CARE HOMES FOR OLDER PEOPLE
Stoneleigh Care Home Durham Road Annfield Plain County Durham DH9 7XD Lead Inspector
Belinda Parker Unannounced Inspection 14th December 2005 09:00 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 Stoneleigh Care Home DS0000000755.V266297.R01.S.doc Version 5.0 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. Stoneleigh Care Home DS0000000755.V266297.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Stoneleigh Care Home Address Durham Road Annfield Plain County Durham DH9 7XD 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) 01207 290214 01207 299559 stoneleigh@highfield-cafe.com Southern Cross Care Homes Limited Mrs Bettina Webster Care Home 36 Category(ies) of Old age, not falling within any other category registration, with number (36), Physical disability (4), Terminally ill (1) of places Stoneleigh Care Home DS0000000755.V266297.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. Up to 4 persons with a physical disability over the age of 50 may be accommodated, commensurate with the home`s Statement of Purpose. The home may accommodate a named individual: As set out in a letter to the registered person dated 3 February, 20 May and 6 July 2005 which establishes the basis on which the individual`s needs will be met by the home. Where necessary the homes statement of purpose shall reflect any changes in service provision required for this arrangement. This condition may not apply to anyone else other than the named individual who falls outside the registered category. 9th August 2005 Date of last inspection Brief Description of the Service: Stoneleigh is a registered care home with nursing providing personal care and accommodation for up to 36 older persons in the category (OP). It is owned by Southern Cross Care Homes Limited and operates within the private sector. The home is located in the centre of Annfield Plain, close to local amenities. The home is a purpose built; two-storey building situated in its own private well-maintained grounds. Personal accommodation and communal space is located on both floors. Service areas are located on the ground floor. Stoneleigh Care Home DS0000000755.V266297.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 14/12/05 over a period of 4 hours. During the inspection we spoke to service users, staff, a number of records were examined and we toured the building. ` What the service does well: What has improved since the last inspection?
Since the last inspection staffing levels have been increased. A new shower facility has been installed. Providing the people who live in the home with a choice of bathing choices. Stoneleigh Care Home DS0000000755.V266297.R01.S.doc Version 5.0 Page 6 What they could do better: 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. Stoneleigh Care Home DS0000000755.V266297.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Stoneleigh Care Home DS0000000755.V266297.R01.S.doc Version 5.0 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 the following standard(s): Standards 1, 2 and 4 The company is reviewing and up dating information on the service provided. This will enable prospective service users to make an informed decision as to whether they wish to live in the home. Service users have easy access to information on the Terms and Conditions of residency. EVIDENCE: The home has in place a Statement of Purpose and Service User Guide for prospective service users information and for the people who live in the home. The company is currently reviewing and up dating these documents. The company has produced a new Statement of the Terms and Conditions of residency due to a recent company merger. The current document is available in service users rooms. A service user spoken to said, “ I read the Terms and Conditions on admission, I know where it is if I need to refer to it”, “ I know it sets out my responsibilities while living in the home. And the home’s responsibility to me”. The manager said the home does not admit service users if they cannot meet their individual needs.
Stoneleigh Care Home DS0000000755.V266297.R01.S.doc Version 5.0 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 the following standard(s): Standards 8, 10 and 11 Staff and service users have formed positive relationships. The home promotes the good health of services users. EVIDENCE: Four care plans examined contained information to show that the individual health needs of the people living in the home were met. A record of visits by other health care professionals to individual service users was included in the individual’s plan of care. A service user spoken to said she liked to maintain her independence. But staff assisted her in an appropriate way with personal care such as bathing if requested to do so. A service user recently moved into the home said, “ Staff are good”, “It is a much nicer place than where I was before”. Another service user said, “ Staff listen to me”, “ The home has regular meetings enabling me to put forward my views”. The home has a policy on death and dying in place. The manager said in the event of serious illness or dying, arrangements will be made for relatives to stay overnight with the service user.
Stoneleigh Care Home DS0000000755.V266297.R01.S.doc Version 5.0 Page 10 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 the following standard(s): Standards 14 and 15 The home enables service users to make their views known. Dietary needs of service users are well catered for with a balanced and varied selection of food available that meets service users tastes and choices. EVIDENCE: The company has recently introduced improved information on Advocacy services. This increases service users choices with regard to whom they wish to speak on their behalf if not themselves or their relatives. Discussion with the cook showed that the home considers the importance of a good diet promoting the health of the people who live in the home. A fourweek rotational menu was viewed, which the cook says changes according to the season. The home has produced a series of coloured photographs for service users who lack capacity to enable them with the support of staff to decide on their choice of meal. The cook said she ensures that service users who require a special diet are given an attractively presented meal. Service users spoken to said, “Lovely food”, “Cook will get you anything you fancy”, “ Food ok, not always my choice, but it is difficult to cater for so many”. Stoneleigh Care Home DS0000000755.V266297.R01.S.doc Version 5.0 Page 11 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 the following standard(s): Standards 16 and 18 There is a clear complaints procedure in the home enabling service users and other visitors to make their views known. Protection of Vulnerable Adults training has been made available to all staff. EVIDENCE: The home has in place a complaints procedure that is displayed in the home for service user and visitors information. Complaints records viewed showed there had been no complaints since the last inspection. The manager said all staff in the home have completed POVA training to ensure service users are protected from harm or neglect. Stoneleigh Care Home DS0000000755.V266297.R01.S.doc Version 5.0 Page 12 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 the following standard(s): Standards 21 and 26 Bathing facilities have been improved providing service users with a choice of bathing options. There is a potential risk of cross infection in the home due to inoperable waste disposal equipment on the upper floor. EVIDENCE: Since the last inspection a new shower facility has been installed. This facility provides service users with an improved choice of bathing options. On touring the home it was observed to be clean and free from any offensive odours. The manager said the company is still considering relocation of the laundry, due to a health and safety risk to staff passing through the laundry to access the staff room. The manager said the bedpan washer on the upper floor is beyond repair and renewal remains outstanding. This poses a risk of cross infection, as staff have to transfer waste to the ground floor. Since the last inspection some extra storage has been created in the home. Stoneleigh Care Home DS0000000755.V266297.R01.S.doc Version 5.0 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27,28, 29 and 30 Staffing levels in the home reflect the dependency needs of service users. Robust procedures ensure staff employed by the home have the appropriate checks prior to employment to maintain the protection of service users. Training records should be available and reflect that staff have up to skills and competency level to ensure good service delivery. EVIDENCE: Since the last inspection the manager said that an extra carer has been employed on the evening shift to meet the increasing dependency levels of service users in the home. The manager said the programme for all care staff to achieve NVQ2 in Care is unchanged at present due to waiting for funding from training provider for staff to continue with course. Staff personnel files examined contained all the required information to ensure service users are protected from abuse. CRB checks were in place for all staff working in the home. The manager said she is currently reviewing and implementing a new recording system for training attended by staff. Up to date training records for all staff were not available during the inspection. Stoneleigh Care Home DS0000000755.V266297.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 35 and 38 The manager has a clear sense of development and vision for the home. The present system for money held on behalf of service users by the home is restrictive. There is a potential risk of the spread of infection due to inoperable waste disposal equipment. EVIDENCE: The manager is a qualified nurse and experienced in working with older people. The manager said she is continuing to work towards the Registered Managers Award. Stoneleigh Care Home DS0000000755.V266297.R01.S.doc Version 5.0 Page 15 The procedure for holding money on behalf of service users in the home requires reviewing to ensure service users have access to their money at weekends. The manager must ensure all waste disposal equipment in the home is in working order to prevent the risk of cross infection and maintain health and safety. Stoneleigh Care Home DS0000000755.V266297.R01.S.doc Version 5.0 Page 16 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 3 3 x 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 3 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 x x 3 x x x x 2 STAFFING Standard No Score 27 3 28 x 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x x x 2 x x 2 Stoneleigh Care Home DS0000000755.V266297.R01.S.doc Version 5.0 Page 17 Are there any outstanding requirements from the last inspection? NA 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 OP38OP26 Regulation 23 (C) Requirement The registered manager must ensure the bedpan washer on the upper floor is repaired or replaced. To prevent the potential risk of the spread of infection. Timescale for action 31/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP35 OP30 Good Practice Recommendations The registered manager should ensure arrangements are put in place to allow service users to access at any time money held on their behalf by the home. The registered manager should continue to review and make available for inspection current training records for all staff. Stoneleigh Care Home DS0000000755.V266297.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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