Inspection on 01/09/05 for Stoneham House

This inspection was carried out on 1st September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 but made no statutory requirements on the home.

Other inspections for this house

Stoneham House 02/12/09

Stoneham House 28/11/08

Stoneham House 05/12/07

Stoneham House 25/05/07

Stoneham House 15/01/07

Stoneham House 28/04/06

Stoneham House 13/04/05

Stoneham House 19/10/04

Stoneham House 12/05/04

Stoneham House 14/01/04

Stoneham House 11/07/03

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Stoneham House 4 Bracken Place Chilworth Southampton SO16 3NG Lead Inspector Beverely Rand Unnannounced 01.09.05 9:00 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 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. Stoneham House H54 S12356 Stoneham House V246827 010905.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Stoneham House Address 4 Bracken Place Chilworth Southampton Hampshire SO16 3NG 02380 768715 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs W L Bellett Mrs Josephine Mary Ann Mills Care Home 37 Category(ies) of Dementia, over 65 - DE(E) - 37 registration, with number Old Age - OP - 37 of places Stoneham House H54 S12356 Stoneham House V246827 010905.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13.04.05 Brief Description of the Service: Stoneham House is a care home providing personal care and accommodation for a maximum of 37 older people, most of whom have dementia. The home is located on the outskirts of Southampton with easy vehicular access to local amenities. The home was opened in 1995 and is a large detached property standing in extensive grounds. There is a car parking area at the front and the side of the building. The building stands on a slight hill, so has three floor levels, which can be accessed with a shaft lift. The home has some shared bedrooms, but the present philosophy of the home is to operate at less than full capacity, thus ensuring that current residents have a single room. Communal space is provided by way of a large lounge, a dining room and a conservatory area. There are also two patio areas, with some furniture. Stoneham House H54 S12356 Stoneham House V246827 010905.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was the second unannounced one of the year and took place over seven hours. The inspectors spoke with residents, staff, the registered manager, Josie Mills, the general manager and the provider, Mrs Bellett. Records such as staff files and care plans were looked at. Most of the residents have communication difficulties so the inspectors spent time observing the interaction between staff and residents. What the service does well: What has improved since the last inspection? What they could do better: Stoneham House H54 S12356 Stoneham House V246827 010905.doc Version 1.40 Page 6 Care plans need to be more detailed, reviewed and updated to ensure that resident’s health and social care needs are met. Some specific health needs, such as needing lots of fluid need to be more closely recorded and monitored. The home does not formally seek the views of residents and visitors which would help the management know if residents are happy. Residents’ financial records need to be clearer. Staff should have formal supervision sessions to support them in their work. 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. Stoneham House H54 S12356 Stoneham House V246827 010905.doc Version 1.40 Page 7 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 Standards Statutory Requirements Identified During the Inspection Stoneham House H54 S12356 Stoneham House V246827 010905.doc Version 1.40 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 The assessment process ensures that residents move into the home after having their needs assessed, and knowing that the home can meet their needs. EVIDENCE: Three new residents’ assessments were sampled and found to contain a range of information. Assessments were completed before residents moved in to the home. The files contained a thorough assessment including mobility, history of falls, feeding, diet, sight, hearing, continence, areas prone to pressure, medication, what name the person likes to be known by, etc. The home identifies in writing that it is able to meet needs and the room offered is the room residents move into. The manager also asks during assessment if there are any outstanding hospital appointments, or if a district nurse is currently visiting. The manager will complete the assessment either at the prospective residents home/hospital, or at Stoneham House. Prospective residents and relatives are encouraged to visit the home. Assessments are also sought from social workers or health care professionals. Stoneham House H54 S12356 Stoneham House V246827 010905.doc Version 1.40 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 & 10 The home does not have adequate procedures in place to ensure that resident’s health and social care needs are met. The manager and staff do work in a way which means residents feel they are treated with respect. EVIDENCE: Care plans were studied with regard to residents who exhibit challenging behaviour. On one care plan there was no mention of deteriorating behaviour, and on another challenging behaviour was identified using one sentence, but there were no strategies in place for staff to adhere to. Individual staff told the inspectors that they used strategies such as talking quietly and distracting with comments about the weather. Challenging behaviour should be responded to in a consistent way, which should be detailed in the individual’s care plan and regularly reviewed. Daily records showed that one resident was being hoisted, but this was not in the care plan, and a review had not taken place because the manager was on leave. Daily records were sometimes difficult to follow accurately because of the way they were written. Some evidence was seen of clear guidance with regard to how residents liked to undertake their individual personal care. Stoneham House H54 S12356 Stoneham House V246827 010905.doc Version 1.40 Page 10 Both permanent staff said that if a resident asked to see their doctor, they would telephone the surgery to organise this, and the agency worker said that they would speak to permanent staff. Three files sampled showed that doctors and district nurses visited the home as necessary. However, entries in daily logs showed that residents had individual needs which were not followed through, such as needing, ‘lots of fluid’ which was not detailed in the careplan. The amount needed was not recorded, nor was there a record as to how much the resident had taken. A subsequent entry in the log showed the resident being dehydrated when they went into hospital. Staff gave the inspectors examples about how they respected residents’ privacy and dignity, which included appropriate personal care procedures. Staff were observed knocking on bedroom doors before entering and talking with residents in a friendly and caring way. However, the inspectors saw that a shared en-suite toilet did not have working locks and the manager agreed to rectify this. Stoneham House H54 S12356 Stoneham House V246827 010905.doc Version 1.40 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 14 The home ensures that residents can make choices in their lives. EVIDENCE: It was evident that residents can bring their own ornaments and furniture into the home. The home’s statement of purpose refers to residents making choices in their lives. Residents can manage their own money if they are able, and can choose how to spend it. Stoneham House H54 S12356 Stoneham House V246827 010905.doc Version 1.40 Page 12 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 The home ensures that residents feel their complaints will be listened to. The lack of full understanding regarding adult protection procedures means that residents may not be protected from abuse. EVIDENCE: The home has not received any complaints since the last time this standard was assessed. The complaints procedure is displayed on the hall notice board and is in the statement of purpose. The procedure includes appropriate timescales. The staff spoken with generally understood what they must do if they witnessed abuse at the home, but were less clear about the procedure which would be followed by the manager, and the role of Social Services. They were also unclear about what to do if the manager was suspected of abuse. Stoneham House H54 S12356 Stoneham House V246827 010905.doc Version 1.40 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 The manager ensures that residents live in a generally safe environment, but residents would benefit from more attention to the hygiene of some bedrooms. EVIDENCE: Since the last inspection the home has re-carpeted one bedroom and two bedrooms have been painted and carpeted. One bedroom has had new curtains and track; an electric insect catcher has been installed; and a new office created for the manager. The inspectors found razors, Steradent and prescribed creams in the bathroom, and the manager removed them. Bathrooms were functional but not inviting, and some bedroom furniture is worn. Five of the bedrooms sampled smelt of stale urine: one of these rooms was vacant although a new resident was due to move in in the near future. The gardens were well kept and tubs were filled with summer bedding. Stoneham House H54 S12356 Stoneham House V246827 010905.doc Version 1.40 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 30 The manager ensures that staff are trained to do their jobs. EVIDENCE: New staff undertake formal induction and complete a workbook. Records showed that staff had completed training in Food Hygiene, use of hoist, Fire Safety, Risk Assessment, Medication etc. Individual training needs analysis forms are completed. Stoneham House H54 S12356 Stoneham House V246827 010905.doc Version 1.40 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35, 36 & 38 The home does not have a quality assurance programme so cannot ensure that the home is run in the best interests of the service users. The home ensures that residents’ financial interests are safeguarded but this would be helped by using a clearer record system. The manager does not ensure that staff are appropriately supervised. The home is generally mindful of health and safety but would benefit from closer monitoring of items left in bathrooms. EVIDENCE: The home does not have a quality assurance system in place. The manager does not have a job description, and when job descriptions for the manager, general manager and administrator, quality assurance was not detailed. All staff, including managers should have a job description. The inspectors sampled three financial records of residents. The records were not clear or up to date for two residents, which meant that the inspectors had to deduct Stoneham House H54 S12356 Stoneham House V246827 010905.doc Version 1.40 Page 16 money before the balance could be obtained. Two of the accounts were higher than they should have been – the manager said that this was because they may not have the right money at the time. Receipts are kept. The manager said that she was undertaking supervision every month, and that this covered both her agenda and staff’s agenda and training needs. However, the manager does not have a system in place for ensuring that all staff have supervision every two months. Supervision sessions are recorded in the diary and this showed that only four staff had received supervision, out of twelve. Some of the four had had more regular supervision than the others. The manager makes notes but does not give a copy to the staff member: the inspectors advised that this should be done. Up to date maintenance certificates were available for the lift, hoists etc. and a fire exit had been made safer. Staff have training regarding health and safety issues, as detailed above. Razors, Steradent and prescribed creams were found in one of the bathrooms and these pose a possible risk to residents with dementia. Food was appropriately stored and labelled. Stoneham House H54 S12356 Stoneham House V246827 010905.doc Version 1.40 Page 17 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 4 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 x COMPLAINTS AND PROTECTION 2 x x x x x x x STAFFING Standard No Score 27 x 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x x x x 2 2 x 2 Stoneham House H54 S12356 Stoneham House V246827 010905.doc Version 1.40 Page 18 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 OP7 Regulation 15 Requirement Service user plans must cover all aspects of care, including how staff should deal with challenging behaviour. (Repeated requirement of 13/4/05) Care plans must be reviewed and amended when needs change. Health care needs, such as fluid intake monitoring must be recorded in care plans and followed through. The home must be kept odour free. A formal quality assurance system must be implemented. Care staff must receive supervision at least six times a year. Supervision must follow the format required by the standard, and must be recorded. (Repeated requirement from 13/4/05). 7. 8. Timescale for action 1/11/05 2. 3. OP7 OP7 15 (2)(b) 12 (1)(a) 1/11/05 1/11/05 4. 5. 6. OP19 OP33 OP36 23 (2)(d) 24 18 (2) 1/11/05 1/12/05 1/11/05 Stoneham House H54 S12356 Stoneham House V246827 010905.doc Version 1.40 Page 19 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. 2. 3. Refer to Standard OP18 OP33 OP35 Good Practice Recommendations All staff should be clear with regard to Adult Protection procedures, and the role of Social Services. The registered manager should be given a copy of their job description. A clearer system for recording residents monies should be implemented. Stoneham House H54 S12356 Stoneham House V246827 010905.doc Version 1.40 Page 20 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southampton SO15 1GW 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 Stoneham House H54 S12356 Stoneham House V246827 010905.doc Version 1.40 Page 21 - 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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