Inspection on 08/12/05 for Stonecroft

This inspection was carried out on 8th December 2005.

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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Stonecroft 30/10/08

Stonecroft 29/05/07

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 09/07/2008.

CARE HOME ADULTS 18-65 Stonecroft Kibblesworth Gateshead Tyne & Wear NE11 0YJ Lead Inspector Miss Nic Shaw Announced Inspection 8th December 2005 10:00 Stonecroft DS0000007418.V254199.R01.S.doc Version 5.0 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 Stonecroft DS0000007418.V254199.R01.S.doc Version 5.0 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 Adults 18-65. 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. Stonecroft DS0000007418.V254199.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Stonecroft Address Kibblesworth Gateshead Tyne & Wear NE11 0YJ 0191 410 3323 0191 410 3323 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) Northgate & Prudhoe NHS Trust Susan Lawrence Care Home 5 Category(ies) of Learning disability (5), Physical disability (1), registration, with number Sensory impairment (1) of places Stonecroft DS0000007418.V254199.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st June 2005 Brief Description of the Service: Stonecroft was first opened in 1997 as part of Northgate and Prudhoe NHS Trusts, The Trust, resettlement programme. It provides ordinary housing for people with learning disabilities who were formerly resident in long stay hospitals. Stonecroft can provide personal care for 5 people who have a learning disability. The service cannot provide nursing care. The home is a large detached bungalow set in its own grounds. The house is spacious with a large living room, dining room, kitchen, sun lounge, breakfast area and six bedrooms. The home has wide passageways and is accessible for people who use wheelchairs. There is a separate laundry and storage facilities. There are pleasant gardens to all sides of the home that service users can reach safely. The home is situated in the village of Kibblesworth a few miles from the town centre of Birtley and the Team Valley Trading Estate. The village itself has a number of local amenities including shops, public house and community centre. There are bus stops nearby which link with the main regional centres and the home has its own transport which has been adapted to make it accessible to service users who use a wheelchair. Stonecroft DS0000007418.V254199.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 5.5 hours in December 2005 and was a scheduled announced inspection. The inspection process involved observing interactions between the staff and service users as well as talking to the service users, staff, and manager. Prior to the inspection the manager had completed a pre-inspection questionnaire and this together with a questionnaire which had completed by one relative, were used to assist with the inspection process. A sample of records were examined including care plans, complaints and the quality assurance system. A tour of the building took place which included all communal areas. The judgements made are based on the evidence available on the day of the inspection. What the service does well: Stonecroft provides a safe and comfortable environment that is well maintained, attractive and reflects the likes and preferences of the service users. Staff actively support service users to become involved in activities both in the home and in the local community. On the morning of the inspection the atmosphere in the home was warm, welcoming and friendly as the staff assisted the service users to prepare for the days activities, a trip out in the mini bus for lunch. The routines of the home are flexible and this was evident with one service user having a lie in after, the night before, enjoying a late night out at the Metro Arena seeing Rod Stewart in concert. Meals are nutritious and attractively served and the staff are developing a picture menu so that service users can be more involved in the menu planning process. Each service user is supported to maintain contact with their family and, through regular review meetings, relatives are encouraged to take an active part in the development of the service users individual plans of care. Service users benefit from a consistent staff team who are provided with ongoing training which helps them to support the people living in the home. Stonecroft DS0000007418.V254199.R01.S.doc Version 5.0 Page 6 The manager is experienced and competent and knows the service users well. She is able to successfully direct and demonstrate to staff how service users are to be supported. What has improved since the last inspection? 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. Stonecroft DS0000007418.V254199.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Stonecroft DS0000007418.V254199.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Each service user’s care needs were assessed prior to their move to the home, and have been periodically thereafter. This will help ensure that each service user’s needs are met at the home and inappropriate admissions avoided. EVIDENCE: All current service users have had an assessment carried out by the Local Authority social worker prior to their admission to the home. Discussions with the manager confirmed that should a vacancy become available in the home, then any future prospective service user would be referred to the home through a social worker where a full comprehensive assessment would be carried out. The home’s admissions policy and procedure, a copy of which is contained within the Statement of Purpose, confirmed that this would be the case. Stonecroft DS0000007418.V254199.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6&7 The health and personal care needs recorded in the care plans reflect the service users care needs, therefore in practice their care needs are effectively met. The staff ensure that support is available so that service users are able to make decisions about their lives as part of living an independent lifestyle. EVIDENCE: Of the sample of care plans examined information recorded was of a good standard providing staff with detailed step by step information of the actions they need to take to meet each service user’s assessed care needs. The care plans are holistic and cover all aspects of the service users lives including physical, emotional, medical, psychological and leisure needs. They are regularly updated by staff, overseen by the manager, and evaluated each month. Six monthly review meetings are held and minutes maintained of these confirmed that the service user’s relatives are always invited to attend them. It was also positive to note that other staff involved in the service users care contribute towards the review and this was evident from a report prepared by the enabler, (member of staff employed by the Trust specifically to support the service users with leisure activities), in relation to the service Stonecroft DS0000007418.V254199.R01.S.doc Version 5.0 Page 10 users participation in leisure activities. It was evident that much work has been undertaken by the staff to develop the communication dictionaries. Those viewed contain much information to advise the reader of the non-verbal gestures used by the service user to communicate their needs and wishes. Discussion with the staff confirmed that they continually aim to involve the service users in decision making processes and clearly demonstrated an awareness of how in practise this may present challenges, particularly in those situations where a service user may not fully understand the information presented to them. In order to address this issue the staff continually strive to find innovative ways of communicating with the service users and the development of the communication dictionaries is a good example of this. Staff spoken to were able to describe examples of how they support the service users to make decisions for themselves. These include assisting the service users to choose and buy their own clothes, choose their own colour schemes for their bedrooms, and deciding whether or not to take part in activities. Stonecroft DS0000007418.V254199.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,14,15&17 Service users are assisted to lead active and fulfilling lifestyles by having the opportunity to take part in range of activities with their rights as individuals being respected. This will assist in them leading an empowered, fulfilling and enjoyable life. This is supported by good contact being maintained between service users and their relatives. A good range of meals is available to service users which meet their dietary needs. EVIDENCE: On the morning of the inspection an enabler arrived to support the service users with a leisure activity in the community. An enabler is allocated to Stonecroft 10am-5pm Monday to Friday in order to ensure that all of the service users are provided with opportunities to enjoy a range of leisure activities. For one service user this means they can go horse riding every week, and everyone can enjoy trips out to places of interest such as Harperley prisoner of war camp, trips out for lunch, and attending a weekly Disco. Other regular activities include bike rides and visits to a multi-sensory room. The evening before the inspection some of the service users had enjoyed going to Stonecroft DS0000007418.V254199.R01.S.doc Version 5.0 Page 12 see Rod Stewart who was performing at the Metro Arena. One service user attends a Day Centre each week day morning where opportunities are provided for personal development. In addition to these regular activities each service user is supported by staff to enjoy a holiday, paid for by the Trust. Service users have contact with their relatives and this is encouraged by staff who invite them to take part in review meetings as well as involving them in decision making processes. One relative is to spend Christmas day with the service users at Stonecroft, sharing Christmas lunch with them. The service users are encouraged by staff to live independently and this is reflected in the care plans which include details of each service users strengths and abilities. Staff were observed to interact positively with the service users encouraging them to take an active part in the inspection process. Although the lunchtime meal was not sampled it was evident that the service users enjoyed the food, which was a light meal consisting of waffles and baked beans. In order to involve the service users in the menu planning process the staff are in the process of developing a picture menu. One member of staff, who is responsible for this aspect of service provision, has joined a “nutritional standards group” run by the Trust in order to assist them with this process. Stonecroft DS0000007418.V254199.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The key standards were not assessed on this occasion. They were assessed as met during the last inspection. EVIDENCE: Stonecroft DS0000007418.V254199.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 Whilst service users communication skills are very limited, arrangements are in place through the complaints process to promote their safety and offer protection. EVIDENCE: There is a complaints procedure available, specifically designed for the service users, entitled “Tell Us”. This provides the reader with clear guidance in relation to how to make a complaint. However, due to the service users communication needs, they would not be able to actively use this procedure or formally make a complaint. A discussion took place with the manager in relation to how the staff recognise when service users are demonstrating a concern or complaint. The manager described changes in behaviour as a key indicator that a service user may be unhappy. Such changes are closely monitored and documented within the care plan. The last complaint recorded was 14th November 2004. A detailed record of the manager’s investigation in addition to the outcome were maintained as evidence of how the relatives’ views are listened to and acted upon. Stonecroft DS0000007418.V254199.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24&30 The home provides service users with a clean, homely environment in which to live. However, the length of time it has taken to address one outstanding maintenance issue could compromise the safety of the service users. EVIDENCE: The home was found to be clean, warm, tidy and generally well maintained. However, the base of the shower was found to be very worn and is a potential hazard. It also cannot be cleaned effectively and therefore is a potential source of cross infection. The manager confirmed that she has reported this issue to the maintenance department on a number of occasions, however, has not as yet received confirmation as to when this is to be addressed. An immediate requirement notification was issued to the manager in respect of this issue. Policies and procedures are available in relation to infection control and all of the staff are provided with training by the Trust in relation to this issue. Throughout the inspection the staff demonstrated an awareness of infection control and used protective gloves and aprons appropriately. Stonecroft DS0000007418.V254199.R01.S.doc Version 5.0 Page 16 Stonecroft DS0000007418.V254199.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35&36 The service users benefit from a well trained closely supervised staff team. Staff records are not held within the home and as such it was not possible to confirm that the service users are supported and protected by the home’s recruitment practices. EVIDENCE: Discussion with the manager, and information provided within the preinspection questionnaire, confirmed that the staff are provided with a range of training by the organisation. This has included person centred planning, protection of vulnerable adults and feeding and nutrition. Of the ten care staff three have achieved the NVQ level 2 qualification in care, three staff are in the process of completing this whilst the remainder are to commence this qualification in 2006. When those staff currently completing the NVQ level 2 qualification in care have achieved this, the 50 target will be met. The manager carries out a supervision with each member of staff a minimum of one every eight weeks. A monitoring sheet is in place as a management tool to ensure staff receive this at the required frequency. Staff spoken to also confirmed that they received regular supervision, which consists of a mixture of formal 1:1 meetings and informal discussions. The deputy manager is soon Stonecroft DS0000007418.V254199.R01.S.doc Version 5.0 Page 18 to assist the manager with this process and has been provided with training by the manager to enable her to carry this out effectively. There are no staff recruitment records available to inspect in the home as required by the Care Home Regulations but these are available at the Trust’s main office. As such it was not possible to fully assess the staff recruitment procedures in order to ensure that they are robust and protect the service users. Stonecroft DS0000007418.V254199.R01.S.doc Version 5.0 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39&42 The manager offers clear leadership and direction to the staff so that they can consistently meet the needs of service users. Systems are in place to obtain the views of service users, however, further work is needed in the area of quality assurance to provide evidence that their views are listened to and acted upon. Arrangements to ensure that the health safety and welfare of service users and staff are in place and are usually successful. EVIDENCE: Stonecroft DS0000007418.V254199.R01.S.doc Version 5.0 Page 20 The registered manger has considerable experience in a variety of care roles as well as has three years experience in management. From observations and discussions, it was evident that the manager is sufficiently competent and skilled to carry out this role and has demonstrated the capacity to undertake additional training in order to update and expand her experience by completing the NVQ level 4 qualification in management. There are clear lines of accountability within the home. Staff spoken to confirmed that the ethos of the home ensures that where possible service users, and their relatives as advocates on their behalf, and staff are consulted about issues affecting the home. The manager is able to communicate a sense of direction and leadership, through staff meetings and by working directly with staff. Discussion with the staff and manager confirmed that staff are trained to ensure the health, safety and welfare of service users. Discussions with staff confirmed that they had attended mandatory training including first aid and moving handling. Other than the base of the shower, discussed earlier in the report, there were no noticeable hazards to the health and safety of the staff or the service users noted on the day of the inspection. During the inspection a service user was involved in a minor accident. Staff were observed to respond to this appropriately documenting the event within the accident book. There are a number of different ways in which the manager obtains feedback on the quality of the service provided. These include inviting relatives to provide her with feedback during the service users six monthly review meetings as well as each month the home’s line manager sampling an aspect of the quality of the service. In addition to this the manager confirmed that the quality assurance department within the Trust have recently sent out questionnaires to relatives in order to obtain their views on the quality of the service provided. This information needs to be collated, evaluated and evidence provided that it is used to improve the service by producing an annual development plan for the home. Stonecroft DS0000007418.V254199.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X X Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 X 14 3 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 2 X 2 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Stonecroft Score X X X x Standard No 37 38 39 40 41 42 43 Score 3 X 2 X X 3 X DS0000007418.V254199.R01.S.doc Version 5.0 Page 22 Yes Are there any outstanding requirements from the last inspection? 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. 2. 3. Standard YA24 YA32 YA34 Regulation Requirement Timescale for action 08/12/05 13(3)&(4)(a) The base of the shower must be repaired or replaced without further delay. 18(1)( c ) 50 of the care staff must 31/12/05 have a care NVQ level 2 qualifications. 19 Records of staff recruitment 31/03/05 must be available for inspection. (Previous timescale 1st June 2005). 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 YA39 Good Practice Recommendations The continued development of the quality assurance system. Stonecroft DS0000007418.V254199.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection South of Tyne Area Office Baltic House Port of Tyne Tyne Dock South Shields NE34 9PT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Stonecroft DS0000007418.V254199.R01.S.doc Version 5.0 Page 24 - 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. 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