Inspection on 09/07/07 for Stonebridge Nursing Home

This inspection was carried out on 9th July 2007.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Stonebridge Nursing Home 19/01/07

Similar services:

The Lodge Nursing Home

Bracken House

Sunnycroft

Field Farm House

Edgeview Nursing Home

Church Terrace Nursing & Residential Home

The Forbury

The Maples

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

CARE HOMES FOR OLDER PEOPLE Stonebridge Nursing Home 180 Birchfield Road Headless Cross Redditch Worcs B97 4NA Lead Inspector Chris Potter Key Unannounced Inspection 9th July 2007 09:30 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 Stonebridge Nursing Home DS0000068267.V339890.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. Stonebridge Nursing Home DS0000068267.V339890.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stonebridge Nursing Home Address 180 Birchfield Road Headless Cross Redditch Worcs B97 4NA 01527 542128 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) Alexandra House Care Services Ltd Julia Marie Foley Care Home 52 Category(ies) of Dementia (4), Dementia - over 65 years of age registration, with number (52), Mental Disorder, excluding learning of places disability or dementia - over 65 years of age (52) Stonebridge Nursing Home DS0000068267.V339890.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Registered person may provide personal care (including nursing care) to service users of both sexes whose primary care needs on admission to the home are within the following categories: Dementia over 65 years of age (DE)(E) 52 Mental Disorder over 65 years of age (MD)(E) 52 Dementia over 55 years of age (DE) 4 The maximum number of service users to be accommodated is 52. 2. Date of last inspection 2nd May 2007 Brief Description of the Service: Stonebridge Nursing Home is registered to accommodate a maximum of 52 service users with dementia or a mental disorder, who require twenty-four hour nursing care. Alexandra House Care Services Limited, who have one other nursing home in the West Midlands, operates the home. The registered manager is Ms J Foley, who is a first level registered mental nurse with many years experience. Accommodation is provided in single and double bedrooms, which are located on ground and first floor levels. A passenger lift enables service users with mobility difficulties to access both floors. The home provides a large communal lounge area with combined dining facilities on the ground floor for service users, and a separate conservatory. Communal toilet and bathing facilities are located on both floors, and central kitchen and laundry services are located on the ground floor. The home is situated in a residential area of Redditch, which is convenient for public transport and access to the town centre. There is an enclosed private garden to the rear of the property. The home’s weekly fees are from £600.00 per person per week, and this includes all costs with the exception of daily newspapers. Stonebridge Nursing Home DS0000068267.V339890.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was Stonebridge Nursing Home’s unannounced key inspection for 2007. The last key inspection was in January 2007 followed by a random inspection in May 2007. This inspection focused on the outcome for the service users and was carried out over two part days lasting a total of nine hours. On the days of the inspection the unit was caring for 49 people. Methods used to inspect the service included a tour of the unit. Case tracking the care for three service users, which included reviewing their care records. The opinions of three service users, five relatives and five staff members were also sought to ascertain their opinions about the home. Some maintenance records and relevant policies and procedures were examined during the inspection. Observations of care practises was also monitored over the two days. Due to the clinical conditions the majority of residents are unable to express their opinions about the quality of service provision. A Short Observational Framework for Inspection (SOFI) was undertaken. This is an assessment tool used to directly observe and report on the quality of care by service users who have communication difficulties. The home also completed the Annual Quality Assurance Assessment (AQAA) and returned this to the CSCI, and this assisted with the inspection process. No comment cards were received from service users, relatives or other professionals prior to the inspection. The Directors and registered manager were present throughout the inspection and the inspector would like to thank them for their time and assistance. What the service does well: The new owners have operated the home for the last seven months, and have continued with their responsible approach to improve the quality of the service. They have adopted the person centred approach which enables the service users individual needs to be fully assessed and recognised by the staff. They have invested in training courses to ensure the staff have the appropriate skills to ensure the needs of the service users are fully met. Comments received from relatives and service users spoken to during the inspection included “ I like the home”. “Everyone is friendly, I have no complaints.” “The attitude of the staff is very good, and the owners are most supportive.” Stonebridge Nursing Home DS0000068267.V339890.R01.S.doc Version 5.2 Page 6 The Directors and manager have introduced new and updated policies and procedures to ensure that the service users are further protected, and staff are being regularly monitored and supervised to ensure that they follow the correct procedures. The home’s recruitment policy ensures appropriate checks are completed before the member of staff commences. The home then provides induction training for them. The quality of the service provided by the on-site laundry is commendable and this was confirmed from relatives during the inspection. What has improved since the last inspection? What they could do better: The home is awaiting planning permission to upgrade the internal layout of the home, which will further benefit the service users and address any outstanding work. Stonebridge Nursing Home DS0000068267.V339890.R01.S.doc Version 5.2 Page 7 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. Stonebridge Nursing Home DS0000068267.V339890.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 Stonebridge Nursing Home DS0000068267.V339890.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): 1,2,3 and 4 (standard 6 is not applicable to this service) Quality in this outcome area is good. Residents and their representatives are provided with suitable information prior to admission to ensure that an informed choice can be made. Comprehensive assessments of the service users mental and physical health are undertaken prior to a service user being admitted to the unit. This ensures that the service users assessed needs can be fully met by the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home provides prospective service users and their representatives with a copy of their Service Users Guide. Since the last inspection the home has updated the Service User’s Guide and Statement of Purpose. Relatives spoken Stonebridge Nursing Home DS0000068267.V339890.R01.S.doc Version 5.2 Page 10 to confirmed that they had received a copy of the document and that the manager had also explained the contents to them. Three service users care records were reviewed during the inspection. These included a pre-admission assessment of the service users’ mental and physical health needs. Other relevant information from other professionals was also available within the service users care records. The manager confirmed that service users are only admitted if she is sure that they can meet their assessed needs fully. Relatives confirmed that the home was more than meeting their relatives care needs. They confirmed that they were pleased with their choice and appreciative of the new owners and the changes, which have improved the service provision. Positive comments were received about how approachable the owners and managers were and they had no complaints with the level of care. All residents are provided with a contract of terms and conditions on admission to the home, these have been updated since the last inspection. The home also provides details of an advocacy service to act independently for them. From observation there was a calm relaxed atmosphere in the home. Staff were observed interacting well with the service users and one to one diversional therapies were being encouraged by the care staff. A good rapport between the staff and service users was obvious. Stonebridge Nursing Home DS0000068267.V339890.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. There is clear and consistent care planning system in place to provide staff with the information they need to meet resident’s needs. The management of medication was well organised. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care records for three service users were reviewed during the inspection. These showed that the home had further improved and developed the quality of care documentation since the last inspection. This has been achieved from providing training for the nurses and the Director and manager completing regular auditing of the care records. The home also hold regular reviews about the service users and discuss any changes in their care needs with managers, nurses, care staff, chef and housekeeping staff. The care plans covered all Stonebridge Nursing Home DS0000068267.V339890.R01.S.doc Version 5.2 Page 12 aspects of the service users mental and physical healthcare needs. Documentation available showed that appropriate risk assessments were taking place, and action being taken to minimise the risk once it had been identified. All staff spoken with reported that they access the care records and find the information relevant in assisting them to meet the service users care needs. Carers also felt that they now had a more active role with the care documentation and felt more valued. The owners have also invested and purchased equipment and aids to assist with the prevention of skin pressure damage, and lifting equipment. All staff spoken to were clear and understanding of the service users needs. The managers audit the care records monthly and highlight any issues to the key worker to address. Staff were observed being respectful to the service users, and a relaxed atmosphere was evident. The management of medication was reviewed. The home use a monitored dosage system provided by the dispensing pharmacy. The system provides an audit trail of medication received, administered and disposed of. There were no gaps on the Medication Administration Record and codes were being used appropriately. The manager confirmed that all nurses had received pharmacy training and that she completes regular audits of the medication system. Accident records were reviewed, since the last inspection and following a requirement from CSCI the home have provided staff with training and updated their policy and procedure. The manager is completing monthly audits of any accident and notifying the CSCI of significant events that occur. Stonebridge Nursing Home DS0000068267.V339890.R01.S.doc Version 5.2 Page 13 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. A range of recreational activities are provided so that they meet the individuals needs and expectations. Meals are well managed, and provide daily variety and flexibility for people living in the home. People living in the home are able to maintain open contact with family and friends. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has adopted the person centred approach of meeting the service users individual needs. The home now delegates social care activities to the care staff that assess their individual needs and capabilities. On the days of the inspection service users were engaged in various activities. Some were having one to one playing cards, games, art and craftwork. Others were watching television, whilst others were just chatting to the staff. Service users were observed wandering around the home during both days of the inspection. The manager confirmed that some service users go into the garden when the Stonebridge Nursing Home DS0000068267.V339890.R01.S.doc Version 5.2 Page 14 weather permits and they are looking to purchase more garden furniture. In addition the home provides regular movement to music sessions. Carers spoken to felt that the level of activities were about right, but would like to see more outings for those residents able to go out. The home continues to access external agencies when required to meet the service users religious beliefs. The manager confirmed that the home could accommodate anybody with differing beliefs or from different cultures. Visitors are welcome to visit the home at any time. Visitors spoken to confirmed this and also stated that the staff communicate any changes to them when they visit. Since the last inspection the home has reviewed their mealtime protocols, and introduced a more effective system of menu choice. The home also provides access to snacks and drinks 24 hours a day for the service users. Service users confirmed that the food was good and that they had a choice of food. A carer goes around the service users with pictures of the daily choices to ascertain what they want to eat, this appeared to work well. A record is maintained of the food and drink the service user has. The dining area appears more inviting with flowers and condiments on the tables. Staff were assisting service users where required in a respectful manner. Stonebridge Nursing Home DS0000068267.V339890.R01.S.doc Version 5.2 Page 15 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. There is a robust complaints procedure in place, and the home takes vigorous steps to safeguard the service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last key inspection in January 2007, they have received one complaint which was also reported to the CSCI. A random inspection was carried out as a result of the complaint, and the home followed their internal complaints policy. Following a full investigation, which the home co-operated with fully. The home acknowledged that the element about the cleanliness of the service users room accepted. All other elements of the complaint were not substantiated. The home has a robust protection of vulnerable adults policy in place, and all staff spoken with were confident that they would have no hesitation in reporting any concerns. The home referred a recent incident to the Worcestershire’s multi agency adult protection team and this was fully investigated with the homes full co –operation. The Directors and managers feel more confident with the staff team and feel that the person-centred Stonebridge Nursing Home DS0000068267.V339890.R01.S.doc Version 5.2 Page 16 dementia training has given them the knowledge and understanding to meet the service users needs. Stonebridge Nursing Home DS0000068267.V339890.R01.S.doc Version 5.2 Page 17 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 adequate. The need to develop the home’s physical environment has been noted by the owners, and planning permission is being sought to implement these changes to provide enhanced care facilities for the people who live there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The current owners have managed the service for the last seven months, and in that time have invested into many areas of the service. They have plans to provide specialist areas within the home and are awaiting planning permission to commence the building work. In the interim they are maintaining the home and providing health and safety checks and cosmetic work to ensure the home Stonebridge Nursing Home DS0000068267.V339890.R01.S.doc Version 5.2 Page 18 remains to an acceptable level. On the days of the inspection several rooms were having floor coverings replaced. Since the last inspection in January 2007 they have redecorated and recarpeted the lounge, dining area and reception area, which has enhanced these areas. The accommodation for residents is located on two levels and a lift is provided to assist service users to access all areas of the home. The bedrooms seen were comfortable and the majority of them have been personalised to reflect the individual’s personality. Service users and relatives confirmed that they were pleased with their bedroom. The home has contracts in place for the servicing and maintenance checks of all systems. Hot water outlets have thermostatic control valves fitted and all windows have window restrictors fitted. Service users appeared appropriately dressed and the clothes were laundered to a high standard this is commended. The home was generally tidy; some odours were evident, in the rooms where the floor covering was being replaced. The inspector was informed that the floorboards were being treated prior to the floor covering being fitted. Stonebridge Nursing Home DS0000068267.V339890.R01.S.doc Version 5.2 Page 19 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. Staff in the home are trained, skilled and in sufficient numbers to support the service users, and to support the smooth running of the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staff duty rotas indicated that sufficient staff are available to care for the service users. The home is still using some agency staff to maintain the staffing levels, but this has reduced considerably. Staff spoken to commented that they felt that the staffing levels were appropriate for them to meet the needs of the service users. Relatives also commented that they felt that there was sufficient staff on duty when they visited. The Directors, managers and all staff were knowledgeable and understanding of the service users needs and this was demonstrated to the inspector through discussions and observation. The home has achieved 62 of care staff with an NVQ qualification level 2 or above which is commended. Stonebridge Nursing Home DS0000068267.V339890.R01.S.doc Version 5.2 Page 20 Three staff files were reviewed and they contained all of the required checks for staff prior to employment. New staff spoken with confirmed that they had gone through the recruitment procedure and also given induction training on commencement of duties. Stonebridge Nursing Home DS0000068267.V339890.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36 and 38 Quality in this outcome area is good. The home has an experienced and trained manager who ensures it is run in the best interests of the people who live and work there This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager is a first level registered mental nurse with many years experience. She has also completed the registered manager’s award. The Directors are clearly committed and provide support to the manager. The Stonebridge Nursing Home DS0000068267.V339890.R01.S.doc Version 5.2 Page 22 Director of Nursing is responsible for the planning and implementation of revised and new policy, training and quality assurance. All grades of staff spoken to confirmed that the Directors and manager were approachable and supportive. Regular staff meetings are being held to give staff the opportunity to offer their views and opinion about the service provision. The home also has regular supervision with staff and annual appraisals, which they find helpful in monitoring their progress and identifying training needs. The new owners have changed the policy about service users monies and have no dealings with the service users monies, to ensure that everyone is protected. The home employs a maintenance operative who is responsible for ensuring that all the appropriate safety checks and servicing is undertaken. The home provided all details of these in their AQAA. The fire records were reviewed during the inspection and were up to date. Stonebridge Nursing Home DS0000068267.V339890.R01.S.doc Version 5.2 Page 23 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 3 3 3 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 X X X X X X 2 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 2 X 3 4 X 3 Stonebridge Nursing Home DS0000068267.V339890.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP33 Good Practice Recommendations It is recommended that the home produce their results from the quality assurance audit annually. Stonebridge Nursing Home DS0000068267.V339890.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Stonebridge Nursing Home DS0000068267.V339890.R01.S.doc Version 5.2 Page 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!