CARE HOMES FOR OLDER PEOPLE
Stoneleigh Care Home Durham Road Annfield Plain County Durham DH9 7XD Lead Inspector
Mr Stephen Ellis Unannounced Inspection 27th February 2007 2:15 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.V329645.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Stoneleigh Care Home DS0000000755.V329645.R01.S.doc Version 5.2 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@schealthcare.co.uk 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) of places Stoneleigh Care Home DS0000000755.V329645.R01.S.doc Version 5.2 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 6 July 2005, which establishes the basis on which the individual’s needs shall be met by the home. Where necessary the home’s 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. The home may accommodate a named individual as set out in a letter to the registered person dated 1st August 2006, which establishes the basis on which the individual’s needs shall be met by the home. Where necessary, the home’s 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. 14th December 2005 3. Date of last inspection Brief Description of the Service: Stoneleigh is a registered care home with nursing, providing personal care and accommodation, plus continuous nursing care in some instances, for up to 36 older persons. It may also accommodate up to 4 people with physical disability over the age of 50. It is located in the centre of Annfield Plain, close to all local amenities. Southern Cross Homes Properties Ltd. is the registered provider. The home is a two-storey building, situated in its own grounds, with enclosed garden area and car parking at the rear. Personal accommodation and communal space is located on all floors. Service areas (e.g. kitchen and laundry) are located on the ground floor. There are 36 single bedrooms, all with wash hand basins, but none with en suite facilities. Most bedrooms are suitable for wheelchair users and are fairly spacious. The weekly fees vary between £364.50 and £565.07. The fee covers all accommodation, meals and personal care (plus continuous nursing care in certain instances). Hairdressing, toiletries, newspapers, plus services from private opticians, dentists and chiropodists are not included in the fee. The actual amount people pay will depend upon their individual circumstances. Stoneleigh Care Home DS0000000755.V329645.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 4 hours. It included a tour of the building, examination of a number of records and discussions with 12 residents, 2 relatives and 7 staff. Comment cards were also received from 2 other relatives. The overall quality rating for this care home is: ‘excellent’. This judgment has been made from evidence gathered both during and before the visit to this service. What the service does well:
Residents and relatives said they were very satisfied with the care and facilities provided. Typical comments included “It’s grand here, the food is very good, the staff are very good and I have a pleasant room with a comfy bed and a good view; I can have visitors at any time, I go out on organised trips in the adapted bus, I can follow my own interests such as reading and listening to my music; I’m as happy as you can be living away from home, the food is plentiful and there is quite good variety, my room is comfy, staff act as if they are of us, my health care arrangements are good, it’s not a problem to see a doctor; I am quite satisfied with the care and attention provided, we like classical music and I can bring in tapes and visit any time; I can talk easily to staff, the food is excellent, there is good communication and I just need to ask, he kept the same GP when he moved here, the terms and conditions are plain and easy to understand, I received a contract that was clear and the service user’s guide is good; I like it here very much, I like the carers – they’re all very good, nothing’s too much trouble for them; my health care needs are well taken care of.” They liked their rooms and described them as comfortable and pleasant. All residents spoken with said they enjoyed the meals and felt their preferences were well catered for. Residents and visitors get on well with the staff and would not hesitate to discuss any concerns or complaints with staff or management. They described a cheerful, happy environment. The home has lounges and dining areas on each floor, which allow residents to meet in groups of various sizes for a number of social and recreational activities. The home is generally well maintained. Staffing levels and staff training are good. At least 50 of care staff members are expected to achieve National Vocational Qualifications (NVQ) in care at either level 2 or 3 by the end of March 2007 (9 at level 3) and a further 6 staff members are expected to start NVQ level 3 in care at the next intake later this year. There is a friendly, welcoming atmosphere. Management are keen to receive comments from residents and others about the quality of service provided by the home. The service is well run and the information provided to residents and prospective service users is detailed and explicit. Stoneleigh Care Home DS0000000755.V329645.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Stoneleigh Care Home DS0000000755.V329645.R01.S.doc Version 5.2 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.V329645.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents and their representatives have the information needed to choose a home that will meet their needs. They have their needs assessed and a contract which tells them about the service they will receive. EVIDENCE: Comments received from residents and relatives confirmed that full assessments of needs were carried out prior to admission to the home. They confirmed that there was enough information from which to make a choice about being admitted. A service user’s guide and statement of terms and conditions of residence are supplied routinely. These are helpful documents and the content is detailed and explicit. Large print versions are available. As one relative said: “the terms and conditions are plain and easy to understand, I received a contract that was clear and the service user’s guide is good.” Care plans revealed comprehensive, detailed assessments of need being carried out both prior to admission and afterwards, as confirmed by members of staff and management. These assessments showed that the home only admitted people whose assessed needs it could meet. There are no intermediate care beds provided at this home.
Stoneleigh Care Home DS0000000755.V329645.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The health and personal care, which a resident receives, is based on their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: Residents and relatives said that service users’ health and social care needs were well known by staff and were being fully met. They said that the home’s nursing staff or community nurse or doctor would see the resident whenever required. Residents are encouraged to keep their own GP when they move into the home, wherever possible, to promote continuity of health care. Residents’ personal and social care needs were well known, understood and respected by the staff team. They said that they felt they were treated with respect and sensitivity. Typical comments from residents and relatives included: “Staff act as if they are of us, my health care arrangements are good, it’s not a problem to see a doctor; I am quite satisfied with the care and attention provided; I can talk easily to staff, there is good communication and I just need to ask, he kept the same GP when he moved here; I like it here very much, I like the carers – they’re all very good, nothing’s too much trouble for them; my health care needs are well taken care of.” These comments were supported by detailed, service user plans of care that were comprehensive and well
Stoneleigh Care Home DS0000000755.V329645.R01.S.doc Version 5.2 Page 10 maintained. Also, there was ample evidence of appropriate equipment, such as special beds, pressure relieving mattresses and bed rails that had been subjected to thorough risk assessment. Laminated photographs of named key workers are provided in each resident’s bedroom. Staff training in care (for example, National Vocational Qualifications (NVQ) at levels 2 and 3) has included the important issues of privacy and dignity and at least 50 of care staff are expected to complete NVQ in care by the end of March 2007. There are good arrangements for the safe administration of medicines. All staff members responsible for medicines have completed Safe Handling of Medicines training. There is good support from a local Pharmacist who supplies most of the medication in monitored dosage blister packs. There are good storage systems and staff thoroughly check all medication when it is received into the home. The home requires medication to be administered only from the container(s) into which the pharmacist dispensed it originally. Medication is kept securely in lockable cabinets and trolleys. Residents may attend to their own medication, but in practice most prefer to delegate this responsibility to staff. Unwanted medicines are sent for waste disposal using a licensed agency. The home is careful not to stockpile large quantities. Senior staff confirmed that medicine audits are carried out routinely and that the local pharmacist provides consultation and advice. Stoneleigh Care Home DS0000000755.V329645.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are able to choose their lifestyle, social activity and keep in contact with family and friends. Social, cultural and recreational activities meet residents’ expectations. Residents receive a healthy, varied diet according to their assessed requirement and choice. EVIDENCE: Residents and relatives said that service users enjoyed living at the home and got on well with the staff. All described the staff as being kind and helpful. Typical comments included: “It’s grand here, the food is very good, the staff are very good and I have a pleasant room with a comfy bed and a good view; I can have visitors at any time, I go out on organised trips in the adapted bus, I can follow my own interests such as reading and listening to my music; I’m as happy as you can be living away from home, the food is plentiful and there is quite good variety, staff act as if they are of us; we like classical music and I can bring in tapes and visit any time; I can talk easily to staff, the food is excellent, there is good communication and I just need to ask; I like it here very much, I like the carers – they’re all very good, nothing’s too much trouble for them.” Residents and their relatives confirmed that service users could choose how they spent their time in the home and were free not to join in activities and social events if they did not wish to. An activities organizer arranges and leads a full programme of social and recreational activities. Residents, relatives and staff confirmed that relatives and friends may visit at
Stoneleigh Care Home DS0000000755.V329645.R01.S.doc Version 5.2 Page 12 any reasonable time and are always made welcome. All residents spoken with said they liked the meals at the home. There was a good choice of menu and residents’ preferences were catered for wherever possible. Relatives’ comments confirmed these views, adding that special diets were provided, in accordance with residents’ individual needs and wishes. Stoneleigh Care Home DS0000000755.V329645.R01.S.doc Version 5.2 Page 13 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have access to a robust, effective complaints procedure and are protected from abuse. EVIDENCE: All residents and relatives said that they were confident about approaching staff and management about any concerns or complaints they might have. They described the staff and management as being very approachable, helpful and friendly. A written complaints procedure is provided in the statement of purpose and service user’s guide. Staff and management are aware of the need to safeguard adults from abuse or neglect and have undergone training in these issues. They are aware of the home’s ‘whistle blowing’ policy, which encourages staff to speak out about any suspected abuse. All staff members have had enhanced Criminal Records Bureau (CRB) checks and Protection of Vulnerable Adults (POVA) checks carried out as required by law. Also, two references are obtained in respect of each new employee, with special attention given to the last employment. This is to ensure that unsuitable people are not employed to care for vulnerable adults. Staff confirmed that new staff members go through induction and foundation training so that they have the right knowledge and skills to do their jobs competently. Stoneleigh Care Home DS0000000755.V329645.R01.S.doc Version 5.2 Page 14 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables residents to live in a safe, wellmaintained and comfortable environment, which encourages independence. EVIDENCE: There were no unpleasant odours and the home was found to be clean in all the areas inspected. All nursing and care staff members have completed training in health and safety, fire safety, food hygiene and infection control. Residents said that they were pleased with the premises, finding them comfortable and homely as well as practical. They also described the home as being clean. The home is well maintained with repairs and servicing being carried out promptly and according to schedule. Stoneleigh Care Home DS0000000755.V329645.R01.S.doc Version 5.2 Page 15 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to fulfil the aims of the home and meet the changing needs of residents. EVIDENCE: On the day of inspection, there were 31 residents being accommodated, including 15 in receipt of continuous nursing care. Residents and relatives said that they got on well with staff and most felt that there were sufficient numbers of staff to meet their needs. This view was reflected in staff comments. Ideally, staff would like 5 - 6 carers on each floor during the day, but this is not always achieved. However, there is some flexibility in the way staff members are deployed and staff morale was reported to be very good. During the day (7.30 am to 9.30 pm) there is at least one registered nurse on duty (for example, between 2 and 4 pm there are 2 registered nurses on duty) plus 4 - 5 carers (at least 5 carers from 7.30 am to 2.30 pm and 4 carers from 2.30 to 9.30 pm). In addition, there is a dedicated activities organizer. The registered manager is also a registered nurse and is full time, Monday to Friday. Her hours are not included in the nursing hours available. The home employs an administrator and a maintenance officer. There are dedicated catering and domestic staff deployed in sufficient numbers for the needs of the home. At night, there is one registered nurse and up to 3 carers on duty. A wide ranging staff training and development programme is in operation for all staff. Staff confirmed that they had undergone comprehensive induction and foundation training. At least 50 of care staff will have completed National Vocational Qualifications (NVQ) in care at level 2 or 3, by the end of March
Stoneleigh Care Home DS0000000755.V329645.R01.S.doc Version 5.2 Page 16 2007 and a further 6 staff members will start NVQ training and assessment later this year. Stoneleigh Care Home DS0000000755.V329645.R01.S.doc Version 5.2 Page 17 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 and 38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a qualified, competent manager. EVIDENCE: The registered manager is experienced and competent in her role. Residents, relatives and staff spoke well of her accessibility and commitment to good outcomes for residents. She was described as being very approachable and caring, providing excellent leadership and reinforcing the good values and principles of the service. She expects to complete the Registered Manager’s Award at NVQ level 4 later this year. Staff confirmed that they participate in regular supervision sessions and training, as recorded in individual staff files. The manager plans a full programme of staff supervision sessions for two months ahead. There is a named photograph of each member of staff in the entrance foyer, along with copies of helpful documents including the home’s
Stoneleigh Care Home DS0000000755.V329645.R01.S.doc Version 5.2 Page 18 magazine, service user’s guide, charter of service users’ rights, the home’s philosophy of care and last inspection report. Good accounting procedures are followed, with receipts and signatures obtained for all financial transactions involving residents’ personal monies, in which the home is involved, wherever practicable. Relatives look after the personal monies of many residents. In those situations where the home looks after residents’ monies, such as personal allowances, clear individual records are maintained. Service users have ready access to their money, even at short notice. Comments received from staff confirmed that there are good health and safety policies and practices that promote the health, safety and welfare of residents and staff. All staff members do refresher training in Health and Safety, such as moving and handling, fire safety and food hygiene. This helps reinforce the registered provider’s written policies on Health and Safety. Health and Safety issues are also discussed at regular staff meetings, such as the Health and Safety Committee that meets monthly and has representatives from all the staff groups, and in staff supervision sessions. Residents, relatives and staff expressed satisfaction with the way the home was run and the good standards that were evident in many instances. They said they believed the home was safe and run in the best interests of residents. For example, there are six monthly surveys of residents’ satisfaction carried out and the findings are reported within the home. The registered provider’s representative visits the home frequently to check on the welfare of residents and the progress of the home. The manager routinely invites comments and suggestions for improvements from both residents and visitors to the home, via regular meetings, surveys and consultations. Stoneleigh Care Home DS0000000755.V329645.R01.S.doc Version 5.2 Page 19 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 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 4 x 3 3 x 4 Stoneleigh Care Home DS0000000755.V329645.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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 Care Home DS0000000755.V329645.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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
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