Inspection on 30/10/08 for Stonecroft

This inspection was carried out on 30th October 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Stonecroft 29/05/07

Stonecroft 08/12/05

Stonecroft 01/06/05

Stonecroft 26/02/05

Stonecroft 29/07/04

Stonecroft 29/01/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Stonecroft Kibblesworth Gateshead Tyne & Wear NE11 0YJ The quality rating for this care home is: one star adequate 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: Carole McKay Date: 3 0 1 0 2 0 0 8 Care Homes for Adults (18-65 years) Page 2 of 37 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. They reflect the things that people have said are important to them: 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 Care Homes for Adults (18-65 years) Page 3 of 37 Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) 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. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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.csci.org.uk Page 4 of 37 Internet address Care Homes for Adults (18-65 years) Information about the care home Name of care home: Address: Stonecroft Kibblesworth Gateshead Tyne & Wear NE11 0YJ 01914103323 P/F01914103323 ntawnt.stonecroft@nhs.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Northumberland, Tyne & Wear NHS Trust care home 5 Number of places (if applicable): Under 65 Over 65 5 0 learning disability Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Learning disability - Code LD, maximum number of places: 5 Page 5 of 37 Care Homes for Adults (18-65 years) The maximum number of service users who can be accommodated is: 5 Date of last inspection 2 9 0 5 2 0 0 7 A bit about the care home Stonecroft provides ordinary housing for 5 people with learning disabilities. There are bus stops nearby and the home has its own transport which has been adapted so it can be used by service users who use a wheelchair. Care Homes for Adults (18-65 years) Page 6 of 37 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: One star adequate service Our judgement for each outcome: Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 7 of 37 How we did our inspection: This is what the inspector did when they were at the care home An unannounced visit was made on 30 October 2008. During the visit we talked with people who use the service. Care Homes for Adults (18-65 years) Page 8 of 37 We spoke to some of the staff who work at the service. We looked at some of the care plans of the people that live at the home. Care Homes for Adults (18-65 years) Page 9 of 37 What the care home does well The people who live at the service are supported and cared for in a way that suits their individual needs and preferences. Care Homes for Adults (18-65 years) Page 10 of 37 The service provides people with a safe, comfortable home suited to their abilities and needs. The people who live at Stonecroft are supported to make decisions and to keep in touch with family and friends. Care Homes for Adults (18-65 years) Page 11 of 37 What has got better from the last inspection The premises have been improved. People living at the service have an attractive dining area and bedrooms are personalised. Care Homes for Adults (18-65 years) Page 12 of 37 What the care home could do better Update the assessments for each person who lives at the home. Check that records of medication are accurate so that people who live at the service are kept safe from harm. Care Homes for Adults (18-65 years) Page 13 of 37 Update the records to do with health and support so that the people who live at the home have their changing needs addressed promptly. Update staff training so that the entire staff team can support the people who live at the home in all activities Make sure that a permanent manager is in post so that staff and the people living at the service are suitably supported during a period of change. If you want to read the full report of our inspection please ask the person in charge of the care home Care Homes for Adults (18-65 years) Page 14 of 37 If you want to speak to the inspector please contact Carole McKay St Nicholas Building St. Nicholas Street Newcastle upon Tyne NE1 1NB 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Care Homes for Adults (18-65 years) Page 15 of 37 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 16 of 37 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people using the service have had their needs assessed. These assessments have not been reviewed as part of assisting people to move on to new experiences. Care Homes for Adults (18-65 years) Page 17 of 37 Evidence: There has not been an admission to the home since the last inspection and all the people living there have done so for several years.The assessment process is comprehensive and in surveys staff say that they always have up to date information about the needs of the people they support. But the review of the needs of some of the people living at the home is now overdue. For example one persons file had not had a monthly audit since 7.08.08 and the care plan had not been reviewed since 11.10.07. One staff commented as follows, all changes to care plans are notified to staff via the communication book and handovers The home is due to close as part of a planned review of services by the service provider. Care Homes for Adults (18-65 years) Page 18 of 37 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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. Each person receives the care they need in a planned way and their decision making is supported. Care Homes for Adults (18-65 years) Page 19 of 37 Judgement: The planning for care has not been reviewed to support people through a period of change. Evidence: Each person living at the home has a well developed service user plan for their day to day and longer term needs. These include their preferences and things they are able to do. Some of these now require a review. There is evidence in the plans that risks are assessed and plans for managing these risks are written down for staff to follow. Decision making by service users who may not have speech, is supported by having advocates involved and using other methods of communication. The service has used the expertise of speech and language therapists to develop these methods and they were in use at the time of the visit. Care Homes for Adults (18-65 years) Page 20 of 37 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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. Care Homes for Adults (18-65 years) Page 21 of 37 Judgement: People living at the service have opportunities to take part in leisure activities, maintain contact with relatives, have holidays and to eat well. Evidence: The service strives to support individual lifestyles. The service user plans include information about individual preferences and needs. The home has a programme of activity and in house resources to use with people. The staff said that some restrictions had been experienced due to retraction of services available in the community and staff shortages. And one service user would like to go out a lot more than the service is able to support at the moment. But two of the people living at the home were away for a short holiday at the time of the visit. Service user plans take account of relatives and friends of each person living at the home. Support to make and keep contact is recorded. In surveys the relatives spoke highly of the home and the staff, but expressed disappointment at the closure of the service. One person had noted a fall off of contact with them of late over family birthdays. The food preferences and dietary needs of the people who live at the service are recorded in their care plans. The menus are varied and planned around individual needs for content and presentation. The home has had support from specialists to do with diet and eating. Care Homes for Adults (18-65 years) Page 22 of 37 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service will have their personal care and health needs met in an individualised way. Better record keeping will ensure their safety and well being. Care Homes for Adults (18-65 years) Page 23 of 37 Evidence: The home has strong links with outside specialists to help them address the varied health needs of the people who live at the service. They have drawn on the expertise of Consultants, Physiotherapists, Speech and Language therapists and behaviour management specialists. The health care plans are very detailed and in general the special needs of service users are managed well. There is some evidence that some of the routine health checks that are carried out in house and some of the recording processes have fallen behind of late. For example monthly weight monitoring and records to do with monitoring how behaviour is managed. And staff training in specialised techniques has not kept pace with staff turnover. Specialist medication procedures are very well described and recorded. Routine medication is stored and managed well. The records are generally good but hand written entries in the medication administration record are not being countersigned as correct. Care Homes for Adults (18-65 years) Page 24 of 37 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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. Whilst service users communication skills are very limited, arrangements are in place through the complaints and safeguarding process to promote their safety and offer protection. Evidence: There is a complaints procedure available to the service users in plain language and large print. In surveys staff and relatives said that they had experience of and/ or knew how to raise concerns. No complaints have been made since the last inspection. Care Homes for Adults (18-65 years) Page 25 of 37 Evidence: Staff said that they had received training in safeguarding vulnerable adults. There is written information available to staff advising them of their duty of care and guidance from the Department of Health about how to safely protect people from harm or self harm. The manager and staff clearly understand the safeguarding adults procedures and attend meetings and make referrals appropriately. Referrals have been made and these have been in response to the changing needs of the people who live at the service. Outcomes from these have been well managed by the service. Care Homes for Adults (18-65 years) Page 26 of 37 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service live in safe, accessible and comfortable surroundings. Evidence: Although the home is not purpose built the premises are suited to the needs of the people who live there. A large ramp has been built at the front of the bungalow to compensate for the steep Care Homes for Adults (18-65 years) Page 27 of 37 Evidence: driveway and internally there is level access throughout. The building is discreet and in keeping with nearby properties. Communal space is plentiful, with two dining areas and a large lounge. None of the people who live at the home have to share a bedroom. Aids and adaptations have been introduced for the individual needs of people. These are sited in bedrooms and bathrooms. Rooms are comfortably furnished and the home is well maintained, clean and attractively decorated. Individual personal space has been personalised by way of sensory equipment and personal belongings. Good facilities for laundry and food preparation are provided and these are clean and well organised. Although the village has few amenities a modern large shopping centre is a short drive away from the home. Care Homes for Adults (18-65 years) Page 28 of 37 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live at the home are supported by sufficient numbers of staff, some of whom will require updated training in order to continue to meet all of their needs. Evidence: Since the last inspection the home has lost several staff including the registered manager. The rotas are being covered by four permanent staff. All other staff are employed under varied Care Homes for Adults (18-65 years) Page 29 of 37 Evidence: temporary arrangements. The staff cover is adequate, but some of the staff support systems have fallen behind, for example the last recorded meeting was in April 2008. Staff mandatory training is now due. Staff arrangements are more restrictive now due to the need for some service users to have staff on duty with them who have had specialised training. Care Homes for Adults (18-65 years) Page 30 of 37 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management arrangements are temporary but this is not affecting the safety of people who live at the home. The people using the service are being supported through a period of change in a planned way. Care Homes for Adults (18-65 years) Page 31 of 37 Evidence: Following a detailed review of services by the provider organisation, the service is undergoing a planned closure. The representatives of the people who live at the home have been consulted. The staff said that an open day is planned for the people who live at the service to attend in the near future. This is to help plan for their future arrangements. The home no longer has a registered manager. The nominated manager is due to leave, but another person currently in post at the home will replace them. There is no application for any person to be registered as manager. Care Homes for Adults (18-65 years) Page 32 of 37 Are there any outstanding requirements from the last inspection? Yes  No  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 Adults (18-65 years) Page 33 of 37 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 Description 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 1 Standard 2 Regulation Description 2 Timescale for action 30/01/2009 Service users assessments must be reviewed in line with changing circumstances This will support the people who use the service through the transition period to new services. Care Homes for Adults (18-65 years) Page 34 of 37 2 6 15 30/01/2009 Service user plans must be reviewed to take account of changes in circumstances. This will support people through a period of transition in their lives. 3 32 18 New and temporary 16/01/2009 staff must receive specialist training in emergency physical intervention and administering buccal midazolam. Service users activities will be able to continue safely and unimpeded by staff availability and they will be safe. 4 34 18 16/01/2009 Staff must receive updated training in mandatory and specialist subjects. Service users will be supported by competent and confident staff. Care Homes for Adults (18-65 years) Page 35 of 37 5 37 39 The registered person 30/01/2009 must inform the inspector of future management arrangements for the service. This is to ensure that the people who use the service will have stable support for the changes ahead. 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 1 2 Refer to Standard 19 20 Good Practice Recommendations Records of health monitoring and monitoring checks should be brought up to date. All handwritten entries in the medication administration records should be checked for accuracy by a second person and counter signed by that person. Care Homes for Adults (18-65 years) Page 36 of 37 Helpline: 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 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 © (2008) 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. 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