Inspection on 28/06/07 for Stoneleigh

This inspection was carried out on 28th June 2007.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Stoneleigh 17/05/06

Stoneleigh 10/01/06

Similar services:

Flint House

The Ley Community

Yeldall Manor

21 High Street

Vale House

Chestnut Walk

The Old Vicarage

Cherwood House Care Centre

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

CARE HOME ADULTS 18-65 Stoneleigh Stoneleigh 11 Arthurs Hill Shanklin Isle of Wight PO37 6EU Lead Inspector Ian Craig Unannounced Inspection 28th June 2007 11:00 Stoneleigh DS0000063853.V338721.R01.S.doc Version 5.2 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 Stoneleigh DS0000063853.V338721.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 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. Stoneleigh DS0000063853.V338721.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stoneleigh Address Stoneleigh 11 Arthurs Hill Shanklin Isle of Wight PO37 6EU 01983 862931 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) Mr Kevin Michael Bell Clare Shilton Care Home 9 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (7), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (2) Stoneleigh DS0000063853.V338721.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is currently accommodating 1 person under the age of 65 years with a past or present dependence on alcohol. This named person may remain at the home. 17th May 2006 Date of last inspection Brief Description of the Service: Stoneleigh is a residential care home caring for adults who have, or have had, mental health difficulties. It is registered for a total of 9 residents. The categories of residents are 2 over 65 years and the remainder under 65 years. The home is situated within easy reach of the town of Shanklin and is close to the seafront and all other amenities. Residents are able to involve themselves with the local community if they wish. Stoneleigh is a detached house with gardens. At least two staff are on duty at any given time over a 24-hour period. Each resident has his or her own bedroom. The weekly fees range from £369.25 to £422.17. Stoneleigh DS0000063853.V338721.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection consisted of a tour of the premises, examination of records, documents, policies and procedures. Several residents were spoken to, and two were interviewed in private. Five residents and four staff from the local community health team returned survey forms to the Commission. Information contained in these survey forms was used to assess the service. One staff member was interviewed, and discussions took place with the manager and the owner. The visit lasted approximately 5 hours. What the service does well: Action has been taken to address the requirements made in the last inspection report, although two of these are not yet fully completed. The home liaises well with the local community mental health services and other health professionals regarding residents’ health. Each resident’s personal care is monitored with support given in a sensitive manner. Residents described the staff as helpful and kind. There is freedom for residents to decide how they spend their time but they are also encouraged to lead active lives. Leisure and occupational activities are arranged according to the needs and wishes of the individual resident. A resident stated, “You can choose how you spend your time.” Residents also have their own meetings to discuss matters relating to life at the home. Residents spoke of how much they like living at the home. Residents attend daytime activities aimed at developing occupational and leisure interests such as cookery, woodwork, gardening and arts and crafts. Daily running records are of a good standard with detailed entries to show that mental health and social needs are monitored. Both of the residents who were interviewed were complimentary about the food and described how they are able to choose the food they like. One person Stoneleigh DS0000063853.V338721.R01.S.doc Version 5.2 Page 6 stated how much he/she likes the curries, and another person referred to the good quality roast dinners. Contact with residents’ families and friends is promoted. A barbecue for residents and their families had been arranged for the weekend following the inspection. Medication procedures are satisfactory with the exception of the testing of a resident’s blood sugar levels. The home has policies and procedures for the protection of vulnerable adults including local authority guidance and a policy regarding staff receiving gifts from service users. Bedrooms are personalised with residents’ belongings. One person described how much he likes his/her bedroom, saying, “I have it just how I want it.” At least 2 staff are on duty at any given time and staff have access to NVQ training courses. Measures are taken to protect residents when new staff are recruited. The home has recruited a balance of male and female staff so that residents have an element of choice in who they receive care from. Feedback from community mental health professionals is positive referring to good communication to ensure that changing needs are monitored. Comments included the following: • ‘Friendly and easy going atmosphere. Staff available to discuss. Clients appear to enjoy living there.’ • ‘Very good structure exists with keyworkers identified.’ • ‘High standards always in place, actively promote actual daily living skills – independence.’ • ‘Regular discussion, review and feedback from staff. Willing to seek advice/input when necessary.’ What has improved since the last inspection? Improvements have been made to the physical environment with redecoration of several bedrooms and communal areas. A specialist bath has been installed in a ground floor bathroom in recognition of the advancement of age of the residents. The home’s management recognise that further refurbishment is necessary. Stoneleigh DS0000063853.V338721.R01.S.doc Version 5.2 Page 7 Additional staff have been recruited. Requirements made in the last inspection have been met with the exception of two, which have only been partially completed. The completed requirements are as follows: • The home carries out an assessment of those referred for possible admission. • Each person has a contract. • Care plans have been updated and are regularly reviewed. • Records are accurately completed when staff administer medication. • Staff have received training in working with service users with mental health needs. • Staff recruitment checks are completed. • New staff have an induction programme. • The manager is studying for a management qualification. • Residents’ views are sought as part of a quality assurance process. What they could do better: Whilst the home has a Service Users’ Guide and Statement of Purpose it was not clear that residents are provided with a copy of these documents. Care plans need to be developed further to show that activities involving risk and any safeguards, such as restrictions, are assessed, reviewed, updated and recorded. Information communicated by the manager during the inspection regarding the assessment of resident’s needs to be recorded. The home needs to liaise with the community nursing team regarding staff receiving training in testing a resident’s blood sugar levels. Written care plan procedures are needed for this. Improvements are needed to the physical environment and specifically the following: • Curtains were not securely in place on windows in two bedrooms, which compromises privacy. • One resident does not have a lock on his/her bedroom door when he/she expressed a wish to have one. • Locks on bathroom and toilet doors need to be changed where they do not allow staff access in an emergency. • A mirror above a wash basin in a bedroom needs to be replaced. • A wash basin unit was chipped in one bedroom. Stoneleigh DS0000063853.V338721.R01.S.doc Version 5.2 Page 8 Risk assessment procedures for the following need greater attention: protecting residents from hot water and hot surfaces, and regarding the possibility of falls from first floor windows. 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. Stoneleigh DS0000063853.V338721.R01.S.doc Version 5.2 Page 9 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 Stoneleigh DS0000063853.V338721.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home ensures that it only admits those residents whose needs it can meet. Residents are given information about the home before moving in to help them decide if the home is suitable for their needs and wishes. EVIDENCE: The home has a Service Users’ Guide, which contains details of the staff, the management of the home and the complaints procedure. The guide also contains a copy of the Statement of Purpose and each person’s contract. The manager explained that each resident has been supplied with a copy of the Guide. One resident stated that he/she was given information about the home before he/she decided to move in. Another resident stated that he did not have a copy of the Guide. The home does not have a record to show that each person has been provided with a copy of the Guide. The inspector suggested that in view of the feedback from a resident that a record is maintained to show that each person has been provided with a copy of the Service Users’ Guide. Stoneleigh DS0000063853.V338721.R01.S.doc Version 5.2 Page 11 From a sample of three residents there were two contracts, which had been signed and dated by the resident and a representative from the home. For the third person without a contract the manager stated that this person had been supplied with a copy; there was also a copy of contract between the purchasing local authority and the home for this person’s placement. Copies of the previous two CSCI inspection reports were available for residents and visitors to read. Records show that the home assesses each potential resident’s needs before agreeing to the placement. This involves liaison with referring community mental health professionals and attendance at multi agency meetings arranged under the procedures of the hospital and community mental health teams care programme approach. Copies of these documents are held on each person’s file where applicable. Records show that the home incorporates the relevant information regarding the supervision of the service user in his or her care plans. Stoneleigh DS0000063853.V338721.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 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. Whilst each person has a care plan setting out how assessed needs are to be met, additional information is needed to show that residents are supported to take risks as part of an independent lifestyle and that assessment needs are recorded. Residents are able to make decisions about their lives. EVIDENCE: The home has developed its written assessments of each person’s needs and the care plans to meet those needs. Care records include the following assessment sections: Stoneleigh DS0000063853.V338721.R01.S.doc Version 5.2 Page 13 • • • • • • • • • Personal details Prescribed medication Physical health Mental health Psychological symptoms Self care, appearance, physical health Social, such as budgeting Individual strengths Lifestyle Care plans are recorded for each of the following: • Personal plan: wishes/opinions and feelings • Personal care and hygiene • Health • Personal plan • Communication and comprehension • Psychological guidelines • Household skills • Finances These records include details of behaviour and mental health needs and how these should be monitored. This is referred to in more detail in the Personal and Health Care section of this report. Daily running records are also maintained with comprehensive details of daily events demonstrating that resident’s needs are met. Records show that behaviour and mental health symptoms are monitored. There is evidence of residents’ being involved in their care plans although one resident stated that he/she does not have a care plan. Assessments of risk are carried out and recorded for activities and other circumstances related to health needs. It was noted the assessments of need and care plans should be developed. For one person’s daily activities plan, the approach taken by the home and as described by the manager, was not recorded. For another situation where the resident was being supervised to go out there was a lack of a risk assessment although daily records showed that this had been reviewed leading to a decision that the person was safe to go out alone. Residents described how they can spend their time as they wish. Residents meetings are held where matters about the home can be discussed. It was also confirmed that residents’ views regarding menu planning is taken into account. The manager stated that applicants for care posts meet the Stoneleigh DS0000063853.V338721.R01.S.doc Version 5.2 Page 14 residents and that the residents have an opportunity to comment on the suitability of the person for a job at the home. Stoneleigh DS0000063853.V338721.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported to develop their social, educational, occupational and leisure needs as well as accessing community facilities. EVIDENCE: Residents attend a variety of activities according to their needs and wishes. For instance, some residents choose to have a full activity schedule attending a day centre for 3 days a week whereas others have been assessed as needing a more sensitive introduction to activities. Assessments related to activities by a clinical psychologist were available for one person and this had been used in the home’s own plans for the person. There are also opportunities to attend specialist occupational activities such as woodwork, gardening and cookery. A Stoneleigh DS0000063853.V338721.R01.S.doc Version 5.2 Page 16 resident described how much he enjoys attending a local day centre where there he/she can socialise and join-in activities. Arrangements for trips out and holidays were discussed with the manager. There are opportunities for day trips with the home and with day services. One resident has a holiday with his/her family. The provision of outings and holidays for the residents should be developed. There is encouragement to be involved in household domestic activities with records being kept of cleaning and cooking for each person. Community mental health professionals referred to the home supporting residents to develop independent living skills. A resident described how he/she likes to visit a relative and records how that the home supports residents to maintain contact with families. The residents have a varied, nutritious and varied diet. This is evidenced from menu plans, records of meals provided, and from discussions with the residents. Records show attention to detail in monitoring food and fluid intake when this has been assessed as appropriate. Stoneleigh DS0000063853.V338721.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents’ personal and healthcare needs are met, although improvements are needed to ensure all aspects of care needs are assessed and recorded. EVIDENCE: Records show that residents’ health and personal care needs are addressed. These include records of assisting residents with personal care and hygiene. Care plans incorporate each person’s “wishes, opinions and feelings.” A staff member commented on the achievements in improving the personal care skills of the residents. Records show that health needs are monitored, such as weight, diet and mental health. There is evidence of residents having appointments for physical health needs with general practitioners, a variety of specialist community nurses, chiropodists and opticians. The inspector suggested that the home uses a monitoring format to ensure that each Stoneleigh DS0000063853.V338721.R01.S.doc Version 5.2 Page 18 resident has regular checks with the dentist, optician, general practitioner and so on. Mental health needs are recorded and include details of the signs and symptoms of illness and action that staff should take. For one person there are guidelines for staff to follow in dealing with a resident’s anxiety. The home works with hospital and community mental health teams to ensure that each person has arrangements for accessing appropriate medical care. This included specific arrangements for accessing an emergency hospital placement in the event of a deterioration in the person’s mental state. The inspector viewed this as an example of good interagency practice. Additional details are needed to highlight the symptoms that warrant a referral using this system. The manager immediately acknowledged this and agreed to implement this. Survey forms completed by community mental health professionals referred to the home ‘always’ monitoring health care needs and that liaison with mental health services are good. One professional stated, “They refer/liaise with professionals appropriately when additional help/support/treatment is required.” Another community care coordinator stated, “Staff communicate any problems to myself and the GP.” Attention is needed to assess and record the symptoms and risks associated with any resident who has a neurological condition. Guidelines are available for staff but these are of a general nature and do not refer to the individual’s specific circumstances. The manager should also consider training for staff in this area. Medication procedures were examined and found to be satisfactory with the following exceptions: • Medication was predispensed into named dosset boxes at the prescribed time and taken from the office into the lounge area where residents sit. The inspector explained the risks of error by not dispensing medication from the pharmacist’s container and the manager stated that the procedure would be changed. • The home assists one person with a blood sugar test involving a piercing of the skin. There is no written procedure for this and staff have not received training from a member of the community nursing team. Details of the signs and symptoms of when medication ‘as required’ is needed are recorded. Those staff who handle medication have completed a training course at a local college in medication. Copies of training certificates were available. In house instruction is provided for the remaining staff. Stoneleigh DS0000063853.V338721.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ views are listened to and the home has procedures for protecting service users. EVIDENCE: Residents stated that they are aware of how to make a complaint and that they know who to speak to if they are unhappy. The home has a complaints procedure, which is provided to each resident. There are various policies and procedures to protect the residents including the home’s own adult protection policy as well as a copy of the local authority procedure. The manager has attended a course in adult protection and staff receive this training as part of their NVQ qualification. Procedures are in place regarding staff receiving gifts from residents. Written guidance is available for dealing with aggression towards staff. The home’s policies for handling and managing residents’ finances were examined. Each person has a finance pack detailing the individual arrangements based on each person’s abilities to safely manage their money. Stoneleigh DS0000063853.V338721.R01.S.doc Version 5.2 Page 20 Any restrictions on residents accessing their finances are specified in multi agency care programme approach records and include the agreement of the resident. Records of any amounts being held are maintained with signatures of a staff member and the resident as well as a record of each transaction. Stoneleigh DS0000063853.V338721.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 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. Improvements have been made to the home but these need to be continued, as the present environment does not promote the privacy and dignity of the residents. EVIDENCE: It was confirmed from a staff member, and the owners, that considerable improvements have been made to the home’s physical environment, including redecoration of bedrooms and communal areas as well as the installation of a specialist bath. Residents are able to express themselves in the communal areas and in their bedrooms. For instance, one resident has purchased a piano, which is located in the home’s front lounge. Residents’ bedrooms contain numerous items of personal possessions. One resident has painting materials Stoneleigh DS0000063853.V338721.R01.S.doc Version 5.2 Page 22 in his/her bedroom for their hobby. The home encourages residents to be involved in daily domestic tasks. A resident was observed placing vegetable peelings in a compost bin in the garden and another resident was seen sat at a table in the garden. The home has a garden where vegetables and flowers are grown. The front garden also has plants and shrubs. Residents’ confirmed how they like the home’s facilities. One person was satisfied with the environment but also said that he/she would like a key to his/her bedroom door and would like the curtains repaired which compromised his/her privacy. This was also found to be the case in another bedroom where the curtains have become detached from the track. A mirror above a wash hand basin in a bedroom needs to be replaced and the basin stand is chipped and in need of repair. Privacy locks on bathrooms and toilet doors do not allow access for staff in an emergency. The home has two ground floor communal rooms for residents to use including a dining/living room area and a comfortable lounge at the front of the home. The inspector was informed that the flooring in the dining/living area will be replaced in the near future. Stoneleigh DS0000063853.V338721.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well-trained staff team who are subject to recruitment checks for the purposes of protecting residents. EVIDENCE: The home operates with at least two care staff on duty at any given time. This was evidenced from the staff rotas, observation, and discussions with the staff and management. The home’s management have assessed this as sufficient to meet the needs of the residents. Residents also confirmed that they consider the home to have enough staff on duty. Residents described the staff as kind, helpful and approachable. Survey forms were returned by a number of members of the community mental health team who described the home’s staff as being good at liaison and giving updates on the needs of the service users. One of the community mental health staff Stoneleigh DS0000063853.V338721.R01.S.doc Version 5.2 Page 24 stated, “Staff at Stoneleigh are very good at adapting to meet the needs of the clients whenever possible.” The process of recruiting newly appointed staff was assessed. Each applicant undergoes a number of checks as required by the regulations. This was evidenced in the records held by the home, which include criminal record bureau (CRB) and protection of vulnerable adults (POVA) checks. Two written references are obtained and the home’s management assess each applicant’s suitability to work in the home, which is recorded on a score matrix. Newly appointed staff complete an induction which involves a period of ‘shadowing’ more established staff. An induction checklist is completed by the staff member. Staff have access to National Vocational Qualification (NVQ) training. Two staff have completed NVQ level 2 and a further two staff are studying for the qualification. Two staff are studying NVQ level 3 and two staff NVQ 4. Training has also been provided for the staff from a community psychiatric nurse in ‘mental health awareness.’ The home should look into the provision of further staff training in mental health, substance misuse and other needs particular to the residents. Records show that staff attend supervision sessions once every 3 months and this was also confirmed from a staff member. The manager should monitor the frequency of the supervision sessions so that individual staff receive the appropriate support. One of the staff described how much he/she enjoys working at the home and that there is a positive morale amongst the team. Stoneleigh DS0000063853.V338721.R01.S.doc Version 5.2 Page 25 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Improvements have been made to the running of the home but there are a number of areas that need to be addressed, including requirements from the last report that have not been fully actioned. EVIDENCE: The manager has attained NVQ level 4 in care and is presently studying for the Registered Manager’s Award. Stoneleigh DS0000063853.V338721.R01.S.doc Version 5.2 Page 26 A staff member described improvements that have been made to the service since the present owner and manager assumed responsibility for the home. These include improvements to the environment and in the quality of the food, as well as closer attention to residents’ personal care. The home’s management was described as approachable and open to suggestions of how the service can be improved. Comment from a community care coordinator included the following: “My contact with the manager has been very positive at a time of crisis for the client.” Several areas of the home’s operation need to be addressed such as the need for locks on bedroom doors, suitable curtains, as well as risk assessments regarding possible burns from radiators and falls from first floor windows. The home is developing its quality assurance system. Questionnaires have been completed by 6 residents regarding their satisfaction with the service. This needs to be extended to residents’ relatives, community health and social care professionals and collated into a format that can be used to plan for the service’s future development. Other checks are made on a regular basis, such as food hygiene procedures and a maintenance book is completed for any outstanding repairs. The home should also devise an annual development plan as part of its quality assurance system. Health and safety procedures in the home were examined. Staff receive training in first aid, infection control and food hygiene. Not all staff are trained in moving and handling as the residents do not have moving and handling needs. The inspector suggested that the home has its own assessment of the risks of injury to staff from any lifting tasks. The home completed the CSCI annual quality assurance assessment, which confirmed that the appliances and equipment are regularly serviced. A risk assessment has been completed regarding the possibility of residents receiving burns from uncovered radiators. This was required by the previous inspection report. The assessment, however, is general applying to the whole home rather than to individual radiators as specified in the requirement. It was accepted that this was due to a misunderstanding, but the requirement is repeated in this report. There is a procedure contained in each resident’s care records regarding the steps that should be taken to prevent possible scalding from hot bath or shower water. This was queried as being sufficient as it does not reflect the varying needs and risks for each person. Stoneleigh DS0000063853.V338721.R01.S.doc Version 5.2 Page 27 The home does not have written risk assessments for the possibility of residents falling from first floor windows although it was understood that access to the opening part of the window is restricted to the upper part of the window frame. Stoneleigh DS0000063853.V338721.R01.S.doc Version 5.2 Page 28 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 3 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 2 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 X 2 X 2 X X 2 X Stoneleigh DS0000063853.V338721.R01.S.doc Version 5.2 Page 29 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 YA9 Regulation 15 Requirement Care plans must record how service users are supported to take responsible risks as part of an independent lifestyle. These assessments must show how the person has been assessed for activities such as going out. This is an amended repeat requirement for the inspection of 17/05/06. Care plans must show how the home has assessed the support needed for daily activities and the approach being taken. 2 YA19 15 Care plans must detail health care needs such as neurological conditions and any action plans. 28/08/07 Timescale for action 28/09/07 3 YA20 13 The home must have a 28/08/07 procedure for testing blood sugar levels where there is piercing of the skin. The home must seek the advice of the district nursing service regarding the testing of blood sugar levels and the need for staff training in this area. Stoneleigh DS0000063853.V338721.R01.S.doc Version 5.2 Page 30 4 YA26 16 Residents must be provided with adequate curtains that provide privacy. Repairs must be made to the broken mirror and wash hand basin stand in a bedroom. Residents must be provided with a lock and a key to their bedroom door where they wish to have one. Staff must be able to override privacy locks in an emergency. 29/08/07 5 YA27 16 Privacy locks on toilet and bathroom doors must be able to be overridden by staff in an emergency. Radiators and hot pipe work in the home must be individually risk assessed and covered where a risk is identified. This is a partial repeat requirement from the inspection of 17/05/06. Risk assessments regarding the possibility of residents falling from first floor windows must be carried out and recorded. 29/09/07 6 YA42 13 30/08/07 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 Standard Good Practice Recommendations Stoneleigh DS0000063853.V338721.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Stoneleigh DS0000063853.V338721.R01.S.doc Version 5.2 Page 32 - 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!