CARE HOME ADULTS 18-65
Stonecroft House Care Home Barnetby North Lincolnshire DN38 6DY Lead Inspector
Theresa Bryson Unannounced Inspection 14th February 2006 09:30 Stonecroft House Care Home DS0000002805.V281415.R01.S.doc Version 5.1 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 House Care Home DS0000002805.V281415.R01.S.doc Version 5.1 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 House Care Home DS0000002805.V281415.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Stonecroft House Care Home Address Barnetby North Lincolnshire DN38 6DY 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) 01652 688344 01652 688594 Leonard Cheshire Margaret Ann Fotherby Care Home 29 Category(ies) of Physical disability (29), Physical disability over registration, with number 65 years of age (29) of places Stonecroft House Care Home DS0000002805.V281415.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 5 day care places available in addition to the above Date of last inspection 15th November 2005 Brief Description of the Service: Stonecroft Care Home is situated in a rural position close to the small village of Barnetby and the M180 motorway. The main house is Victorian in style, with a modern extension and set in extensive grounds overlooking the Lincolnshire Wolds. All rooms have views of open countryside and are styled for the individual service users. All bedrooms are single occupancy and eight have en-suite facilities. The home is designed for easy access for those in wheelchairs. The gardens are well maintained and offer a variety of settings to sit and walk in and service users are encouraged to take part in their maintenance. There are a number of different sitting rooms within the home, plus a very large dining area and separate activities room. The home provides care for those with a physical disability from residential category service users through to those with more complex nursing needs. These include 5 places for those with an acquired brain injury. Stonecroft is owned by the Leonard Cheshire Foundation and the local team of Matron, professionally trained nurses, carers and other ancillary staff are supported by a regional and head office team. Stonecroft House Care Home DS0000002805.V281415.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over one day in February 2006. Records were seen to ensure that staff employed had received checks on them to ensure they were safe to work with the people who live in the home and that they were trained to do their job. Paperwork was also seen to ensure that the home was safe and comfortable to live and work in. Staff working in the home on the day were spoken to and some people who live there. The manager was away on the day of the inspection and the inspector saw the Care Manager and other staff. What the service does well:
The staff were friendly and appeared to know a lot about the people who live there. The people who live there are consulted about the running of the home. Information is given to the people who live there about the home and The Foundation also publishes a newsletter for the whole of the Country, detailing its services in other areas and news about staff and other people living in their homes. A wide choice of activities is available to enable the people who live there to exercise their social, religious and cultural needs and to develop relationships. Policies and procedures for staff to follow are kept up to date by The Foundation’s main policy board. There was adequate staff on duty at all times to ensure that the needs of the people who live there are being met. Stonecroft House Care Home DS0000002805.V281415.R01.S.doc Version 5.1 Page 6 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.
Stonecroft House Care Home DS0000002805.V281415.R01.S.doc Version 5.1 Page 7 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Stonecroft House Care Home DS0000002805.V281415.R01.S.doc Version 5.1 Page 8 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 House Care Home DS0000002805.V281415.R01.S.doc Version 5.1 Page 9 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): No standards were inspected in this section. EVIDENCE: Stonecroft House Care Home DS0000002805.V281415.R01.S.doc Version 5.1 Page 10 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 The care plans seen had not been audited and there were only spasmodic reviews recorded, which could put service users at risk from not having up to date needs assessed. EVIDENCE: 2 care plans were seen in depth and 6 scanned for reviews and updating to be checked. The Foundation supplies comprehensive documentation to enable staff to keep up to date with service users needs. There was little evidence that this has been completed and this requirement has been out standing since 2004. The daily report sheets had been well written and gave details of the care delivered, but theses had not been audited. The home has a system of the care staff being in 3 teams, led by a professionally trained nurse. The home also has a registered manager who could check the care plans. There was no evidence that this was being completed. The Foundation’s own policy states that reviews and evaluations should take place 6 weekly and the National Minimum Standards are also quite specific in
Stonecroft House Care Home DS0000002805.V281415.R01.S.doc Version 5.1 Page 11 their time scales. Without regular review and evaluations of care the up to date needs of each service user cannot be seen to be met, which could put them at risk from poor care being delivered. The Foundation must ensure that by the time of the next inspection there is written evidence that all care plans have been reviewed and that a senior member of staff has audited them. Stonecroft House Care Home DS0000002805.V281415.R01.S.doc Version 5.1 Page 12 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): 15. Service users are encouraged to maintain personal relationships and space is given to enable them to fulfil their individual needs. EVIDENCE: The Foundation has policies for staff to read to enable them to allow service users to express their individual personal needs. These include; - personal relationships, consent and sexual relationships. The care plans seen detailed the individual persons needs, some of which had to be monitored to ensure there were no breaches of abuse of another person. Some care plans also had an gender chart for staff to identify a service user’s position in a family and personal relationships, which had been formed both inside and outside the home. This enables staff to assist each person to have as full a life as possible, with in the confines of their medical and psychological needs. Stonecroft House Care Home DS0000002805.V281415.R01.S.doc Version 5.1 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): 20 The administration of medication records were not correct and could put service users at risk from incorrect drugs being given. EVIDENCE: The drug administration records were checked and there were still gaps in the signature boxes with no explanation as to why they had not been signed for at the time stated on the sheets. There were also some crossing out marks on some drugs listed, with no explanation of who had authorised changes. This requirement remains outstanding from the last inspection and needs to have priority with the Manager that all records have been checked and audited by a senior member of staff. Errors could result in service users being given the incorrect medication, which could put them at risk. Stonecroft House Care Home DS0000002805.V281415.R01.S.doc Version 5.1 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): 23. The Home has an up to date restraint policy to ensure staff are aware of not putting service users at risk from unsafe practises. EVIDENCE: The Foundation has two policy manuals for staff to follow. In one are the details of different policies to encompass restraint usage in the home. The matrix indicated that most have a review period of 3 years, but the professional relationship manager for CSCI is speaking to the Foundation over how they keep up to date with latest legislation, if it changes within that period of time. The policies seen cover the following topics; - challenging behaviour, restraint, access to records, management and violence, harassment and bullying and challenging behaviour. Staff appeared to be aware of the where the policies were kept, but not say whether they had read them. Stonecroft House Care Home DS0000002805.V281415.R01.S.doc Version 5.1 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): 26 and 29. The maintenance of the building had improved, making it a more welcoming environment in which service users can live. EVIDENCE: The senior handyman and the health and safety office accompanied the inspector on a tour of the building. The main corridor has nearly been completed in its redecoration and this makes for a lighter and cleaner looking environment. Some flooring is being replaced and some has been completed. The officers spoken to our discussing with service users picture in the corridors to liven the area up even further. The handyman stated that the bathrooms and toilets are the next areas to be addressed on the programme, with the smokers lounge. The doors are still being heavily marked and are being looked at to see if coverings can be found to help the paintwork not to be so heavily damaged. This has been due to service users being allowed to exercise their independence by using their own wheelchairs and not always being able to judge distances.
Stonecroft House Care Home DS0000002805.V281415.R01.S.doc Version 5.1 Page 16 Service users had individualised their own rooms, which has helped them to settle into the home. The new domestic cupboard is now in use and has given them a larger space in which to store their equipment. The Foundation has also purchased new boilers and a water boiler, which were working at the time of the visit. The gardens were tidy and the car park and ramps free from hazards. Now that some major work has been completed in the home the Manager needs to ensure that the Foundation is aware of any other redecoration and renewal plans which may come to light during the auditing process of the handyman and health and safety officers checks. This will ensure that service users are living in a clean, comfortable and safe environment at all times. Stonecroft House Care Home DS0000002805.V281415.R01.S.doc Version 5.1 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 The training records showed that most staff had completed up dated training in the last year, but this must encompass all staff to ensure they are fit to look after the service users. EVIDENCE: The training matrix was sent to the inspector just after the inspection, as there was no one available to access the computer records. This came as a paper copy and on a floppy disk. The record was quite detailed but still did not show that all staff had accessed mandatory training up dates and service specific training. A number of staff had not received 2 fire training sessions, a large number of staff need to up date their manual handling training, food handling and infection control. A number of different courses were listed, but did not show that staff had attended. It was stated by the training co-ordinator in a letter that the records were in the process of being audited, and this needs to be sent when completed. The manager needs to ensure that all staff have received adequate training to enable them to be fit to look after the service users.
Stonecroft House Care Home DS0000002805.V281415.R01.S.doc Version 5.1 Page 18 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 and 40. Policies and procedures are in place to ensure staff are aware of all issues that may arise when looking after service users and they can live in a safe environment. EVIDENCE: The manager is still completing her Registered Manager’s Award but was not available on the day to discus the progress of this award. The policy and procedure manuals were seen and the schedule is in place, which takes the review process up to 2007. This time scale is being looked at by the professional relationship manager for the CSCI at a higher level. The concern of the local office has been that latest legislation needs to be fed down to the local home level from the Foundations policy board to enable the staff working with service users to have the latest information at all times. Stonecroft House Care Home DS0000002805.V281415.R01.S.doc Version 5.1 Page 19 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 Standard No Score 1 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 3 ENVIRONMENT Standard No Score 24 X 25 X 26 3 27 X 28 X 29 3 30 X STAFFING Standard No Score 31 X 32 2 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 2 X 2 X X 3 X X X Stonecroft House Care Home DS0000002805.V281415.R01.S.doc Version 5.1 Page 20 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. Standard YA6 Regulation 15.2. Requirement The registered person must ensure that reviews on in house care programme are completed. (Previous time scale of 20/02/04 and 30/01/06 not met). The registered person must ensure that all administration records for medication are accurate and there is good stock control. (Previous time scale of 30/01/06 not met). The registered person must ensure that all staff have received up dated training in all mandatory subjects and service specific training. Timescale for action 30/04/06 2. YA20 13.2. 30/04/06 3 YA32 18.1.c.i. 30/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations
DS0000002805.V281415.R01.S.doc Version 5.1 Page 21 Stonecroft House Care Home 1 2 Standard YA32 YA37 The manager is aware of the deadline for completion of NVA training for staff. The manager is aware of the deadline to complete her Registered manager’s award. Stonecroft House Care Home DS0000002805.V281415.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Hessle Area Office First Floor 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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