Inspection on 15/10/08 for Stradbroke Court

This inspection was carried out on 15th October 2008.

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

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.

Other inspections for this house

Stradbroke Court 01/11/06

Stradbroke Court 16/12/05

Stradbroke Court 20/04/05

Stradbroke Court 06/10/04

Stradbroke Court 23/04/04

Similar services:

Claremont House

Chesham House

Oak Ridge

Argyll House

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Stradbroke Court Green Drive Lowestoft Suffolk NR33 7JS     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: John Goodship     Date: 1 5 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Stradbroke Court Green Drive Lowestoft Suffolk NR33 7JS 01502405494 01502405494 meike.weststrate@socserv.suffolkcc.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Meike Weststrate Type of registration: Number of places registered: Suffolk County Council care home 35 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: One named person, whose name was given to the Commission in September 2005, aged 65 years and over, who requires care by reason of mental health. One named person, whose name was made known to the Commission in April 2005, aged 65 years and over, who require care by reason of dementia. Date of last inspection Brief description of the care home Stradbroke Court is a purpose built home for older people, which was refurbished a few years ago to a high standard. It currently provides 13 residential care places (including 2 short-term care places), 10 special needs places and 12 rehabilitation places. The Care Homes for Older People Page 4 of 28 Over 65 11 1 25 0 0 0 0 1 Brief description of the care home four residents listed under the Conditions above are all accommodated within the 13 residential care places. The accommodation is all located on the ground floor and is divided into separate units. A day service is also provided in the building. This is not subject to inspection by the Commission. The fee level was 694 pounds per week at the time of the inspection. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was key unannounced inspection focussing on the outcomes for the residents measured against national standards. It took place on a weekday and lasted six hours. We toured the home, spoke to all the residents in the Hickling unit, and to four residents in Trinity. We also spoke to two relatives who were visiting the Hickling unit. We spoke in depth to two staff, and observed care practices throughout the home. We examined care plans, staff records, training and maintenance records. The acting manager was present throughout and assisted our inspection. Before the visit, we asked the manager to distribute our survey questionnaires Have your say about.. We received eight back from residents, eight from relatives and friends, four from staff and one from a health care professional. The manager was also Care Homes for Older People Page 6 of 28 required to complete our Annual Quality Assurance Assessment (AQAA). Information and comments from all these sources have been used in this report. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Older People Page 8 of 28 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents can be assured that they will have sufficient information to decide if this is the home where they wish to live. They can be assured that the home will collect information about their needs to confirm that the home can support them appropriately. Evidence: Six residents told us that they received enough information about the home before they moved in to help them decide if Stradbroke Court was the right place for them. One person in the intermediate care unit said that they were told it would help them recover their independence. At the time, I was too ill to take in the information. We checked the Statement of Purpose and the Service Users Guide. They were clearly written and held the information needed by prospective residents.Both clearly set out the aims of the three units in the building, how they were staffed, and how a residents Care Homes for Older People Page 11 of 28 Evidence: care would be arranged with them. Comments received by the home from residents and relatives about the home would add a personal touch to these documents. These could be taken from the homes surveys and from thank you letters. Contracts are given and agreed with each new resident and we saw copies of these in the files. They set out the terms and conditions which apply to both parties about a persons stay in the home. The AQAA told us that pre-admission assessments were undertaken prior to admission to any of the units, using the community care assessment and the homes own assessment. These were seen in the residents files that we examined. We were told that for short-term care and for permanent placements, the home offered a trial visit. A resident who was in the home for a week confirmed that they had visited and liked what they saw. The intermediate care unit, East Point, is in a self-contained wing of the building with its own staff, called enablers, and visiting occupational therapists and physiotherapists. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can expect staff to identify and review their care needs to ensure appropriate care is given. Their safety is assured by the home’s medication procedure and medication audits. Evidence: All the residents who replied to our survey said that they always or usually received the care and support they needed. All said that they always received the medical support they needed. We examined two care plans, one for a resident in the intermediate care unit (East Point),and one on the mainstream unit (Trinity). Both were comprehensive in identifying the persons personal care needs as well as their social needs and preferences. The plan for the person on East Point concentrated on the rehabilitation aspects of the persons stay, listing progress towards goals to improve mobility, using domestic appliances, and increasing independence in personal care tasks. A planning meeting had been held within two weeks of admission to plan their discharge. This Care Homes for Older People Page 13 of 28 Evidence: meeting involved the person themselves, their relatives and the multi-disciplinary team. The plan for the person on Trinity included their life story. A staff member told us that this helped them to understand the person better and to involve them in suitable activities and discussion. There was detailed records of visits by health professionals, nutritional assessments and monitoring and a clear diagram at the front of the plan listing the persons preferences regarding for example having their door open at night , dislike of soap on the face and use of their hearing aid. We saw the record of the last two six monthly reviews involving the resident, their relative, and staff. The team leader also reviewed the plan monthly. At the last review, the resident had asked for their room to be decorated. We were told that this would be taken up with the providers estates department. Two relatives were visiting to meet the community nurse to discuss their family members changing needs, and whether Stradbroke Court was still the most appropriate place for them. These relatives told us that they were satisfied with the overall care. They were disappointed that most residents on Hickling always congregated in the dining room, and did not seem to use the several small and well furnished sitting areas on the unit. They told us that it was difficult to find a place for a private discussion as nearly all the sitting areas were also through routes with people constantly passing. They wondered if the home had originally been designed to provide a home for more able and mobile residents. The home had reported five medication errors to us since February 2008. There was no pattern to these. The home had implemented a stricter audit of medication to reduce the incidence. The night team leader was responsible for auditing the records monthly, although all errors had been reported by staff at the time of the occurrence. We observed the lunch time medication round on Trinity. All procedures were followed correctly. We checked the controlled drugs(CD) for one resident at random. The amount remaining tallied with the amount recorded in the CD book. The acting manager had been identified as a Dignity Champion as part of a government drive to improve the dignity of all people in care. We noted that staff were aware of the right of residents to be treated with dignity and for their privacy to be respected. One member of staff described to us how they supported a resident to choose their clothes each day. A health professional who replied to our survey told us: Staff have provided very good individualised care to the residents I have been involved with. They respect their residents needs and opinions and maintain their dignity during my visits. Staff appear to involve them in choices whenever possible. Care Homes for Older People Page 14 of 28 Evidence: Plumbed-in drinking water coolers had been installed around the home. We were told that this would promote a better water intake for both residents and staff. Staff were aware that other care homes had shown that improved water intake helped to prevent infection and reduce the number of falls. Care Homes for Older People Page 15 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can expect to be offered a choice of activities. They will be supported to maintain family and other contacts. They can expect to be offered a choice of nutritional meals. Evidence: Four of the eight residents who replied to our survey told us that there were always or usually activities arranged by the home that they could take part in. Four told us that only sometimes were there such activities. A relative told us that: I have attended events with my relative on a regular basis. Another relative told us: We feel that more activities should go on in the home to stimulate the residents. Also days out would be a change for them to get away from the four walls. Another relative of a resident on Hickling told us: We have not seen any sign of stimulation or exercises. We saw evidence of the events that were arranged by the home. One resident was looking through a photo album and showed us photos of the Easter tea, the celebrations for St Georges Day, the July coffee afternoon and a trip to the seafront. The latter had been organised with families and ten residents walked or were pushed in their wheelchairs to the promenade in early October. Several residents told us how Care Homes for Older People Page 16 of 28 Evidence: much they had enjoyed this outing. We saw an information folder in one of the sitting areas for families to read, giving notices about future events, and details of previous events, and how much money was raised at fundraising events. The home provided many facilities to assist the staff to provide activities on a daily basis to stimulate residentsHhowever it was not clear how often they were used particularly with those residents on Hickling, the special needs unit. The personal activities record in one care plan had no entries. The manager told us that staff often did not recognise that all the activities they were carrying out on a daily basis such as reminiscence, playing games, reading, and going for walks, should be recorded as they contributed to residents stimulation. A staff member who had been on a course called Changing culture in dementia care recognised the value of stimulation for residents. Although the opportunities for residents on East Point and on Trinity were varied and well used, including attending the day centre entertainments and activities, it was not evident that the residents on Hickling were receiving enough support and stimulation relevant to their needs and capabilities. We saw several visitors in the home and one of them told us that a family support group had been set up recently. One meeting had taken place which was recorded in a newsletter. The home had a link with a local Rotary Club who were bringing the sensory garden back into shape. The AQAA told us that some residents handled their own finances, others had somebody acting as power of attorney. We observed lunches being served on Trinity and Hickling. There was a choice of fish and chips with peas and tomatoes, or steamed fish, or sausages. Choice depended on their wishes and on any dietary restrictions. Everyone we spoke to said how much they enjoyed the food and how good the choice was. The food was brought from the main kitchen in a heated trolley and plated up by the staff. Tables were laid with coloured tablecloths, with condiments and drinks. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be assured that their views will be listened to, taken seriously and acted upon. There is a proper policy, procedure and training programme in place to give residents confidence that they are protected from abuse. Evidence: Residents and relatives told us in our survey that they knew how to make a complaint. Information on how to complain was contained in the information given to new residents. The provider had a complaints policy called; Having Your Say. Forms to complete for a complaint were available in the foyer. There had been one recorded complaint in the last twelve months. The record showed how the matter had been investigated, dealt with and what action was taken. The manager described how residents had been offered the opportunity to take part in the consultation process about the proposed boundary changes in Suffolk. Staff told us that they received training in the safeguarding of vulnerable adults during their induction and every two years. They were aware of what could constitue abuse and how they should report it. Care Homes for Older People Page 18 of 28 Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can expect to live in a safe comfortable environment that is well maintained and hygienic. Evidence: Stradbroke Court was divided into three units. Trinity was for mainstream residents, Hickling for those with dementia, and East Point for intermediate care. Each unit had a mini kitchen, communal bathrooms and toilets. Each room had its own toilet and hand wash basin. All units had access to garden areas. The Hickling unit had been redecorated this year for the better orientation of the residents. They had been consulted about the colours. One told us: I chose the colours in the dining room. Although residents in all units were able to walk around in the home, the doors to the Hickling unit were alarmed to alert staff when a resident left the unit so as to be aware of their safety. All the residents who replied to our survey said that the home was always fresh and clean. When we visited, the home was clean and free from any unpleasant odours. Housekeeping staff ticked a chart when jobs had been done. The home was using the Department of Health guidance on cleaning and cross infection in care homes called Essential Steps. Infection control procedures were in operation for soiled or infected Care Homes for Older People Page 20 of 28 Evidence: linen and the laundry had the machines to cope with these items. One of the team leaders took the lead in infection control and told us that they were shortly to start an NVQ Level 2 in Infection Control. The washing from the intermediate care unit was done there with domestic machines as part of the rehabilitation process. The environmental health officer had visited the home to check that a food safety management system had been implemented. The home now used the Safer food, better business system. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can expect to be cared for by well-trained staff, and protected by the homes recruitment procedures. Evidence: Residents told us that they always received the care and support they needed. One said:The staff could not be more helpful and encouraging. The staff surveyed told us that there were usually enough staff on duty to meet the needs of all the people who used the service. The manager told us that the home had vacancies for two carers and two relief carers. The AQAA showed that there had been a high usage of agency staff earlier in the year. The rota showed that this was dropping. But the manager said that if all the relief staff were rostered to cover maternity leave and long term sickness, they had to call in agency staff to cover any further gaps. The home also employed domestic, catering and maintenance staff. Training records showed that 80 of care staff were trained to NVQ Level 2. All team leaders held Level 3 and the senior team leader was undertaking Level 4. This ensured that residents were in safe hands at all times. The home operated the recruitment procedures of the County Council using the central human resources section. No new staff had been recruited since the previous Care Homes for Older People Page 22 of 28 Evidence: inspection. At that time, we noted that safe recruitment procedures were used to protect residents. This low turnover gave stability for residents who knew the staff caring for them. All the staff had received induction training to the Common Induction Standards. We saw the schedule of a full programme of in-house and external training. All the staff in our survey told us that they received sufficient training to help them meet the individual needs of the residents. A staff member told us about the specialist training they had received for caring for residents on Hickling. They described how they had been able to use this training, for instance when handling someone with an aggressive outburst. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be assured that there is a system for obtaining their views on the running of the home to ensure it is run in their best interests. A process of staff supervision protects residents by continually monitoring and improving the skills of the staff. The system of quality assurance ensures that the home is safe. Evidence: The registered manager was on maternity leave at the time of our visit. The acting manager had been seconded by the provider from another of its homes. She was experienced in the care of older people and had worked at Stradbroke Court previously. The provider had a comprehensive quality assurance system. This covered surveys of residents, residents meetings, staff meetings and monthly inspections and reports from a senior manager. Meetings with relatives of those in the Hickling unit had Care Homes for Older People Page 24 of 28 Evidence: started, to provide information about dementia and to provide mutual support. We saw records of all these aspects of the system. These showed us that the home was run in the best interests of the residents. Some residents handled their own financial affairs, others had someone to act as power of attorney. Residents were told that they could choose whether they wanted their full personal allowance each week, part of it or want to access it as and when. The home followed the financial procedures of the County Council,with receipts and written records of all transactions. All staff received formal supervision sessions six times a year. We saw the records of these. One acting team leader told us they were due to receive training in carrying out supervision discussions with their staff to achieve benefit for the person concerned, and to improve care practices where needed. The records that we saw of health and safety checks, for example, the fire log, maintenance checks, hot water temperatures and incident forms showed that the residents were protected. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 12 Programmes of group and one to one activities should be developed for those with special needs, and their reaction to these should be recorded to contribute to the reviews of their progress. Care Homes for Older People Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!