Inspection on 11/02/09 for Stoneacre Lodge

This inspection was carried out on 11th February 2009.

CSCI found this care home to be providing an Good service.

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

Stoneacre Lodge 17/10/06

Stoneacre Lodge 05/05/05

Stoneacre Lodge 18/01/05

Similar services:

Abbey The

Snydale Care Home

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 10/07/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Stoneacre Lodge High Street Dunsville Doncaster DN7 4BS     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Ramchand Samachetty     Date: 1 1 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Stoneacre Lodge High Street Dunsville Doncaster DN7 4BS 01302882148 01302882178 NONE Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Seth Homes Ltd Name of registered manager (if applicable) Linda England Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Stoneacre Lodge is registered to provide accommodation and care for up to 31 service users. The home is owned by Seth Homes Ltd, and it is managed by Mrs. L. England. It is situated in the village of Dunsville, which is approximately 5 miles from Doncaster town centre. The building consists of a large detached house that has been extended. The accommodation is provided on two floors and there is a stair lift to facilitate access between the floors. The communal areas are located on the ground floor and consist of 3 lounges, one of which is a sun lounge and a dining room. The kitchen, laundry facilities and office are also on the ground floor. There is car parking to the front and a garden at the rear of the building. The information about fees and charges was provided on 11 February 2009, and was as follows: Care Homes for Older People Page 4 of 26 0 Over 65 31 care home 31 Brief description of the care home £390.62 per person per week. Additional charges: Private chiropody and hairdressing. For further information about fees and charges. For further information please contact the home. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This key unannounced inspection was carried out on 11 February 2009, starting at 09.45 and finished at 17.30 hours. the manager, Mrs L. England was present throughout the inspection. The owner and responsible person, Mr M. Seth was present for part of this inspection. The service is registered to provide care for up to 31 older people. There were 27 people living at the home at the time of this inspection. The manager informed us that the fees charged by the home was three hundred and ninety pounds and sixty- two pence per resident per week. There were separate charges for private chiropody and hairdressing. Care Homes for Older People Page 6 of 26 All the key national minimum standards for Care Homes for Older People were assessed. the inspection included a tour of the premises, examination of care documents and other records, including those pertaining to complaints, staff employment, staff rota, medicines management and maintenance of equipment and quality assurance methods. We checked and used some of the information contained in the Annual Quality Assurance Assessment that was submitted to us before this inspection. We considered the views of people using the service and those of their representatives. we took into account the views of staff who worked at the home. We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. We gave feedback about our initial findings to both the manager and the responsible individual. We would like to thank all the people living at the home, their relatives, the manager and her staff for their assistance with this inspection. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who used the service were provided with sufficient information in order to help them choose it. Assessments of needs were carried out before people were admitted and this helped to make sure that their identified needs could be met. Evidence: The registered manager confirmed that the homes statement of purpose and service user guide had been reviewed to provide all necessary information about the service. These documents were provided to people who used the service, their relatives and people who enquired about the home. The relative of one person who had been recently admitted to the home said that she had been given sufficient information to help them make a choice of home. The care files of two people who had been recently admitted to the home, were checked. They showed that full assessments of their care needs had been carried out Care Homes for Older People Page 10 of 26 Evidence: before their admission. This helped to establish that their care needs could be met at the home. The home does not provide intermediate care services. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal and health care needs were appropriately provided for, taking account of their preferences and wishes. However, greater care was needed in the process of reviewing their care plans. Evidence: People who used the service and their relatives said that they were satisfied with the care and support that was provided. They said that the care staff were good and caring. People who lived at the home and who could express their views commented that they were well looked after. One person said carers are very polite and patient and spend time talking to me. People living at the home confirmed that their personal care was always provided in private. Relatives told us that the care staff were courteous to people in their care and that they were good at listening and talking to them. During our visit, we noted that people who used the service, were in good attire. One person said that she had been helped to choose her dress and a matching coat and was happy about it. Care Homes for Older People Page 12 of 26 Evidence: We looked at the care plans of three people who used the service. Individual care plans for each person was developed from their assessment of needs. We noted that a new and improved care planning system had been introduced. The new care plan documentation allowed for comprehensive and relevant information to be recorded and used. This helped to improve the way care was organised and delivered. We also noted that the recording of care that was provided to each person, was improving. We checked the reviews of individual care plans. These were carried out on a regular basis. However, the process undertaken to review some care plans were not clear and the outcomes of such reviews were also unclear. The care plans that we checked showed that people using the service were appropriately assisted to access community health care services. These included the services of GPs, dentists, dietitians and community nursing, including mental health. We looked at the way medicines were handled and managed at the home. We noted that the storage of medicines had improved. Receipts of medicines were appropriately recorded. We checked a sample of medicines administration record (MAR) sheets. They were satisfactorily maintained. Medicines administered were appropriately signed for. Two persons who used the service were administering their own medicines. Records showed that they had been risk assessed and considered safe and able to do so. They had been provided with lockable furniture in their bedrooms for safe keeping of their medicines. Regular audits of medicines were carried out to make sure that problems were identified and rectified in a timely and safe manner. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home were able to benefit from the recreational and social activities that were provided to them and these helped to maintain and improve their quality of life. Evidence: During our visit, we observed people who lived at the home, spending time in lounges, watching television, listening to radio, reading or engaged in conversations. A few people chose to stay in their own rooms and spend time in their own way. We noted members of staff also spending time talking with people, while attending to their care. Relatives told us that they felt routines at the home were flexible and this benefited their loved ones. They said that people could get up from and retire to bed at times that suited them best. They could also choose how to spend their time. Relatives confirmed that they were always welcomed at the home. They said that staff, in particular, the key workers, communicated well with them and this ensured the wellbeing of their loved ones. The activities co-ordinator and other staff explained that both indoor and outdoor Care Homes for Older People Page 14 of 26 Evidence: activities were held at the home. Individual care plans gave details of social and recreational needs of each person and these were taken into account in organising activities at the home. We noted that there was a section in the care plan relating to ones life history and this also helped in ensuring that personal preferences were included in the planning of activities. Records of social activities included appropriate faith and cultural preferences of the people concerned. There were reminiscence sessions, sing-alongs, board games and trips out in the local area. We also noted that care staff occasionally gave their time to people, especially those who were frail, on a one-to-one basis. This helped to ensure their social stimulation. Events and activities were well publicised within the home to make sure that everybody was informed of such opportunities. People who lived at the home and their relatives told us that the meals provided at the home were wholesome and tasty. People said that they were offered good menu choices. We observed the lunchtime meal, which was the main cooked meal of the day. It consisted of braising steak, fish, seasonal vegetables, deserts and fruit juices and water, tea or coffee. In discussion, staff showed that they were aware of the nutritional needs and preferences of people who lived at the home. We also observed staff helping a few people to eat their meals. They offered their assistance in an unhurried manner, whilst ensuring the dignity of the people who they were helping. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The views and concerns of people who used the service and of their representatives were listened to. However, records relating to complaints management could be improved. People who lived at the home were appropriately protected from potential harm and abuse and these actions helped to maintain and improve their wellbeing. Evidence: The complaints procedure for the home was displayed and copies had been provided to people who used the service and their relatives. People said that they were aware of the procedure and would use it if they needed to do so. Relatives told us that they would talk to staff if they had any concern. They were confident that staff would address their concerns promptly and appropriately. The manager confirmed that she had received only one complaint since the last inspection, in October 2006. We looked at the complaints records. The complaint had been investigated and resolved satisfactorily. However, it was not clear from the records whether the complaint had been upheld or not and what actions were subsequently taken, if any. The home had use of an adult protection policy in order to promote the safety and wellbeing of people who used its services. The manager confirmed that there had not been any adult safeguarding referral since the last inspection. In discussion, we noted Care Homes for Older People Page 16 of 26 Evidence: that staff were aware of the local adult safeguarding procedures. A sample of training records showed that care staff had received training on the protection of vulnerable adults. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who lived at the home and their relatives were satisfied that the accommodation was safe, clean, comfortable and pleasant. This helped to maintain and promote the health and wellbeing of people who lived there. Evidence: We checked the premises in the company of the manager. The building comprised of two floors and there was a chair lift and a set of stairs to facilitate access between them. The manager explained that the chair lift had been replaced since the last inspection and was a new one. The building was in good state of repair. The furniture and soft furnishings were in good condition. The communal areas included three lounges and a dining room. The manager stated that the home had undergone substantial refurbishment since our last visit in October 2006. A new office had been set up and a computer system had been installed. New equipment have been provided for laundry and cleaning functions in the home. These included a new sluicing machine, new sinks and a steam cleaner. A new room had been provided in order to improve the storage of medicines. A new shower room had also been installed to provide a better choice of bathing facilities to people living at the home. A number of bedrooms had been decorated and provided with new carpets and new beds. People who lived at the home and their relatives told Care Homes for Older People Page 18 of 26 Evidence: us that the home was very pleasant, safe, comfortable and homely. People said that they were able free to use any communal part of the home. We viewed a few bedrooms with the permission of people who occupied them. The rooms were clean, tidy and odour free. A few people had brought in some memorabilia and this helped them to personalise their bedrooms. They told us that they were happy with their private accommodation. The surrounding grounds were also well maintained for the time of the year. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who used the service benefited from good recruitment and training arrangements, which ensured that they received appropriate care by skilled and competent staff. This helped to protect and promote their health and wellbeing. Evidence: There were 27 people in residence at the time of this inspection. Besides the manager and the deputy manager, there were five care workers on duty throughout the day. Two care workers were scheduled to work at night, between 20.00 and 07.00 hours. Other support staff during the day included the cooks, domestic and laundry worker. A part-time activities co-ordinator was also on duty at the time of this inspection. The manager stated that she was using guidance of the Residential Forum in deploying care staff at the home. We looked at the duty rota and it showed that appropriate and consistent levels of care staff were deployed to meet the needs of people who lived at the home. In discussion, people who could express their views and visiting relatives told us that, in their view, there were always sufficient staff around. People said that they received good care from staff. We looked at the files of three members of staff who had been recently recruited to work at the home. The appropriate recruitment and selection procedures had been followed. All the pre-employment checks, including written references and appropriate Care Homes for Older People Page 20 of 26 Evidence: disclosures had been sought and obtained. The new staff had all been provided with induction and training to make sure that they had the necessary skills and competence to provide care. However, we noted that there were no male care staff working at the home. The manager explained that there had been no interest from male candidates in care staff vacancies at the home. The manager explained that staff had been provided with on-going training on a range of topics. These included refresher training on moving and handling, fire precautions, first aid and food hygiene. Training had also been provided on adult safeguarding, using the new care plan, infection control and dementia. Training was being arranged for care staff on the Mental Capacity Act and the Deprivation of Liberty. The manager also confirmed that staff who administered medicines were appropriately trained to do so. Training records also showed that staff had received the training as stated. We noted that 13 out 18 permanent care workers had achieved their National Vocational Qualification (NVQ) level 2 in care. A number of care workers at the home had worked there for a long time and this led to a low turnover of staff together with good continuity of care. Staff told us that they were satisfied with the training opportunities that they were offered and that they felt well supported in the work they do. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Appropriate management arrangements were in place to ensure the proper day-to-day running of the home. This helped to maintain and promote the health, safety and welfare of people who lived and worked at the home. Evidence: People who lived at the home, relatives and staff told us that the home was well organised and well run. The registered manager had achieved her Registered Managers Award. She has experience of working in residential care for older people. The manager was also well supported in her work by the home owner. We noted that reports relating to the owners visits to the home were compiled and kept at the home. These reports were also used as a management monitoring tool to improve the service. We also noted that there was good forward planning in place to ensure continual improvement of the service. There was a deputy manager in post to assist in the daily running of the home. Another senior member of staff also helped out with the management of medicines and other administration duties. Care Homes for Older People Page 22 of 26 Evidence: In discussion, staff stated that they felt well supported in their work. They confirmed that they were receiving regular supervision. Notes of such supervisions were seen in staff files that we checked. The manager explained that she had use of various quality monitoring tools to help her evaluate the service. These included medicines and care plan audits, regular health and safety audits and risk assessments. She also carried out residents and relatives satisfaction surveys, staff and residents meetings. Minutes of all the meetings were kept at the home and they showed some of the actions that followed from them. We checked a sample of the audits that were undertaken and they were appropriately recorded and actioned. Arrangements were in place to support people living at the home with the management of their personal allowances. The financial transactions undertaken on behalf of people concerned and that we checked, were recorded, witnessed and signed for and receipts were kept. We noted that people at the home were able to obtain their money, outside office hours, if they required it. The manager had submitted the homes Annual Quality Assurance assessment to us prior to this inspection. It showed that all appliances and equipment used at the home had been appropriately serviced and maintained. Appropriate risk assessments and health and safety measures, including infection control and fire precautions, were in place and this helped to maintain the health and well being of people who lived and worked at the home. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 The reviews of individual care plans should be improved to show how such reviews are conducted and what outcomes had been achieved. This should assist in the evaluation of care of each person using the service. The records relating to the management of complaints should be improved to show clear outcomes following investigations and also the actions taken to put things right, as necessary. 2 16 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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!