Inspection on 21/09/05 for Stonehaven

This inspection was carried out on 21st September 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Stonehaven 15/05/06

Stonehaven 12/12/05

Stonehaven 20/01/05

Stonehaven 21/07/04

Similar services:

Ashlea Mews Residential Home

Eastwood

West Lodge

Arran House

Avenue Community Nursing Home

Cosin Lodge

Farmborough Court

Cragston Court

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

CARE HOME ADULTS 18-65 Stonehaven The Willows Red Row Northumberland NE61 5AX Lead Inspector Jim Lamb Unannounced 21 September 2005 09:30 st 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Stonehaven B53-B03 S558 Stonehaven V234890 210905 Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Stonehaven Address The Willows Red Row Northumberland NE61 5AX 01670 760692 N/A N/A Mrs Elsie Hazel 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) Vacant CRH 3 Category(ies) of MD - Mental Disorder (3) registration, with number of places Stonehaven B53-B03 S558 Stonehaven V234890 210905 Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 3 residents with a learning disability/mental disorder Date of last inspection 20.1.05. Brief Description of the Service: StoneHaven is a small Purpose- built home in the rural Northumberland village of Red Row. The home provides personal care and support for three younger adults who have learning disabilities. The home is sett in its own grounds, there are country views leading to the sea. Stonehaven is very close to a main road and this offers car access to the surrounding towns and local places of interest. Stonehaven B53-B03 S558 Stonehaven V234890 210905 Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the homes first annual unannounced inspection visit. The inspection took place during the morning and early afternoon. Time was spent talking to the manager, examining records and the homes policies and procedures. Time was spent talking to the service users, and touring the home. What the service does well: What has improved since the last inspection? What they could do better: There is an acting manager who has been in post since 17. 3. 04. However her application to be registered was not submitted until April 2005. This should have happened following her appointment. Transport must be made available each week to enable staff and service users to do the weekly bulk food shopping, and enable staff to follow the homes stated menus. There should be additional time allocated to allow staff to provide a handover at the end of every shift. The acting manager should be provided with an agreed amount of supernumerary hours in-order to maintain records, and carryout formal staff supervision sessions. She should also be provided with an appropriate job description. Social care plans should be introduced. Stonehaven B53-B03 S558 Stonehaven V234890 210905 Stage4.doc Version 1.30 Page 6 All care plans and risk assessments should be agreed and signed by the service users representative’s. All staff employed must undertake Protection of Vulnerable Adult training. 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. Stonehaven B53-B03 S558 Stonehaven V234890 210905 Stage4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Stonehaven B53-B03 S558 Stonehaven V234890 210905 Stage4.doc Version 1.30 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 standard(s) 1 2 3 4 5 There are good clear admission procedures in place, and all service users were properly assessed before admission. Information about the home is available in large print and on audiotape. EVIDENCE: Details of the extra charges and what these are for, are in the contract given to service users and are agreed prior to their admission. The homes Statement of Purpose and the Service Users Guide both contained the full range of information required. These are available in a range of formats eg on audiotape, and large print. The inspector saw a copy of the standard contract used. It contained the range of information required by the standards. Two service users’ files were checked and on each were a copy of a full needs assessment. They did contain a range of appropriate information and service users were involved in drawing up both these initial assessments and the home’s subsequent service user plans. Stonehaven B53-B03 S558 Stonehaven V234890 210905 Stage4.doc Version 1.30 Page 9 The 2 service user plans checked by the inspector were comprehensive, and listed details of service user’s needs and actions taken by the staff to meet these needs. The two service users interviewed said their needs were met and they were happy with the care offered to them. The care plan checked confirmed that a range of specialist services was provided to service users. Admissions to the home are very rare however; appropriate policies and procedures were seen to be in place, these stated that all potential service users are invited to visit the home prior to admission to meet other service users and staff. Overnight stays can also be arranged. Unplanned admissions are avoided. Stonehaven B53-B03 S558 Stonehaven V234890 210905 Stage4.doc Version 1.30 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 standard(s) 6 7 8 9 The service users personal health and social care needs are identified and met. The care records were very well managed. Individual care records including risk assessments should be agreed and signed by the service users representatives. EVIDENCE: There is evidence of a comprehensive assessment in the service users’ care plans. There is also a comprehensive risk assessment of service users. The care plans were recorded to a very good standard, they clearly identify service users needs and how these needs will be met. It is recommended that care plans and risk assessments are agreed and signed by each service users representatives. There was evidence of advocacy arrangements, as well as family input. Each service user has an allocated key worker. Stonehaven B53-B03 S558 Stonehaven V234890 210905 Stage4.doc Version 1.30 Page 11 Care plans are drawn up with service users. There is evidence that plans are amended and reviewed on a regular basis. The proposed manager will introduce social care plans. Service users can access a range of external agencies that promote independence; any rights that are restricted are linked to risk assessments. Each service user receives support from staff to manage their finances. Service users’ both indicated that they are able to make decisions for themselves. Stonehaven B53-B03 S558 Stonehaven V234890 210905 Stage4.doc Version 1.30 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 standard(s) 11 14 15 16 17 Social activities are well organised both inside the home and in the wider community. The menus appeared nutritious however; transport systems must be in place to ensure that the weekly grocery shopping takes place on the agreed day, and that menus are followed. EVIDENCE: Each service user has a practical life skills assessment carried out and this is reviewed and updated on a regular basis, all service users participate in this process, and their relatives are invited to attend these meetings. The service users confirmed that they have access to a range of communitybased services, which promote and provide opportunities to learn and use life skills. There was evidence that each service user has the opportunity to participate in community-based activities, including supported work programmes, education and training. Stonehaven B53-B03 S558 Stonehaven V234890 210905 Stage4.doc Version 1.30 Page 13 All service users are supported to maintain very close links with their families. All are able to choose who they want to see and when. On the day of the inspection, one service user was away on holiday with his brother. Another enjoyed a holiday in Blackpool; she said that she had a “great time” Since the homes previous inspection visit there is now evidence that daily routines promote independence, choice and freedom of movement. Service users are now involved in light housekeeping jobs around the home; they said that they enjoyed these tasks. The Home’s menus are based on the known likes and dislikes of the service users. At least two hot meals are provided on a daily basis. Service users have access to the kitchen and are able to prepare snacks for themselves if they wish. The service users that I spoke with said that the food was good. Service users are involved with the food shopping, however transport is not consistently available each week to allow staff and service users to do the weekly shopping. Therefore the homes agreed menus are not always followed. This issue needs to be addressed by the homes proprietor as soon as possible. A special diet is prepared for one service user. Stonehaven B53-B03 S558 Stonehaven V234890 210905 Stage4.doc Version 1.30 Page 14 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 standard(s) 18 19 20 The health care needs of the service users are identified and met. Medication systems are well managed. EVIDENCE: No service users currently have any moving and handling needs. The inspector was informed that service users mainly need supervision and minimum help with their personal care tasks, such as bathing. No service users currently have or require any technical aids or equipment. The service users all indicated that they felt their privacy is respected. There was evidence within the service users care records that they have access to external health care services. G.P.’s visit when necessary, and service users are referred for specialist health care if appropriate. All service users receive regular health care checks. The records and the procedures for the administration of medication were checked; these appeared to be appropriately detailed. A new medication system has recently been introduced, and it was reported to be working well. Stonehaven B53-B03 S558 Stonehaven V234890 210905 Stage4.doc Version 1.30 Page 15 The medication systems were examined for ordering, receiving and administering and disposal. All were well maintained. The dispensing pharmacist offers good support training and advice. The inspector was informed that staff had received appropriate medication training. Stonehaven B53-B03 S558 Stonehaven V234890 210905 Stage4.doc Version 1.30 Page 16 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 standard(s) 22 23 Complaints appear to be handled properly, the service users indicated that their concerns will be listened to and acted upon. All care staff employed requires POVA training. EVIDENCE: The home does have a complaints procedure, which the inspector saw. It contains details of how to contact the CSCI to make a complaint. The service users confirmed that staff listened to their complaints and dealt with them fairly. The home does keep a record of complaints. Since the last inspection visit there have been no complaints received. The home has a Whistle Blowing policy procedure as well as, the Local Authorities Vulnerable Adults procedures. The proposed manager has undertaken POVA training; it is essential that all care staff employed also receive this training. The Home maintains detailed financial records on behalf of the service users; each has an individual bank account. The cash balance held for service users was found to be accurate. There was evidence of personal spending and receipts are kept. Stonehaven B53-B03 S558 Stonehaven V234890 210905 Stage4.doc Version 1.30 Page 17 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 standard(s) 24 25 26 27 28 29 30 The environment provides a very homely, comfortable and safe place to live. The home is extremely well maintained. EVIDENCE: On the day of the inspection the home was clean, very well decorated and well maintained. The home is in a residential location. The grounds were tidy, safe, attractive and accessible. The home does have an appropriate amount of sitting, recreational and dining space. There are sufficient rooms for a variety of activities to take place. Service users can see visitors in private in their own rooms. The dining area is large enough to cater for all service users and staff. There is a smoke-free sitting room, leading to a highly attractive conservatory with country views. Stonehaven B53-B03 S558 Stonehaven V234890 210905 Stage4.doc Version 1.30 Page 18 Outdoor space and all areas of the home are accessible to people in wheelchairs. Furnishings and fittings were domestic in design and in very good condition. Lighting was sufficiently bright and also domestic in design. Bedroom doors were had privacy locks. The two service user’s present invited the inspector to see their bedrooms; they were highly personalised, comfortable and spacious each having a double bed, the rooms were centrally heated and the heating level could be controlled within each bedroom. Radiator covers were fitted. The proposed manager said that valves are in situ at water outlets to ensure water is provided close to 43°C to prevent scalding. The home was extremely clean and free from offensive odours. The laundry facilities appeared to be well organised. Stonehaven B53-B03 S558 Stonehaven V234890 210905 Stage4.doc Version 1.30 Page 19 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 36 Currently the deployment and number of staff is sufficient to meet the needs of the service users, should this change, the proprietor should consider using agency staff. The proprietor should also make arrangements for additional allocated staff time, for handovers at the end of every shift. The proposed manager should have an agreed amount of supernumerary hours. This will enable her to co-ordinate formal staff supervision sessions. EVIDENCE: Staff levels on the day of the inspection did meet the agreed level. All the staff were over 18 years of age and those left in charge were at least 21. During the last few months there had been several care staff vacancies, shifts were willingly covered by exsisting care staff however, this sometimes meant staff working very long hours. If this situation arises in future, the proprietor must consider using agency staff. Due to lack of supernumerary hours, the proposed manager has not carried out formal supervision sessions with staff. This issue needs to be addressed immediately. Stonehaven B53-B03 S558 Stonehaven V234890 210905 Stage4.doc Version 1.30 Page 20 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 40 41 42 The proposed registered manager is managing the home, she has been in post since March 2004, and it is concerning that the home has been without a registered manager for so long. The proposed manager must be provided with a manager’s job description. EVIDENCE: The proposed registered manager has 16 years experience in care and is working towards a level 4 National Vocational Qualification in management and care. The inspector requires an explanation from the proprietor as to why it has taken so long for Mrs Chester to become registered. Mrs Chester was clear about her responsibilities however, she has been provided with a senior care workers job description, to ensure that she is fully aware of her responsibilities; it is essential that the proprietor provide her with a manager’s job description. Stonehaven B53-B03 S558 Stonehaven V234890 210905 Stage4.doc Version 1.30 Page 21 The service users spoke positively about the manager saying she had encouraged and supported them to become more independent, both spoke enthusiastically about their social activities and the household tasks that they are now involved with. Service users are informed when inspections take place and copies are available for relatives/others to see The records and policies and procedures inspected were found to be appropriately completed, some of these included the fire log book, accident book, personal allowance records, Health and Safey manual. The proposed manager verified that appropriate maintenance contracts for the home are in place. Gas and electrics are serviced annually. Stonehaven B53-B03 S558 Stonehaven V234890 210905 Stage4.doc Version 1.30 Page 22 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 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 x x 3 3 3 2 Standard No 31 32 33 34 35 36 Score x x 3 x x 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Stonehaven Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 x x 3 3 3 x B53-B03 S558 Stonehaven V234890 210905 Stage4.doc Version 1.30 Page 23 no 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 6 Regulation 15 Requirement Social care plans must be introduced, and all plans and risk assessments should be agreed and signed by the service users representatives. Provide regular transport each week to enable staff and service users to do the weekly shopping for the home. There should be additional staff time allocated to enable staff to provide a handover at the end of every shift. Provide the CSCI with a written explaination why this home has been without a registered manager since March 2004. Provide the proposed manager with an agreed amount of supernumerary hours, and provide her with a managers job description. Timescale for action 1.11.05 2. 17 16(i) 30.9.05 3. 33 18 3 10 05 4. 37 8(1) 3.10.05 5. 37 9 3.10.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Stonehaven Refer to Good Practice Recommendations B53-B03 S558 Stonehaven V234890 210905 Stage4.doc Version 1.30 Page 24 1. Standard 37 The home manager must have a level 4 NVQ in care and complete the registered managers award. Stonehaven B53-B03 S558 Stonehaven V234890 210905 Stage4.doc Version 1.30 Page 25 Commission for Social Care Inspection Northumbria House Manor Walks, Cramlington Northumberland NE23 6UR 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. 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