Inspection on 11/06/08 for Stonebow House

This inspection was carried out on 11th June 2008.

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

Stonebow House 01/02/07

Stonebow House 22/03/06

Stonebow House 16/12/05

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOMES FOR OLDER PEOPLE Stonebow House Peopleton Pershore Worcestershire WR10 2DY Lead Inspector Gillian Goldfinch Unannounced Inspection 11th June 2008 11:00 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 Stonebow House DS0000065939.V365390.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. Stonebow House DS0000065939.V365390.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stonebow House Address Peopleton Pershore Worcestershire WR10 2DY 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) 01905 840245 01905 841020 ambercareltd@yahoo.co.uk Amber Care Limited Mrs Rosemarie Jean Hoskins Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Stonebow House DS0000065939.V365390.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service is primarily for people whose care needs are related to old age, but the home may also accommodate a maximum of three people with dementia illnesses, above 65 years of age. 06/02/07 Date of last inspection Brief Description of the Service: Stonebow House is a large, period property that has been converted and extended in order to provide accommodation for a maximum of 30 older people, three of whom may also have a dementia illness. The home stands in its own extensive grounds in a corner position off a main road in a rural area within a few minutes driving distance of Pershore. The home is accessible to people who use wheelchairs and provides space for car parking at the front of the premises. Most of the people who use the service are accommodated on the ground floor. There are five bedrooms i.e. three single bedrooms and two double bedrooms on the first floor of the original part of the building. The home does not have a passenger lift. However, a stair lift has been installed on part of the stairway to enable service users to have easier access to the bedrooms on the first floor. Although the home has two double bedrooms, all of the bedrooms were being used as single rooms. The stated aim of the home is to ‘provide a homely, comfortable and caring environment for elderly people, for long and short stays, encouraging the highest possible standard of life which reflects each individuals dignity and independence’. Information provided in the statement of purpose showed that weekly fees range from £414.00 to £476.00, additional charges are made for some items such as hairdressing, newspapers and chiropody. More up to date information relating to the fees charged for the service is available on request from the Home. Stonebow House DS0000065939.V365390.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good outcomes. This was an unannounced inspection of the Home to look at how the Home is performing in respect of the core national minimum standards (the report says which these standards are). We call this type of inspection a key inspection. The service had previously completed an Annual Quality Assurance Assessment (AQAA). The AQAA is a self-assessment and a dataset that each registered provider has to complete each year and send to us within agreed timescales. The document tells us about how providers of services are meeting outcomes for people who use the service and is an opportunity for them to share with us what aspects of the service they believe they are doing well. Some of the manager’s comments have been included within this inspection report. We also received completed survey forms from seven people who use the service and four of their relatives, four visiting professionals and six staff members. The information from these sources helps us understand how well the home is meeting the needs of the people using the service. During the inspection, we spoke with the care manager, some residents, and some staff and a visiting G.P. There was a tour of parts of the building and time was spent observing what the arrangements were at lunchtime and the administration of medication. Throughout the inspection, there were opportunities to observe and overhear staff contacts with people who live in the Home. Documentation was checked, including the care records of people who live at Stonebow, and some staff files. Copies of policies and procedures were made available. What the service does well: The service provider, manager and staff work hard to continue to improve the service provided at Stonebow. The space available in the building enables people to move around freely. The location is very attractive. Relevant information about the Home is available to people considering it as a Home for them or their relatives. The assessment and admission procedures Stonebow House DS0000065939.V365390.R01.S.doc Version 5.2 Page 6 are suitable. This ensures that the Home only offers care to those whose needs can be met by the service. Staff are caring and respectful towards people living at Stonebow and understand the importance of treating people as individuals. We saw and heard examples of sensitive care practice during the inspection and received positive comments from residents and relatives. The residents’ were satisfied with their healthcare treatment and felt that they were treated with dignity and respect by the staff. The residents’ were satisfied with the social and leisure activities provided within the Home and they were able to maintain contact with their relatives and friends. Visitors to the Home were made welcome. The residents received a balanced and wholesome diet and the food was served in pleasant and comfortable surroundings. There was a good rapport between the residents and staff and the residents felt confident about making complaints. The residents were satisfied that the care they received met their needs. Comments received during the inspection include the following: ‘Visitors to the Home are made very welcome and it always feels friendly and cheerful.’ ‘You couldn’t get a better staff they work hard and I am happy here’. ‘Staff are caring and respectful towards people living here’. The manager has the necessary skills and knowledge to manage the Home and has undertaken relevant training. The Home provides a safe and well maintained environment. This means that residents are kept safe and live in a comfortable environment. What has improved since the last inspection? All requirements made at the previous inspection have been met. This means that the provider is responsive to all requirements made by the commission. Staff have received training in the protection of vulnerable adults from abuse. This ensures that residents are protected by a staff group who are appropriately trained. Redecoration of several rooms has taken place. This has improved the standard of accommodation available to residents. Stonebow House DS0000065939.V365390.R01.S.doc Version 5.2 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Stonebow House DS0000065939.V365390.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 Stonebow House DS0000065939.V365390.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The service provides written information to help people decide if Stonebow is the best place for them or their relative to live. Detailed information is obtained during the assessment of prospective residents and relevant people are asked to provide information; this means that staff have the information they need to decide if they can provide the right care for people. EVIDENCE: People thinking about Stonebow for themselves or a relative are given written information about the Home. This consists of two documents, the Statement of Purpose and the service user guide. These describe aspects of the service provided, and explain that the Home provides accommodation for 30 elderly people including three people with dementia related illnesses. The information tells people about life at Stonebow and the service they can expect. It describes the accommodation and the qualifications and experience of the Stonebow House DS0000065939.V365390.R01.S.doc Version 5.2 Page 10 owners, manager and staff. It also explains how to make a complaint. Copies of these documents are kept in each bedroom so that residents can look at them whenever they wish. All this information is available in different formats, for example on tape for someone with poor eye sight, on request. The relative of a newly admitted resident told us she was happy with the way in which her father’s admission to the Home had taken place; with the information provided by the Home and the way in which her father’s needs had been assessed before he moved in. Four residents who spoke to us confirmed they had been provided with information about the Home before their admission and that this information was in their bedrooms for them to keep. Requirement made at the last inspection for information contained in the Statement of Purpose and service user guide to be updated had been met. Staff from the Home obtain information about people before they offer someone a place at Stonebow. When someone is being assisted with funding by a local authority, this includes obtaining a copy of assessments carried out by the authority’s social care staff. This helps Stonebow staff check that they are likely to be able to meet a person’s needs. Requirement made at the last inspection for the Home to update the form they use to obtain information before people before move in had been met. A G.P we spoke to during the inspection spoke of his team’s confidence in the service and the care taken by staff to help people and their families during the difficult period before and after they move in to the Home. Stonebow House DS0000065939.V365390.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each resident had a plan of care created from the information obtained before their admission to the Home. Each plan of care clearly identified individual health, personal and social care needs and how these were to be met. This means that staff had the necessary information to assist individuals in meeting their needs. Arrangements for the storage and safekeeping of medication need to be improved. Staff showed awareness of the need to treat residents with dignity and respect. EVIDENCE: The plans of care for five residents were inspected. These were comprehensive, containing up to date information on the care needs of each resident and clear instruction to staff on how these were to be met. The care plans were being reviewed and updated as necessary each month, by a senior Stonebow House DS0000065939.V365390.R01.S.doc Version 5.2 Page 12 member of the care team. There were plans for the care staff to take on greater responsibility for the writing and review of care plans which at the moment is undertaken largely by the senior staff. The manager wrote on the pre-inspection AQAA of ideas for the development of the service. “To conduct further training of record keeping for all care staff so that they can be more involved with care planning which should further improve the level of care we provide to our service users”. The home encourages residents to be as independent as they are able. The manager wrote on the pre-inspection AQAA. “Service users are encouraged to be as independent as possible with care staff providing support and encouragement where needed. All care staff are given instruction on the need to be observant and to report any change in the service users needs to a senior member of staff and appropriate action is then taken without delay”. This was confirmed by those residents who spoke to us during the inspection. One residents stated: ‘I am free to manage as I wish and the staff are there to help me if and when I need it’. Staff at the Home work hard to maintain and promote the healthcare needs of residents. The manager stated on the pre-inspection AQAA. ‘Service users have access to a wide range of health care services to help meet the service user needs. Stonebow works very closely with local practitioners to maintain the wellbeing of each individual service user.’ The Home has close links to local health services and works well with visiting healthcare professionals. One of the visiting G.P.’s, in the Home at the time of the inspection, confirmed that the surgery are contacted promptly and appropriately by the Home when residents need to be seen and that the Home is able to meet the health care needs of those who live there. He further stated that the Home acts appropriately and is able to identify when health care needs can no longer be met and on-going nursing care is required. Another healthcare professional commented on a returned questionnaire that: “The senior staff are excellent. They have good judgement and most importantly know their limitations, seeking help when needed, and re-housing Stonebow House DS0000065939.V365390.R01.S.doc Version 5.2 Page 13 residents whose needs cannot be met”. Residents who spoke to us were happy that their needs were being met and that they had access to health care services. Documentation in care records showed that residents had access to community services such as optician, chiropodist and dentist. Staff expressed some concern that there was not always a sufficient supply of continence pads in the Home and that at times supplies had run very low. This was discussed with the manager who explained that when new residents were admitted they did not always bring their pads with them. It was agreed that this issue would be addressed with the continence nurse and action would be taken to ensure that any newly admitted resident in receipt of a continence service would be requested to bring any necessary supplies with them. The Home has a policy and procedure for the administration of medication, which is kept under review and updated when necessary. Amendments had been made to these documents in accordance with recommendations made at the last inspection. We observed the administration of medication at lunch time. This was undertaken by a senior member of care staff. The medication was seen to be appropriately administered. Appropriate records were signed at the point at which the medication was given. All staff involved in the administration of medication had undertaken accredited training in the control and administration of medicines in January 2008. A stock check was carried out of the controlled drugs cupboard. The balance of stock was too high in respect of one drug. The controlled drug register stated there were eight tablets. When the stock was checked thirty eight tablets were found. When asked, the senior carer stated there must have been an error. The box containing thirty tablets had not been checked into the Home or entered into the controlled drugs register when delivered by the pharmacy on May 16th 2008. The senior carer took immediate action to inform the manager and enter the drug into the controlled drugs register. A controlled drug in respect of a resident who died on March 24th 2008 was found in the controlled drug cupboard. This drug should have been returned to the pharmacy eight days after the death of the resident. These practices are poor and potentially dangerous. When we brought these to the attention of the manager, she gave assurance that action would be taken to ensure these practices did not reoccur. The faults identified indicate that stock control and internal audit measures are not sufficiently robust to identify and correct poor practice and we recommend a review of medication arrangements at the Home. Stonebow House DS0000065939.V365390.R01.S.doc Version 5.2 Page 14 We saw staff being gentle, caring and respectful towards residents. Those residents who spoke to us stated they were treated with dignity and respect. The manager wrote on the pre-inspection AQAA. “All service users are treated with dignity and respect and their right to privacy is paramount”. Stonebow House DS0000065939.V365390.R01.S.doc Version 5.2 Page 15 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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Home promoted the residents’ quality of life by seeking their views, offering choice and encouraging them to remain as independent as possible. EVIDENCE: The manager wrote on the pre-inspection AQAA: “All service users have the right to express choice and preferences in all areas of social activities and routines of daily living.” This was confirmed by those individuals who spoke with us during the inspection. Choice and preferences in relation to social, cultural, religious and recreational interests were also recorded in each residents care records and regularly reviewed. One resident told us, “ I am helped to walk in these beautiful gardens whenever I want to, I enjoy being able to watch the seasons change”. Stonebow House DS0000065939.V365390.R01.S.doc Version 5.2 Page 16 Another resident stated, “ I enjoy the exercises and music, it keeps me active”. A record was kept and seen of the range of activities which take place both within and outside of the home on a regular basis. These included: • • • • • • • • Trips to local places of interest as decided by the residents e.g. Purshore Abbey, Garden Centres. Theatre trips Flower arranging Gardening – raised flower beds have been built in the garden area Monthly music for health group Weekly keep fit class Handicrafts Holy communion One resident commented that he preferred to stay in his own room and although he was aware of the activities available it was his choice not to participate. The manager told us that the Home is aiming towards providing a dedicated post of activity co-ordinator with specific responsibility for the organisation of social and recreational activity for residents. A resident meeting is held every 4 – 6 weeks. This is attended by the manager and provides an opportunity for residients to discuss daily life in the home. The minutes of these meetings are displayed on the notice boards in the Home along with the monthly programme of activities. Visitors to the home are welcome and encouraged. The residents with whom discussions were held stated their relatives and friends were always made welcome and offered a drink. The residents also confirmed that they were able to see their relatives and visiting professionals e.g. the GP, district nurse etc, in private. The Homes service users’ guide stated, ‘It is our intention to encourage all residents’ relatives and representatives to maintain as much involvement as possible with the resident, at the time of admission and in their subsequent life at Stonebow House’. Stonebow House DS0000065939.V365390.R01.S.doc Version 5.2 Page 17 The manager and staff supported each resident in their right to exercise personal autonomy and choice. The Homes service users’ guide contained information about the local advocacy service. A poster with similar details was also displayed on the notice board. There was evidence that residents were able to bring personal possessions with them on admission to the Home. The service users’ guide contained information about the residents right of access to records held about them by the home. The residents with whom discussions were held confirmed that they were able to make choices about their daily routines and matters affecting their care e.g. the clothes they wore, the food provided, where they ate their meals and the time they got up and went to bed. Time was spent with residents in the dining room while they were having lunch. The food served looked nutritious and appealing. Residents who spoke to us were satisfied with the variety and amount of food provided. One resident stated, “I didn’t have enough food when I first came, so I mentioned it and now I have plenty” Another resident told us, “The food here is excellent”. The record of food served was seen and showed a varied, wholesome and nutritious diet. Time was spent with the cook on duty who was knowledgeable as to the dietary needs of the residents, their likes, dislikes and any special needs. The cook confirmed that the kitchen equipment was in satisfactory working order. A cleaning schedule was available. A record of the temperature of the food and fridge and freezers was being maintained and was up to date. One resident required assistance from staff with feeding. The staff member was observed to be standing whilst feeding the resident. This is not considered good care practice and does not preserve the dignity of the individual resident. The carer was not at an equal level to the resident, there was no eye contact or communication as to whether the resident was ready to receive the next mouthful of food and no communication as to whether the resident was enjoying the food provided. This situation was discussed with the manager who confirmed that the carer was newly appointed and had not yet received appropriate training. The manager confirmed that this matter would be addressed immediately. It is recommended that newly appointed care staff do not undertake personal care tasks for residents before they have undertaken the appropriate training and are considered competent to complete the specific task. Stonebow House DS0000065939.V365390.R01.S.doc Version 5.2 Page 18 Stonebow House DS0000065939.V365390.R01.S.doc Version 5.2 Page 19 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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Home had a clear complaints procedure and other relevant policies and procedures to ensure that residents were protected from abuse. EVIDENCE: The Home had a clear complaints procedure, which was included in the service users’ guide. A copy of the complaint’s procedure was also displayed on the notice board. Residents with whom discussions were held felt confident about making a complaint. They also felt that any complaint made would be dealt with appropriately. They all felt that the registered manager was approachable. The manager stated on the pre-inspection AQAA that, “Complaints are taken very seriously and documented on standard complaints forms and apprpriate action taken immediately. Service users and their representatives are encouraged to express any concerns to the manager or any senior member of staff at any time.” The complaint’s record was seen and showed that appropriate action had been taken to address any concerns raised. Stonebow House DS0000065939.V365390.R01.S.doc Version 5.2 Page 20 The Home had a policy and procedure for the protection of vulnerable adults from abuse. This had been inspected at the previous inspection and found to be satisfactory. The manager confirmed there had been no changes to the policy since the last inspection. All staff except two had received training in the protection of vulnerable adults from abuse. Staff who spoke to us were clear about what constitutes abuse and what action they would take in the event of discovering an incident of abuse. The manager confirmed that no incidents of alleged or suspected abuse had occurred or had been reported or had otherwise come to her attention since the previous inspection. The manager also confirmed that she had had no reason to refer any member or former member of staff for consideration for inclusion on the protection of vulnerable adults register. The Home had a copy of the Department of Health guidance ‘No Secrets’. The Home’s ‘whistle blowing’ policy and the policy on the service users’ money and financial affairs were satisfactory. Stonebow House DS0000065939.V365390.R01.S.doc Version 5.2 Page 21 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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Home provides a safe and homely environment for residents to live in. EVIDENCE: The Home was suitable for its stated purpose and had been appropriately adapted to meet the needs of older people. The Home was situated in a quiet location and a number of rooms enjoyed outstanding views of the surrounding countryside. The Home was well maintained. Schedules were in place to ensure the continued maintenance and redecoration of the Home. Records were kept for all maintenance carried out on the building. The manager stated on the preinspection AQQA. Stonebow House DS0000065939.V365390.R01.S.doc Version 5.2 Page 22 “Continual monitoring of the environment and risk assessments are conducted. A handyman is employed to conduct on-going maintanance of the home. A log book is kept by the handy man for all maintainance carried out” Residents who spoke to us were positive in their comments about the accomodation”. There were no concerns raised about the hygiene or cleanliness of the Home. One resident told us, “This is a comfortable house, I am more than happy with my room and the wonderful view of the garden”. There was a Fire Safety Risk Assessment in place for the Home. The building meets the requirements of the local fire service.. The Home was visited by the Environmental Health Officer on July 21st 2007, all requirements made in relation to this visit had been met accept for the requirement to repair and replace the draw fronts of the kitchen units. This has not been implemented as the provider has plans to refurbish the kitchen. The home was free from odours and those areas we saw were in a clean and hygienic state. There was an appropriately located and fully equipped laundry facility. Policies and procedures were in place for the control and spread of infection. Staff had received training in infection control. Stonebow House DS0000065939.V365390.R01.S.doc Version 5.2 Page 23 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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff were experienced, trained and employed in sufficient numbers to meet the needs of the residents. Residents were protected by the Home’s thorough recruitment procedures. EVIDENCE: A copy of the staff rota was made available for inspection. . The staff rota showed that the Home was adequately staffed during the day and at night, with additional staff on duty at peak times of activity during the day. There was a separate team of catering staff and separate cleaning staff. Some staff who spoke with us felt it would be useful to have an additional member of kitchen staff available each evening to serve tea. This would enable care staff, who in the absence of kitchen assistance are responsible for serving tea, to spend more time with the residents. A relative commented, “The staff here are helpful and friendly. They provide the best of care for my mother and are always there to respond when she needs them”. Stonebow House DS0000065939.V365390.R01.S.doc Version 5.2 Page 24 Another relative told us, “The staff know what they are doing, they work hard and give care and attention to my mum. We are more than happy with the service”. Residents we spoke to were positive about the staff. One resident told us, ‘The staff are lovely. They work hard’. Another resident said, “The staff do their best, sometimes there could be more of them, but they do a good job.” They are a friendly, happy group”. The provider and manager are committed to providing appropriate training for the staff group. Comprehensive records were kept of training provided and of training planned for the future. All staff had received training in the core areas of health and safety. Many of the staff were working towards or had achieved an NVQ qualification in care at level 2 or 3. The manager wrote on the pre-inspection AQAA, “We actively encourage the taking of NVQ’s and have a high level of commitment to training”. Staff who spoke to us confirmed they received appropriate training. A selection of staff records was inspected to assess the Homes recruitment procedures. A selection of four files were looked at and found to contain all the requirement information. There was evidence that staff had undergone relevant criminal records checks to ensure their suitability for the job and the safety of residents. Recently appointed staff spoke to us of their recruitment process, which was thorough and robust. The Home operates an induction programme for all new staff. As stated earlier in this report it is recommended that care staff do not undertake personal care tasks such as feeding until their manager considers them competent to do so. Stonebow House DS0000065939.V365390.R01.S.doc Version 5.2 Page 25 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33, 35 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 has the experience and qualifications necessary to manage the home. She is working hard to develop a level of service that provides good outcomes for people who live at the home. Residents’ personal monies are well managed in their best interests. The management and administration of the home was based on openness and respect for the residents’ best interests, rights and safety. EVIDENCE: The Manager has several years experience in the care industry. She has established herself at Stonebow and shown her ability to respond appropriately Stonebow House DS0000065939.V365390.R01.S.doc Version 5.2 Page 26 to various situations and work cooperatively with us and with placing authorities. Feedback from relatives to our surveys and the in house quality assurance process provided examples of the positive relationships many feel they have with the Home. “Very nice atmosphere must be the result of good management”. “The manager has an open door policy and is always available for consultation”. One relative commented on being lucky to have such and ‘excellent’ Home for her mother so close to home. The manager displayed a strong ethos of being open and transparent in her management of the home. She was resident focussed. She led and supported a strong staff team who had been trained to a high standard. Staff who spoke with us were complementary in their comments about the manager and her style of leadership. The Home has a quality assurance system and the service providers visit the Home frequently; the service providers prepare monthly reports as required by regulation. We did not look at these during this inspection. Requirements made at the previous inspection for a quality assurance system to be introduced and an annual development plan to be drawn up had been met. Residents who spoke with us stated they felt consulted and involved in the daily life and future of the Home. Plans for future developments of the building were available for residents to view on the notice boards. Residents’ money held in safekeeping and managed on their behalf was stored securely and appropriately receipted and recorded. The financial records of two residents were checked at random and found to be in order. A requirement made at the last inspection for thermostatic valves to be fitted to all hot water outlets had been met. All staff had received training in matters relating to health and safety. Records were checked in respect of fire safety and accidents. These were found to be well kept and up to date. All necessary maintenance and testing of machinery and equipment was being carried out at the required intervals. Residents stated they felt safe and protected in their Home. Stonebow House DS0000065939.V365390.R01.S.doc Version 5.2 Page 27 Stonebow House DS0000065939.V365390.R01.S.doc Version 5.2 Page 28 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x 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 3 x 3 x x x x 3 Stonebow House DS0000065939.V365390.R01.S.doc Version 5.2 Page 29 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 OP9 Regulation 13 (2) Requirement Action must be taken to improve the arrangements for the recording, handling, safekeeping and disposal of medication to protect people who use and work at the service from the risk of medication error. Timescale for action 01/09/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard OP8 OP12 OP27 OP30 Good Practice Recommendations The Home should ensure there are always sufficient continence supplies to meet the needs of the residents. An activities co-ordinator with specific responsibility for the organisation of recreational and social activities for residents should be employed. Additional kitchen staff should be made available to serve tea on a daily basis. This will enable care staff to spend more time with residents. Care staff should receive appropriate training in performing personal care tasks, such as feeding a resident, before they undertake the task unassisted. DS0000065939.V365390.R01.S.doc Version 5.2 Page 30 Stonebow House Stonebow House DS0000065939.V365390.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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. 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