Inspection on 31/01/08 for Stoneswood

This inspection was carried out on 31st January 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Stoneswood 16/12/08

Stoneswood 27/06/06

Stoneswood 29/09/05

Stoneswood 25/04/05

Stoneswood 05/10/04

Stoneswood 19/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Stoneswood Oldham Road Delph Oldham OL3 5EB Lead Inspector Mrs Fiona Bryan Unannounced Inspection 31st January 2008 10:00 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 Stoneswood DS0000005522.V358306.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. Stoneswood DS0000005522.V358306.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stoneswood Address Oldham Road Delph Oldham OL3 5EB 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) 01457874300 NO FAX stones.wood@zen.co.uk Northern Care Homes Limited Mrs Michelle Elizabeth Jacques Care Home 28 Category(ies) of Dementia - over 65 years of age (8), Old age, registration, with number not falling within any other category (18), of places Sensory Impairment over 65 years of age (2) Stoneswood DS0000005522.V358306.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 18 OP up to 8 DE(E) and up to 2 SI (E) Date of last inspection 27th June 2006 Brief Description of the Service: Stoneswood is a residential care home providing personal care and accommodation for up to 28 older people. It is owned by Northern Care Homes Limited, which is a private company. The home, which is a large Victorian building, stands in its own grounds in a semi-rural location on the outskirts of Delph, approximately six miles from Oldham Town Centre. There is a public transport link to Oldham. The home provides 22 single and three double bedrooms. The proprietors have chosen to use the double rooms as singles, and use the remaining three registered places for day care. Accommodation for service users is provided on the ground and first floors of the building, with a passenger lift for ease of access. The basement area is used for storage and utility rooms. The current weekly fees range from £343-£370. A copy of the service user guide is displayed in the reception area of the home and is provided to all prospective new residents. Stoneswood DS0000005522.V358306.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This key unannounced inspection, which included a site visit, took place on Thursday, 31st January 2008. The manager was not told beforehand of the inspection visit. All key inspection standards were assessed at the site visit and information was taken from various sources, which included observing care practices and talking with people who live at the home, visitors, the manager and other members of the staff team. Three people were looked at in detail, looking at their experience of the home from their admission to the present day. A tour of the building was conducted and a selection of staff and care records was examined, including medication records, employment and training records and staff duty rotas. Before the inspection, surveys were sent out to residents and relatives and health care professionals that visit people living in the home, asking what they thought about the care at the home. Seven relatives and two health care professionals responded and their comments have been considered and included in the report. We sent the manager a form called an Annual Quality Assurance Assessment (AQAA), which asks them to tell us what they think they do well, what they have improved upon and what they need to do better and this was returned to us before the site visit. We felt that the manager had tried hard to be objective about how the home was performing and the information she supplied was, in the main, accurate. What the service does well: Residents were assessed to make sure their needs could be met before they came into the home. Stoneswood DS0000005522.V358306.R01.S.doc Version 5.2 Page 6 Residents said staff were kind and treated them well. Comments from residents and relatives included “My grandma is very happy living at Stoneswood, we know she is safe and well cared for”, “all very friendly and helpful all the time”, “all the staff are great with mum”, “ I have always found the staff very helpful. My mother is as happy there as she would be anywhere. Nothing is too much trouble for them” and “everyone of the staff are very caring and pleasant”. Although no activities organiser is currently employed at the home, arrangements are made to provide social events and pastimes for residents. Residents said that they went out of the home on occasions and that their visitors were made welcome. Residents were positive about the food provided and said they had a choice at each mealtime. All residents spoken to and relatives that returned surveys confirmed that they knew how to make a complaint if they needed to do so. One person who had been involved in a complaint said that despite an ongoing investigation, the attitude of the staff and the manager had not changed towards the resident or themselves and they felt that they had been able to maintain a good relationship with everyone in the home. Stoneswood provides a clean and comfortable environment for people to live in. Comments about the home included “Stoneswood provides a light hearted happy atmosphere in a clean and welcoming home”, “looks after my mother very well providing a homely atmosphere”, “Stoneswood, because it is an old Victorian house has a homely feel that makes residents comfortable and it’s the next best thing to their own home. I am always made welcome and I know that my mother feels safe and comfortable”, “most people would like to stay in their own home but when that becomes impossible Stoneswood do their best to make residents feel happy and safe and are very understanding of residents’ feelings” and “they give my grandma the care, comfort and reassurance she needs when I and my family aren’t here”. 68 of care staff are trained to at least NVQ level 2. Records showed that staff were encouraged to undertake training in a variety of topics so they had the skills and knowledge to care for people properly. Residents said they were satisfied with the arrangements for managing their money. Stoneswood DS0000005522.V358306.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: The main issue that needed addressing concerned the management of medicines. A complaint that resulted in an investigation, found the home at fault, having not ensured that a resident received their correct medication. The manager had commenced regular checks of the medicines since then to ensure that staff were following procedures and all aspects of the ordering, receipt, storage, administration and disposal of medicines was managed safely. However, during the site visit we found that errors were still being made, which had not been identified by the manager. This was of concern as a requirement was made at our last inspection that all aspects of the medicine procedures be followed at all times. The systems for checking medicines and other care practices need to be much more robust. The manager must ensure that incidents that are referred to the safeguarding team for investigation are reported to the CSCI. Stoneswood DS0000005522.V358306.R01.S.doc Version 5.2 Page 8 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. Stoneswood DS0000005522.V358306.R01.S.doc Version 5.2 Page 9 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 Stoneswood DS0000005522.V358306.R01.S.doc Version 5.2 Page 10 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 and 3 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Detailed assessments are undertaken before people come into to the home so they can feel confident that their needs can be met. EVIDENCE: A copy of the home’s statement of purpose and the service user guide were displayed in the entrance to the home and copies were also provided in each resident’s bedroom. Both these documents contained up to date information that would allow prospective new residents to understand what services the home offered and make a decision as to whether the home would be suitable for them. Stoneswood DS0000005522.V358306.R01.S.doc Version 5.2 Page 11 One relative who was visiting the home on the day of the site visit said she had looked round the home on behalf of her relative, before they were admitted. She said she had been given a copy of the service user guide to take away and show her relative and had been given enough information about how the home operated. Three residents’ care files were looked at in detail. Assessments had been undertaken for all of them before they came into the home. One resident said her care needs had been discussed with her when she came into the home and a plan of care agreed. Her relative had signed this on her behalf. All of the three files examined showed that assessments had been undertaken with the involvement of the resident and their family and all had been signed to confirm this. In addition to assessments undertaken by staff at the home, assessments were also provided for each person from Oldham MBC. Stoneswood DS0000005522.V358306.R01.S.doc Version 5.2 Page 12 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): Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. The health and personal care residents receive is generally based on their individual needs; the procedures for managing medicines safely are not always followed and may put residents at risk. EVIDENCE: Three residents were case tracked. All had care plans that fully informed staff in a person-centred way, about what they needed to do for the person, what the person could do for themselves and what their preferences and daily routines were. All care plans had been signed either by the resident or by a relative, on their behalf to show that the care plans had been discussed and agreed with them. Care plans had been reviewed at least monthly. The care plans themselves were not updated but changes were recorded on a “change to care plan” form that was attached to the care plan. Stoneswood DS0000005522.V358306.R01.S.doc Version 5.2 Page 13 General health and safety risk assessments had been undertaken that assessed risks, such as falling and scalding from hot water, and also assessed, in a basic way, the resident’s mental capacity and communication abilities. Moving and handling assessments and nutritional risk assessments had also been undertaken but did not always state when they had been reviewed. It was recommended that reviews of these were added to the “changes to care plans” form so they were routinely reviewed monthly. Since the last inspection the format for the daily report had been changed. The daily report was written on a pre-printed form that contained spaces to make entries each morning, afternoon and night shift. There was also space to record what social activities the resident had been involved in and to record food and fluid intake if there was a cause for concern. Night staff also recorded when they had checked on the resident during the night. As the forms were pre-printed, space was limited if staff needed to record a lot of information so staff also used a communication book that detailed a lot of specific information about individual residents and changes to their care, appointments and particular issues that had been dealt with on any given day. The entries in this book could not later be removed and added to individual files so there was a risk that some information would be recorded in one place and other information elsewhere. The manager had recognised this and was about to implement an additional form that allowed staff to write more if necessary that could be kept in the resident’s file. Records showed that residents had seen their GP’s, district nurses, podiatrists and opticians, and had been supported to attend hospital appointments. The records for one resident showed that the GP had requested samples for testing, but there was no further record that these had been obtained. The manager said it had been later decided that the samples were not needed but the file should have been updated to record this decision. Seven relatives returned surveys that we sent out before the site visit. All responded positively about the home. Comments included “every one of the staff are very caring and pleasant and do their utmost to make sure that the residents are warm, clean and well fed”, “if a question needs to be asked for any reason the response is immediate”, “if changes are required they are usually discussed and changes implemented”, “my mother has improved greatly in the five months she has been at Stoneswood” and “if we request anything for her it is done to the best of their ability”. In response to the question “Does the care home give the support or care to your relative that you expect or agreed” one person replied, “sometimes better (than expected) due to the sensitive, caring experience of some staff members”. Stoneswood DS0000005522.V358306.R01.S.doc Version 5.2 Page 14 One resident spoken to on the day of the site visit said that staff were “very good – kind and polite” and their relatives said they were kept informed about any changes to her care needs. Staff were knowledgeable about individual residents and were able to describe their daily routines, preferences and specific care needs. It was observed that a carer was discussing a resident’s care plan with her on the morning of the site visit – whilst it was good to see that residents were being involved and informed about their care plans, the conversation was taking place in the lounge in front of other residents and should have been held in private. Examination of some medicine records showed that further work is needed to ensure policies and procedures are always adhered to and systems need to be improved regarding the ordering and receipt of medicines. Routine prescriptions were ordered and delivered every 28 days. One resident had just “run out of” one of their medicines half way through 28-day cycle. One medicine for another resident had been signed in incorrectly, with the record showing that 28 tablets had been received when in fact 112 tablets had been delivered. Systems for the management of controlled medicines need to be improved. Inspection of the record for one resident showed that on two recent occasions staff had failed to sign the controlled drug book, although the medicine was administered. This meant that the record of the stock balance did not tally with the actual number of tablets remaining. Two health care professionals returned surveys that we sent to them. Whilst mainly positive about the care residents received, one did state that there were sometimes difficulties with the systems in place at the home for reordering residents’ medicines. Since the last inspection there has been a complaint that related to a resident’s medicine, in that, staff failed to ensure that a repeat prescription was obtained. The manager has started to audit the medicines to ensure that staff follow the correct procedures but this system needs to be strengthened and improved to make sure that errors are identified and corrected quickly. Stoneswood DS0000005522.V358306.R01.S.doc Version 5.2 Page 15 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): Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The day-to-day routine of the home, including mealtimes, was relaxed and informal and met service users’ needs. EVIDENCE: Although no activities organiser is currently employed at the home (the manager has been trying to recruit for the post), external contacts have been made and residents have enjoyed a pianist coming to the home, someone who runs handicraft sessions and another person who holds sessions doing armchair exercises. It was reported that a film night was held every Friday and trips out are organised, for example, residents had gone out for a pub lunch the previous week. Church of England services are held once a month and a priest visits some residents weekly and offers Holy Communion. Notices were displayed around the home stating forthcoming activities and events. Minutes from residents’ meetings showed that residents had been asked for suggestions about what they would like to take part in. The activities diary showed that residents had been to the pantomime at Christmas and had parties and get-togethers on special occasions. Stoneswood DS0000005522.V358306.R01.S.doc Version 5.2 Page 16 Most residents said the arrangements for social activities in the home suited them. Residents said routines were flexible and they were able to get up and go to bed when they chose. Some residents preferred to spend most of their time in their own rooms, whilst others tended to spend the day in the lounges chatting with other residents. Visitors said they were always made welcome and residents said they could have visitors when they wanted. Comments from relative surveys included “they (staff) support her to attend church/have the minister attend if requested” and “my grandma is left to go about her day as she chooses”. Comments were positive about the food provided by the home. Residents said they had a choice at meal times and staff came round each morning to discuss the day’s menu and take their order. Examination of the menus showed that a nutritious and varied diet was provided by the home. In the mornings, residents had a choice of cereals, porridge and toast and could also have a cooked breakfast if they wished. Typical food for the main meal of the day included stews, pies, fish, roasts, gammon, braising steak, casseroles, egg and bacon and other options such as omelettes, cauliflower cheese, fish cakes, pasties, sausages and chilli. Lighter teas included sardines, cheese, eggs and beans on toast, lasagne, kippers, hot beef sandwiches, quiche, scampi, jacket potatoes with fillings and home made soup. Lunch was served at about 12:45pm. Although the atmosphere was pleasant, with music playing in the background and residents sitting at small tables seating four people, it was noted that the tables looked somewhat sparse in presentation, with no tablecloths or serviettes. Each table did have a small vase of flowers on it and each resident was served a cold drink to have with their meal. The manager said that there were plans to refurbish the dining room. Many of the meals served to residents were served on quite small plates. The manager said this was because some residents did not have large appetites and only required small helpings. However, small plates reduced the presentation of the meals and some residents were seen trying to eat food that was falling off the side of their plates. Stoneswood DS0000005522.V358306.R01.S.doc Version 5.2 Page 17 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): Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. People who use the service are able to express their concerns, and have access to a robust, effective complaints procedure, and are protected from abuse, and have their rights protected. EVIDENCE: The complaints procedure was displayed in the reception area of the home and was also provided in each resident’s bedroom. Since the last inspection, a suggestion box has also been provided to give residents and relatives the opportunity to raise comments and put their points of view forward. Residents said if they had a complaint they would see the manager and were confident it would be dealt with properly. A record of complaints made was available. This showed that 12 complaints had been made in the past year. Most were of a fairly minor nature and the record showed how they had been investigated and what action had been taken to address the complaint. All the relatives who returned surveys said they were aware of the complaints procedure. Stoneswood DS0000005522.V358306.R01.S.doc Version 5.2 Page 18 Since the last inspection there have been two incidents that have been referred to the safeguarding team for investigation. A final meeting has been arranged to determine the outcome of one complaint and the other is still under investigation. The manager has already acknowledged that medication practices were inadequate at the time of the first incident and was taking steps to improve this area of practice. The CSCI was not notified that the second incident had been referred to the safeguarding team. The manager had notified us of the initial event but should have informed us when she was made aware by the safeguarding team that they were investigating it. A relative of the resident involved in the above incident was visiting the home at the time of the site visit and said that even though the incident resulted in an investigation, the manager and staff at no time made the resident or their relatives feel uncomfortable and remained professional and friendly in their dealings with them. This had made her confident that she could raise matters without feeling that this would have a negative impact on the relationship between staff at the home and the resident. Staff were able to describe what they would do if they suspected abuse and it was reported in the AQAA that all staff had attended training in safeguarding adults. Oldham Council’s policy is kept in the manager’s office for staff to refer to if they need to. Comments from relatives’ surveys included “most old people would like to stay in their own home but when that becomes impossible Stoneswood do their best to make residents feel happy and safe and are very understanding of residents’ feelings”, “my grandma feels happy and comfortable” and “my grandma is very happy living at Stoneswood. We know she is safe and well cared for”. Stoneswood DS0000005522.V358306.R01.S.doc Version 5.2 Page 19 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): Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The home is generally well maintained and provides comfortable living accommodation for residents. EVIDENCE: A tour of the home was conducted. The home was clean, tidy and free from any unpleasant odours. Residents spoken to said they were satisfied with the cleaning and laundry services. One relative commented in a survey that the home was “clean and well run”. The two large lounges had a very homely feel, with large windows that let in the light and gave a feeling of spaciousness. Lots of pictures, ornaments, lamps and soft furnishings, etc., were in keeping with the style of the building and created a welcoming atmosphere. Stoneswood DS0000005522.V358306.R01.S.doc Version 5.2 Page 20 The dining room was sparser and the bathrooms were quite drab but it was reported that extensive refurbishment was planned for the home and these rooms would be upgraded. A small number of residents’ rooms were viewed and all were personalised with small items of furniture, mementos and items of interest to the residents. There was an outside seating area with water fountain and lovely scenery set in four acres, with views across the valley. The manager said in the AQAA that she needed to arrange for the walkways to be cleared within the grounds so they are more accessible to the residents and visitors. It was also reported that since the last inspection both lounges had been redecorated and repaired, the dining room had been painted, along with corridors and some bedrooms and the main bathroom. New soft furnishings had been purchased for both lounges, along with new chairs for one lounge. A new piano had been purchased. The main office had been redecorated along with the second office upstairs. Stoneswood DS0000005522.V358306.R01.S.doc Version 5.2 Page 21 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): Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The home was sufficiently staffed and recruitment procedures ensured that service users were protected. EVIDENCE: Residents, relatives and staff all agreed that there were generally enough staff on duty to meet the residents’ needs. One resident said she used the call bell during the night and staff came quickly if she needed them. Examination of the staff duty rotas for the weeks commencing 21/1/08 and 28/1/08 confirmed that staffing levels were satisfactory. The manager reported that, as at the last inspection, staff turnover remained low, which enabled her to maintain a consistency of care for the residents. Two staff personnel files were examined. Both contained evidence that all the necessary checks had been made before they started work at the home. Stoneswood DS0000005522.V358306.R01.S.doc Version 5.2 Page 22 The staff training file showed that staff had received training over the past year in a range of topics, including food hygiene, management of medicines, diet and nutrition, COSHH, fire safety, optical awareness, safeguarding adults, first aid, incontinence management, moving and handling, disability awareness, health and safety risk assessment, dysphagia, MRSA and an induction workshop for new staff via OMBC adult and community services. Training in all subjects had not been provided to all staff but each person seemed to have attended training in something. The manager is in the process of creating a matrix to clearly identify who has done what and when mandatory updates in health and safety topics are due. The manager said she was planning to arrange training for more staff regarding infection control and nutritional screening. Information supplied in the AQAA reported that 68 of the care staff at the home had successfully completed NVQ training to level 2 or above. One health care professional that returned a survey commented that further training for staff in managing challenging behaviour would be beneficial. Stoneswood DS0000005522.V358306.R01.S.doc Version 5.2 Page 23 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): Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The attitude of the manager and staff creates an open and inclusive atmosphere, which provides a positive home for people to live in. EVIDENCE: The manager has several years’ experience in a management position and holds an appropriate qualification for the role. Good working relationships exist between the manager and the owners, with clear lines of accountability. Evidence was provided that the manager had attended training over the past year to ensure that her skills and knowledge were updated. Stoneswood DS0000005522.V358306.R01.S.doc Version 5.2 Page 24 Residents’ meetings had been held in January, March, June and October 2007. Minutes of these meetings showed that residents had been asked to give their views about the food provided at the home, their rooms, the laundry service and the provision of activities. Minutes of the last meeting were displayed in the reception area of the home and in the dining room, together with a list of dates for meetings throughout 2008. The manager gave examples of how suggestions made by the residents had been implemented, for instance, some residents had said that instead of having an egg and bacon sandwich for breakfast they would prefer a proper cooked breakfast on a plate, so this was changed. Staff, residents and relatives said the manager was approachable and accessible. A notice in reception did advertise regular “manager’s surgeries” when she was available in the evening for anyone wishing to drop in and see her. However, the manager said no-one had ever made use of this time, as most people saw her around the home and would phone her or see her on an ad hoc basis. Twenty-six questionnaires were distributed to relatives and residents in October 2007 and 13 were returned. The majority contained positive responses and information about this had been added to the service user guide. Staff said they had meetings about once every three months and minutes of these meetings were available. The owner of the home works at the home four days a week and has daily input about how the home is managed. She writes a report once a month that is given to the manager to confirm their ongoing discussions. The owner speaks to staff, residents and visitors as part of her report to seek their opinion about how the home is running. Procedures for the management of residents’ money were satisfactory. Staff said there was enough equipment within the home to enable them to carry out their jobs safely. The manager needs to continue to develop and strengthen her systems for checking staff practices (for example, in medicine management) to make sure everyone is following the policies and procedures correctly and thereby minimising the risk of errors. Regular checks had been made of the premises and equipment to ensure that everything was in good working order and well maintained. Stoneswood DS0000005522.V358306.R01.S.doc Version 5.2 Page 25 Fire drills had been recorded but did not state the times at which they were held. Several of the same staff had attended some of them but not all staff on the duty rotas seemed to have been included. The manager was advised to vary and record the times of the fire drills so all staff attend at some point. The manager returned the AQAA promptly and provided clear, relevant information about what changes had been made and where they still needed to make improvements. Stoneswood DS0000005522.V358306.R01.S.doc Version 5.2 Page 26 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 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 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Stoneswood DS0000005522.V358306.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? Yes 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 OP9 Regulation 13 Requirement Timescale for action 29/02/08 2 3 OP18 OP33 37 24 Staff must follow the correct policies and procedures for the management of medicines at all times to ensure that the risk of errors is minimised and protect the residents from harm. (Timescale of 1/8/06 not met). Any incidents that are referred to 15/02/08 the safeguarding team must be reported to the CSCI. The manager must further 29/02/08 develop and strengthen the systems in place for auditing staff practices, to ensure that staff follow the correct policies and procedures and to detect and address shortfalls in practices and identify training needs. Stoneswood DS0000005522.V358306.R01.S.doc Version 5.2 Page 28 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 OP15 OP30 Good Practice Recommendations Consideration should be given to the size of the plates meals are served on, to ensure that residents can eat the food easily and to enhance the presentation of the food. Further training should be made available to staff in managing challenging behaviour. Stoneswood DS0000005522.V358306.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Manchester Local Office Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ 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. 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