30/10/06 2 OP38 23 30/09/06 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 OP14 2 OP15 Refer to Standard Good Practice Recommendations It is recommended that information regarding advocacy services is displayed in a prominent area within the home so service users can access it independently. It is recommended that the choice of menu is recorded on the written menu. Stone House Nursing Home DS0000019253.V304585.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Aylesbury Area Office Cambridge House 8 Bell Business Park Smeaton Close Aylesbury HP19 8JR 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 Stone House Nursing Home DS0000019253.V304585.R01.S.doc Version 5.2 Page 28 - 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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