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Inspection on 06/02/06 for Stowlangtoft Hall Nursing Home

Also see our care home review for Stowlangtoft Hall Nursing Home for more information

This inspection was carried out on 6th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The service user care plans were assessed as positive with the home using the Roper, Logan and Tierney model of care. This enables each member of staff to a follow a structured assessment of care. The risk assessments were clear and informative. The staffing numbers and skill mix were appropriate to ensure that all service users received the care and support identified in the care plans. There was a registered nurse in charge of the home at all times and a nurse manager in post to support the registered manager. There was evidence of a wide selection of meals available for all the service users.

What has improved since the last inspection?

The home has provided a lockable cabinet for one service user to enable them to keep their medication secure in their bedroom.

What the care home could do better:

The home was issued with an immediate requirement relating to all staff adhering to the infection control policy. Since the requirement was made the owner has responded positively and ensured that all staff adhere to the accepted policy. The home is required to maintain a record of all visitors to the home, including the names of visitors.

CARE HOMES FOR OLDER PEOPLE Stowlangtoft Hall Nursing Home Stowlangtoft Bury St Edmunds Suffolk IP31 3JY Lead Inspector Iain Smith Unannounced Inspection 6th February 2006 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 DS0000024506.V282004.R02.S.doc Version 5.1 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. DS0000024506.V282004.R02.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Stowlangtoft Hall Nursing Home Address Stowlangtoft Bury St Edmunds Suffolk IP31 3JY 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) 01359 230216 01359 233346 Mr Hector Iain MacDonald Mrs Hilary Anne MacDonald Mrs Hilary Anne MacDonald Care Home 37 Category(ies) of Old age, not falling within any other category registration, with number (37), Physical disability (37) of places DS0000024506.V282004.R02.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th July 2005 Brief Description of the Service: The present Stowlangtoft Hall was built in 1859 for the Maitland Wilson family and stands in seven acres of garden and woodland. In 1939 the property was let to London County Council as an evacuation centre for mothers and babies from the East End of London. The Hall has been used as a nursing home since 1969. Many of the original features of the hall have been retained for the enjoyment of the service users and visitors, including an Orangery with a glazed dome roof where service users may sit in the warmer weather. The home has established strong links with the local community and the larger grounds around the home are often used for community events. The home is currently registered for 37 service users who are elderly frail and are admitted for either short or long term care. The home actively encourages prospective service users and their relatives to visit and talk to management and service users about the services provided and to attend for trial visits. The present Stowlangtoft Hall was built in 1859 for the Maitland Wilson family and stands in seven acres of garden and woodland. In 1939 the property was let to London County Council as an evacuation centre for mothers and babies from the East End of London. The Hall has been used as a nursing home since 1969. DS0000024506.V282004.R02.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is based on an unannounced inspection of the home, the second inspection for the year 2005/2006. The visit commenced at 08.45 and lasted nearly four hours. The nurse manager Maureen Tilbrook was attendance at the inspection, in addition to Mark Roscoe a registered nurse who has been appointed by the registered manager as the trainee manager for the home. What the service does well: What has improved since the last inspection? What they could do better: The home was issued with an immediate requirement relating to all staff adhering to the infection control policy. Since the requirement was made the owner has responded positively and ensured that all staff adhere to the accepted policy. The home is required to maintain a record of all visitors to the home, including the names of visitors. DS0000024506.V282004.R02.S.doc Version 5.1 Page 6 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. DS0000024506.V282004.R02.S.doc Version 5.1 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 DS0000024506.V282004.R02.S.doc Version 5.1 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): EVIDENCE: No standards were inspected under this section. DS0000024506.V282004.R02.S.doc Version 5.1 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): 7,8,10 and 11. The care plans for each of the service user’s ensure that the appropriate care and support is delivered. The service users were respected and the policies for death and dying ensured that service users would be treated with the appropriate sensitivity. EVIDENCE: One care plan was examined and found to include all the appropriate details relevant for the care and support of the individual. The care plan was formulated from the pre admission assessment. The care plan was broken into five sections including the resident’s problem, the need, the nursing intervention required to address the need, the progress and evaluation. Each of the elements of care included communication, breathing, eating and drinking and elimination as examples. This model of care is identified as the Roper, Logan and Tierney model of care. Each of these elements were then identified within the structure of the care plan, therefore each member of the care staff was able to understand clearly the care and support needs of the service user. DS0000024506.V282004.R02.S.doc Version 5.1 Page 10 The appropriate risk assessments were evidenced in the care plan. The assessments included manual handling. The manual handling assessment stated the aids and equipment necessary to enable the appropriate care to be delivered to the service user. The identification of the assessed aids and equipment ensured that all staff used the same methods of working therefore ensuring the service user received the appropriate care. Staff were seen to knock on service users doors before entering. Staff were observed to address each of the service users by their preferred name. The death and dying procedure assures service users that at the time of death staff will treat them and their families with care, sensitivity and respect. The procedure was examined and found to include a number of sections relevant to inform staff how to approach death and dying, including the care the dying service user, religious beliefs and sudden unexpected deaths. DS0000024506.V282004.R02.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13 and 15. The service users can choose their routines for daily living and activities. The home ensures that service users receive a wholesome, varied and nutritious diet. EVIDENCE: The home employs an activities person. They are responsible for arranging a range of activities and visits both in the home and externally. The activities person stated that ‘they took one service user to Bury St Edmunds shopping recently’. There was evidence that the activities organised for all service users included games and watching films. There was a reminiscence room at the front of the home. This included memorabilia from the 1940’s with books, magazines, clothing and coins available for all the service users to view. The lunch was being prepared when the kitchen was visited. Two catering staff were in the process of making homemade food for example an apple pie. The menus for the day included fish in parsley sauce with chicken, omelette or salad as an alternative. The list for the lunchtime was examined and found that there were more than six different requests from service users. One service user stated that ‘I have requested smoked salmon with tomato each day.’ The home therefore demonstrated that each service users request is met. DS0000024506.V282004.R02.S.doc Version 5.1 Page 12 One service user stated that they have visitors nearly every day. The visitors are invited into the bedroom and sufficient chairs are made available for them to sit on. DS0000024506.V282004.R02.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: No standards were inspected under this section. DS0000024506.V282004.R02.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,24,25 and 26. The home provides a safe and comfortable environment. The infection control procedures for the home were not adhered to. EVIDENCE: The home provides a safe environment with each service user. The service users own rooms provide adequate furniture and furnishings. The remainder of the home offers a dining room, reminiscence room; wide corridors allow wheelchair access to all parts of the home. There are two lifts in the home. Both staff and service users used both the lifts. The lifts ensure that there is access to all parts of the home including bedrooms, dining room and landings. One service users room was visited. This was found to be warm, light and spacious and included adequate furniture and furnishings. The service user stated that they were comfortable in the room and ‘if I want anything I will ring the bell’. There was evidence of personal pictures displayed on the walls and located on the dressing table. A sink was available in the room. DS0000024506.V282004.R02.S.doc Version 5.1 Page 15 On the morning of the inspection there was evidence of a small bag hanging from the end of the staircase on the first landing. The bag contained used incontinence products. The registered nurse stated that the bag would normally be taken from a bedroom and placed directly in a yellow disposable bag in the sluice room. The sluice room was located opposite to where the bag was seen therefore on this occasion the procedure for the disposal of incontinence products had not been followed. The owner has confirmed that the policy for the disposal of incontinence products clearly states that used products are taken from the bedroom directly to the sluice room and placed in a yellow bag. This procedure is appropriate for the home and the owner stated that this would normally be followed. The owner has addressed the immediate requirement issued following the inspection in a positive way and the correct procedure has been reinforced with all care staff. DS0000024506.V282004.R02.S.doc Version 5.1 Page 16 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): 27. The numbers and skill mix of staff are appropriate to meet the needs of the service users. EVIDENCE: The staff rota was examined to assess if the home had sufficient staff on duty to care for the service users. On the morning of the inspection there was a trainee manager, two registered nurses in addition to five carers. The manager stated that there was normally eight care staff on duty in the morning. In the afternoon the rota evidenced that one registered nurse with six care staff were on duty and at night three care staff including one registered nurse. The staff complement was assessed as sufficient to care for the service users. To ensure the staff numbers are maintained, the home utilises agency staff from time to time. The other staff on duty included two people in the kitchen and four housekeepers. These members of staff were correctly included on the staff rota. DS0000024506.V282004.R02.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 36 and 37. There is clear leadership within the home and that ensures service users receive consistent quality care. The staff are appropriately supervised on a regular basis. EVIDENCE: The home has a registered manager and the owner has employed a registered nurse as a trainee manager. There is an appointed nurse manager who supports the trainee manager in their day-to-day operation of the home. The registered manager remains responsible for the home. The nurse manager stated that staff do not receive formal supervision but each member of staff are appropriately supervised. An example is that staff meet with manager or person in charge to discuss issues in the home and seek advice and support. DS0000024506.V282004.R02.S.doc Version 5.1 Page 18 The main entrance to the home is by a front door and on ringing the bell that is linked to the call system, a member of staff will give the visitor access to the home. There is a rear access where staff will enter the home and the nurse manager stated that there are plans to open up a side door for access. There was no evidence of a record or visitors book in the home to ensure that the person in charge was aware of the visitors in the home. DS0000024506.V282004.R02.S.doc Version 5.1 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 X X X X X x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 X 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 x 3 3 X X X 3 3 2 STAFFING Standard No Score 27 3 28 X 29 X 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X 3 2 x DS0000024506.V282004.R02.S.doc Version 5.1 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. 1 Standard OP26 Regulation 13.3 Timescale for action All staff must adhere to the 13/02/06 practice of disposing used incontinence products in the available yellow disposable bags in each of the sluice areas. (The owner has addressed this requirement since the notice was issued) The registered person must 31/03/06 ensure that a record is kept of all visitors to the home including the names of visitors. Requirement 2 OP37 17.2 Schedule 4 (17) 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 DS0000024506.V282004.R02.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI DS0000024506.V282004.R02.S.doc Version 5.1 Page 22 - 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. 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