Inspection on 25/01/08 for Stonecross Nursing Home

This inspection was carried out on 25th January 2008.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Stonecross Nursing Home 03/06/09

Stonecross Nursing Home 11/07/08

Stonecross Nursing Home 15/10/07

Stonecross Nursing Home 28/06/06

Stonecross Nursing Home 01/03/06

Stonecross Nursing Home 23/06/05

Stonecross Nursing Home 23/11/04

Stonecross Nursing Home 17/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Stonecross Nursing Home Milnthorpe Road Kendal Cumbria LA9 5HH Lead Inspector Jenny Donnelly Unannounced Inspection 25th January 2008 09:40 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 Stonecross Nursing Home DS0000006156.V357659.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. Stonecross Nursing Home DS0000006156.V357659.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stonecross Nursing Home Address Milnthorpe Road Kendal Cumbria LA9 5HH 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) 01539 721673 01539 730752 Stonecross Care Limited vacant post Care Home 38 Category(ies) of Dementia (5), Old age, not falling within any registration, with number other category (38) of places Stonecross Nursing Home DS0000006156.V357659.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with nursing: Code N, to people of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category: Code OP (maximum number of places: 38). Dementia: Code DE (maximum number of places: 5). The maximum number of people who can be accommodated is: 38. Date of last inspection 15th October 2007 Brief Description of the Service: Stonecross is registered to offer general nursing care for up to 38 older people, including 5 people with dementia cared for in a separate unit. The home tends to run at 36 places as double bedrooms are generally let singly. Stonecross Care Ltd operates the home; the manager post is currently vacant. The building is a three storey Victorian town house, set in the outskirts of Kendal. It has been adapted for its current use by the installation of a passenger lift, grab rails, and an extension to the rear. The home now has 34 single, and 2 double bedrooms. There is a large lawned garden to the rear of the home, but as this has a steep gradient, it is not easily accessible to people, but is pleasant to look at. There are patio areas with seating and sunshades where people can sit out. The weekly fees at the time of this inspection ranged from £485.00 to £657.63, plus any registered nursing care contribution entitlement from the primary care trust. The home had information for prospective residents and their families, in the form of a statement of purpose, service user guide and CSCI inspection reports. Stonecross Nursing Home DS0000006156.V357659.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 0 star. This means the people who use this service experience poor quality outcomes. This was the second main or ‘key’ inspection of the service within this inspection year. We carried out this second inspection because of growing concerns following the last inspection in October 2007. Since then we were told the manager had left, and we received two complaints about the service, which we passed onto the provider. We also wrote to the provider inviting them to meet with us to discuss management arrangements for the care home. We did not receive any response to these three letters, which the provider states he never received. We were also aware that a new manager had been appointed but had left, without the provider informing us. Prior to the last inspection in October 2007, the home submitted an Annual Quality Assurance Assessment (AQAA) giving us some information about the service. We also gathered surveys from people living in the home and their relatives. These exercises were not repeated for this second inspection. This inspection took place on 25th January between the hours of 09.40 and 15.30 hours by Jenny Donnelly inspector, and Penny Wilkinson regulation manager. During the visit we toured the premises, spoke with people and staff, and inspected care, medication, staff and maintenance records. We visited again on 30th January to follow up certain information. What the service does well: The admission arrangements for new people to move into the care home were good and included a detailed needs assessment. People told us they felt well looked after, and visitors said they were pleased with the level of care provided. Staff were described as “kind and caring”, and the home had a welcoming atmosphere. The home works well with other professionals, such as doctors and community nurses. Medicines are well managed within the home. People were pleased with the meals served, saying there was always a choice and they enjoyed the food. The home was clean and fresh throughout. The majority of bedrooms are nicely decorated and have been made very homely. Stonecross Nursing Home DS0000006156.V357659.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: The service fails to meet the National Minimum Standards and Care Home Regulations in many areas. These include: The statement of purpose, which sets out the services and facilities offered at Stonecross, is not accurate in respect the type of activities and staff qualifications advertised. This could mislead people. Care plans need to be more fully developed to include information on people’s preferences about how they are cared for, and need to include more detail about people’s social needs. The service does not have access to transport, which severely limits people’s opportunity to go out, unless they go with family and friends. The service does not handle complaints well, and fails in its duty to protect people adequately from potential harm. The bathing facilities are not suitable for people with infirmities and need to be upgraded, as people cannot be bathed safely. The conservatory door needs alteration so that people cannot accidentally get locked in there. The refurbishment of the building needs to be completed, so everyone has a pleasant environment to live in. The residents lounge on the top floor needs to be re-instated, so people can use the space. Wheelchair storage needs to be moved out of the lounge area to increase space for people and reduce hazards. Staffing levels need to be maintained, and recruitment practices and induction training need to be strengthened, so people are cared for by properly vetted and competent staff. Care staff should be encouraged and supported to gain National Vocational Qualification (NVQ) in care. The service needs to appoint a manager who is registered with the commission, to take forward the improvements required. The registered provider needs to make available for inspection the written reports of their visits to the service, to demonstrate to us their role in managing the service. The commission must be notified of any events affecting peoples’ well-being. Fire safety checks need to be completed on a regular basis, and the home should have a fire warden. Staff should receive formal supervision six times a year to help them do their jobs well. Stonecross Nursing Home DS0000006156.V357659.R01.S.doc Version 5.2 Page 7 The service must develop a quality assurance system, which includes the views of the people using the service. This will help the manager / provider to keep a check that things are being done properly. 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. Stonecross Nursing Home DS0000006156.V357659.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 Stonecross Nursing Home DS0000006156.V357659.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The homes written information for people is not accurate but the nurses do make satisfactory arrangements to meet the needs of new people. EVIDENCE: The home had a Statement of Purpose on display in the foyer, giving people information about the services provided at Stonecross. We read this document and found that much of the information in it was incorrect. The document listed activities outside of the home, which did not take place, and qualifications that staff did not have. There is more detail about this under the ‘daily life’ and ‘staffing’ sections of this report. Admission arrangements for new people moving into the care home were good. We saw assessments that the deputy manager had conducted to assess peoples care needs before they moved in. One person quite new to the care home said the move here had gone very smoothly and she had soon settled in. Stonecross Nursing Home DS0000006156.V357659.R01.S.doc Version 5.2 Page 10 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 and 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The delivery of basic care was satisfactory, although care planning should place more importance on people’s individual needs and wishes. EVIDENCE: People told us they were well looked after at Stonecross, and felt content living there. We also spoke with visiting relatives who were happy with the care provided. But we were concerned to see so many people staying in bed. There were 31 people in the home of whom 17 remained in bed on the day we visited. We were told that normally about 12 people stay in bed. We spoke to one person after 11am who was waiting for staff to get her up, and she said her back was aching from being left in bed, and she had a tray of cold breakfast on her knees. We saw that many people needed to be hoisted and therefore could not access the baths. We were concerned about the lack of bathing at the last inspection, and we made a recommendation on this. New bath charts had been started Stonecross Nursing Home DS0000006156.V357659.R01.S.doc Version 5.2 Page 11 two weeks previously. The ‘bath list’ showed that once a week, 17 people were due a bed bath and 9 people due a proper bath; seven people were not on the list. There was limited evidence in the care records to show that this bathing had taken place and many of the new bath charts were blank. Staff told us they would like to a bath people properly, but did not have the equipment to do so safely. There is more information on the bathing facilities under the ‘environment’ section of this report. Since the last inspection, new care plan documentation had been put in place. We looked at the care records of five people, and found that a lot of the new pages were blank, as staff had not yet transferred all the details. We saw that risk assessments for peoples moving and handling, skin care and nutritional needs were all complete and up to date. Care plans had also been completed for peoples daily care needs, but these would benefit from being more detailed. For example one care plan stated the person needed a pureed diet and instructed staff to ask the person if there was anything they did or did not like. The person’s dietary preferences should have been assessed and recorded as part of the care plan, so the information would not be lost once this person is too frail to comment. Social care plans were also lacking detail and mostly referred to people watching TV or joining in activities with no record of what the person actually enjoyed. The daily records of people’s lives in the care home gave the impression of a very dull life, with entries of “slept well, washed, changed and fed”. There was evidence that people received adequate healthcare and were able to see the doctor, dentist and other health professionals as necessary. We thought that the delivery of basic care was satisfactory, and the new care documentation showed promise if fully completed. The previous requirement to keep care plans up to date and detailed remains until the new system is fully operational. The management of medicines at the last inspection was good, so we took only a brief look at the medicine storage and records. Again, we thought the medicines were being safely managed, although the morning medicine round was done rather late that day Stonecross Nursing Home DS0000006156.V357659.R01.S.doc Version 5.2 Page 12 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 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The service does not provide all the activities advertised in their literature and there is very little opportunity for people to get out of the care home. The provision of meals was good. EVIDENCE: Unfortunately the activity organiser was off for two weeks when we visited, so there were no activities taking place. The notice on display showed that on the day we visited there should have been nail care and hand massage, but none happened. Other things advertised for the coming week were chair exercises and art. There was a Communion service every other week. Care staff said they did not have the time to provide activities as well as care, so people were wholly reliant on the activity organiser. When we re-visited on 30th January the activity organiser was back and planning to do armchair exercises and a word puzzle. The homes statement of purpose advertises, Stonecross Nursing Home DS0000006156.V357659.R01.S.doc Version 5.2 Page 13 “A programme of activities designed to encourage mental alertness, self esteem and social interaction, provide a variety of social activities, monthly newsletter, bi-monthly residents and friends meetings”, and, “Activities include going for walks, ball games, bingo, music, exercises, cheese and wine in the garden, aromatherapy massage, and outings to garden centres, shops, pub lunches, places of interest and plays / pantomimes”. There had not been any outings, as the home does not have transport, although we made a recommendation on this last time. In October 2007 the provider told us that a mini bus was on order, but staff did not have any more information on this. Staff said the only people that got out of the home were those whose relatives could take them. A family were seen taking one person to attend a dentist appointment. There had been one residents and relatives meeting last year in December, and no newsletters. Staff said there had been a lovely bonfire to which a lot of relatives came and that this had been a great success. The people we spoke to could not remember being involved in any activity recently. There were a number of visitors in the main lounge during the afternoon, and we noticed how much people enjoyed this and how lively some residents became. It was clear that many people would respond well to increased social stimulation. People told us they were very happy with the food provided, and we heard the kitchen staff going round with the menu asking people what they would like to eat. The home had been awarded four stars by the environmental health officer for the kitchen, and this certificate was on display. Stonecross Nursing Home DS0000006156.V357659.R01.S.doc Version 5.2 Page 14 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): Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Complaints are not managed well and people who make complaints don’t always receive a response. Staff had limited understanding of safeguarding vulnerable people and potentially dangerous practice was taking place. EVIDENCE: There was a copy of the complaints procedure on display, which asked people to make any complaints to the home manager, or put them in writing to the provider via the address of another of their care homes. We received an anonymous complaint about care practice, staffing and medication in November 2007, which we forwarded to the provider for investigation. We never received any response to this and the provider has since told us they never received the letter. We wrote another letter, also in November 2007, to the provider asking to be copied into their response to a complaint we knew a relative had made. Again we received no response and the provider stated they had not received the letter. The relative has recently informed us that they have still not received an answer to their complaint. The deputy manager was not aware of these complaints. The service still does not manage complaints well, although we made a recommendation on this last time. During the inspection we found a workman had temporary sleeping arrangements in one of the residents lounges. Care staff confirmed this Stonecross Nursing Home DS0000006156.V357659.R01.S.doc Version 5.2 Page 15 person was staying in the care home. We were told this person was not an employee of the company and there was no evidence that references or a criminal records bureau (CRB) check had been carried out. Staff in the home did not know this persons name, yet he was sleeping next to residents’ bedrooms and had full access around the premises. Some adult protection training had taken place, but no staff had queried the suitability of this arrangement, which showed a limited understanding of keeping people safe. Two staff we spoke to had not received any adult protection training, and were unsure how to refer concerns or allegations. One member of staff did not have a CRB check. We were so concerned about the workman living with residents, that we telephoned the registered provider immediately and asked them to rectify the situation. We returned to the care home the following week to check that this had been dealt with, and the workman was no longer there. The service was not adequately safeguarding vulnerable people from potential harm. Stonecross Nursing Home DS0000006156.V357659.R01.S.doc Version 5.2 Page 16 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, 20, 21, 24 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The majority of the premises were pleasant and comfortable but the remainder needs bringing up to standard, and bathing facilities need to be improved. EVIDENCE: Stonecross is a three storey Victorian town house, set in the outskirts of Kendal. It has been adapted for its current use by the installation of a passenger lift, grab rails, and an extension to the rear. The home now has 34 single, and 2 double bedrooms. There is a large lawned garden to the rear of the home, but as this has a steep gradient, it is not easily accessible to people, but is pleasant to look at. There are patio areas with seating and sunshades where people can sit out. Over the last year a lot of refurbishment work has taken place, but this has not been completed. Many of the newly decorated bedrooms still have the old curtains and some have shabby furniture. The new corridor and lounge Stonecross Nursing Home DS0000006156.V357659.R01.S.doc Version 5.2 Page 17 carpets have not withstood the heavy traffic of wheelchairs and hoists, and are now so badly worn they need to be replaced. The providers told us this was due to happen in the next week. The middle floor corridor was in the process of being decorated when we inspected, but had been left half done when we re-visited the following week. The deputy manager did not know when this work would resume. There are bathrooms on each floor of the home, totalling five. Each of these baths has a seat fitted but no access to get a hoist over the bath. The homes shower cubicle has been out of use for many years, and although there had been plans to create a walk/wheel in shower, nothing has happened with this. In view of the increasing age and dependence of the resident group, and the lack of proper bathing currently taking place, improvements to the bathing facilities are now essential. The main lounge and dining room were pleasant, but the smaller lounge was obstructed with stored wheelchairs, despite people seeing visitors in there. There was a conservatory, but it is of no use in the winter as there is no heating or lighting in there. There is no door handle on the inside of the conservatory door, so if the door is pushed to when people are in there, they cannot get out, without using the external fire escape and walking around the outside of the building. This needs to be remedied. The top floor lounge was out of use and should to be re-instated as a residents lounge. Communal space is already limited without one lounge and the conservatory being out of use. We found the home was clean, and fresh, despite there only being one domestic on duty as the other one was taking leave. Stonecross Nursing Home DS0000006156.V357659.R01.S.doc Version 5.2 Page 18 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 adequate. This judgement has been made using available evidence including a visit to this service. Staff were kind and caring, but the home was short of staff and training in some areas was lacking. Recruitment procedures and induction training need to be tightened. EVIDENCE: The care home has some care staff vacancies, which are due to be filled with workers from Romania and Bulgaria. In the meantime some staff are working 50 to 60 hours a week to provide adequate cover. The usual staffing levels for a morning are the manager, 2 nurses and 6 care staff; but there is no manager in post at present, and the deputy manager has very little time where she is not the nurse on duty. The maintenance man left in November 2007 and this post remains vacant, although there has been some part time cover from another home. The activity organiser and one domestic were on leave. The homes statement of purpose wrongly advertises that: “Senior carers predominately have completed NVQ 2 or 3” “There is a six week induction and mandatory training” “Fees include NVQ trained staff in 24 hour attendance”. Stonecross Nursing Home DS0000006156.V357659.R01.S.doc Version 5.2 Page 19 We looked at recruitment and training files. One new staff member did not have a CRB, and two had no evidence of receiving any induction training. There had been no new training since the moving and handling, and health and safety training records we saw in October 2007. There was one carer with a National Vocational Qualification (NVQ), and three others working towards an NVQ which was due for completion by September 2008. People told us the staff were very nice, and kind and caring. We saw that staff did work well with people and were trying to provide a good service. There was a welcoming atmosphere in the home. Stonecross Nursing Home DS0000006156.V357659.R01.S.doc Version 5.2 Page 20 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, 36 and 38 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. There is lack of robust management, as important managerial tasks are not being carried out to the detriment of the people living and working in the care home. EVIDENCE: At the last inspection we were told the registered manager was on sick leave. Further to that, the provider informed us by telephone the manager had resigned. We issued a new registration certificate in December 2007 showing the manager post as ‘vacant’, but this was not on display in the home. We wrote to the provider requesting a meeting to discuss management arrangements. We received no response and the provider later said they never received our letter. Stonecross Nursing Home DS0000006156.V357659.R01.S.doc Version 5.2 Page 21 We understand that a new manager started in post on 1st November 2007 but left in early January 2008. The provider never advised us of her appointment. We have now been told another manager has been appointed and is waiting for references and a CRB prior to taking up her post. This manager will need to apply for registration with the commission. The deputy told us that no quality assurance work had been done since our last inspection, although we had made a recommendation on this. There was little progress with staff supervision, although we had made a recommendation on this. There was still no fire warden, although we had made a recommendation on this. The deputy told us a place was booked on the fire warden training for March, but she did not know who was to attend this now the maintenance man had left. Although some fire drills had taken place, as recommended, the fire log showed no alarm tests, extinguisher checks, emergency lighting tests or fire training had taken place since November 2007, when the maintenance man left. Staff told us that the providers visit the home regularly, but there were no written reports of these visits available as required under regulation. We had not been informed of people being admitted to hospital as required under regulation. The management of this service, both within the home and externally is poor. There is a lack of continuity and forward planning, and the service is not being managed in people’s best interests. Stonecross Nursing Home DS0000006156.V357659.R01.S.doc Version 5.2 Page 22 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 1 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 1 17 X 18 1 2 2 2 X X 2 X 3 STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 1 X X 2 X 1 Stonecross Nursing Home DS0000006156.V357659.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 OP1 Regulation 4 Requirement The statement of purpose must give an accurate reflection of the services and facilities provided in the care home, so people are not misled. Care plans must be fully completed and set out in detail the persons individual health, personal and social care needs, taking into account any personal wishes and choices. The registered person must ensure any complaints made are fully investigated and a response supplied. Staff must be aware of and understand the safeguarding adults procedures so they can recognise and report unsafe practices. The registered provider must provide bathing facilities that infirm people can access safely and comfortably. Staffing levels must be sufficient to fully meet people’s assessed personal, health and social care needs. All staff employed by the care DS0000006156.V357659.R01.S.doc Timescale for action 01/04/08 2. OP7 15 01/04/08 3. OP16 22 01/04/08 4. OP18 13(6) 01/04/08 5. OP21 23(2) 01/07/08 6. OP27 18 01/03/08 7. OP29 19 01/03/08 Page 24 Stonecross Nursing Home Version 5.2 8. 9. OP31 OP31 8 26 10. OP31 37 11. OP38 23(4) 12. OP38 13(4) home must have a satisfactory criminal records bureau disclosure. The service must have a suitably qualified manager who is registered with the commission. The registered provider must make available to the commission the written reports of his/her monthly visits to the care home. The commission must be notified in writing of any untoward event that affects the well being of a resident. The registered provider must ensure that fire safety equipment is checked and tested in accordance with the recommendations of the local fire authority. The conservatory doors must be adjusted so they can be opened from the inside, to prevent people becoming trapped. 01/07/08 01/03/08 01/03/08 01/03/08 01/03/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP12 Good Practice Recommendations Activities should take place as advertised and more opportunities should be made for people to go on trips out of the care home. The refurbishment of the home should be completed so everyone has a pleasant environment to live in. The top floor lounge should be re-instated and made available for people to use. 2. 3. OP19 OP20 Stonecross Nursing Home DS0000006156.V357659.R01.S.doc Version 5.2 Page 25 4. 5. OP20 OP28 Lounges should not be cluttered with stored wheelchairs and other items of equipment. The home should aim to have 50 of the care staff qualified to NVQ level 2 in care, so people can be cared for by trained and competent staff. There should be an effective quality assurance system that seeks and acts on people’s views to improve the service. All staff should receive regular supervision to assist them to do their job well, identify training needs and develop their skills. The home should have a suitably trained fire warden on the staff group. 6. 7. OP33 OP36 8. OP38 Stonecross Nursing Home DS0000006156.V357659.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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 Stonecross Nursing Home DS0000006156.V357659.R01.S.doc Version 5.2 Page 27 - 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!