Inspection on 04/07/06 for Stratford Court

This inspection was carried out on 4th July 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Stratford Court 28/11/05

Stratford Court 17/05/05

Stratford Court 27/10/04

Stratford Court 11/05/04

Stratford Court 10/02/04

Stratford Court 12/08/03

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Stratford Court 35 Highfield Road Hall Green Birmingham West Midlands B28 0EU Lead Inspector Kulwant Ghuman Unannounced Inspection 4th July 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 Stratford Court DS0000016788.V302362.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. Stratford Court DS0000016788.V302362.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stratford Court Address 35 Highfield Road Hall Green Birmingham West Midlands B28 0EU 0121 778 3366 0121 778 6288 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) Mrs Carole Wilkins Mr Colin Wilkins Mrs Carole Wilkins Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Stratford Court DS0000016788.V302362.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th November 2005 Brief Description of the Service: Stratford Court provides residential care for up to 30 older people on both a long and short-term basis. It is a purpose built care home conveniently placed for local amenities and public transport. The Home offers accommodation over 2 floors and an eight-person lift provides access between floors. Bedrooms range from single rooms with en suite facilities to studio type accommodation. These studio rooms are for single occupancy and also have en suite facilities. They are intended for use by residents who are more independent but who will still benefit from the security of 24-hour supervision, care and support services. There is one double room with en suite for use by couples or friends. There are also fully assisted bathing and showering facilities available. The main complex has three separate lounge areas, a large dining room, and a hairdressing salon. Disabled toilet facilities are available close to the lounges and dining room. The Home is equipped with a loop system and talking books for service users with sensory difficulties. Television and telephone points are sited in all bedrooms and a payphone is also available for residents use. There is a well-tended garden with seating for residents to enjoy, and some car parking facilities are available for visitors. The current fees range from £350 to £460 a week. Stratford Court DS0000016788.V302362.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection was carried out over one day during July 2006. The inspector spoke with five of the twenty-eight residents, the manager, sampled some bedrooms during a tour of the building and inspected two residents’ files, two staff files and some health and safety documents. What the service does well: What has improved since the last inspection? The care plans had been improved since the last inspection and manual handling assessments recorded the actions to be taken in the event of a fall. A path has been laid in the garden enabling residents to walk around the garden safely. Crockery and linen for the dining room had been replaced. Stratford Court DS0000016788.V302362.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Stratford Court DS0000016788.V302362.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Stratford Court DS0000016788.V302362.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents were able to make an informed choice about whether to move into the home or not. The admission process in the home ensures that residents’ needs can be met by the home. EVIDENCE: There was a statement of purpose and service user guide available in the home. These documents were not inspected during this inspection but met the requirements at a previous inspection. The inspector was informed that a copy of the service user guide and menus were given to prospective residents. Residents received a contract and these were kept on a separate file for issues of confidentiality. The two most recent admissions to the home had had a very detailed preadmission assessment undertaken by a member of staff. The manager told Stratford Court DS0000016788.V302362.R01.S.doc Version 5.2 Page 9 the inspector that the pre-admission was usually undertaken during the visit to the home in order to assess if the resident could mobilise around the home. Assessments could be carried out where the resident was living if required. Residents moved into the home on a trial basis for four weeks before deciding whether to stay or not and to ensure that the residents needs could be met by the home. During a conversation with one of the residents the inspector was told that the resident was able to visit the home and realised this was the right home for them. Stratford Court DS0000016788.V302362.R01.S.doc Version 5.2 Page 10 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): 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Health and personal care needs were well met in the home and residents were given the care the assistance required whilst encouraging them to be independent wherever possible. EVIDENCE: Care plans were comprehensive and included a section on life history and relationships with family. Personal care details included times of rising, likes and dislikes in food and social activities, frequency of bathing and whether to be checked during the night. A daily profile gave additional information regarding health, eating and drinking, washing and dressing, clothes, nails and hair care, mobility, sleeping and self image. Stratford Court DS0000016788.V302362.R01.S.doc Version 5.2 Page 11 It was pleasing to note that this document also recorded what tasks the residents were able to undertake themselves and in which tasks they needed assistance. The care plans were discussed with the manager and the improvements in the care plans since the last inspection were acknowledged. The manager also acknowledged that there were areas of the care plan that could be improved by ensuring that the instructions were more detailed so that staff knew exactly what to do. Where assistance with personal care was to be given by staff the assistance required needed to be clearly identified. Care plans were being reviewed on a monthly basis however, the changes were not always fed back into the care plans. There were tissue viability and nutritional assessments in place for the residents. The daily recordings made regarding the care given by care staff were generally good however in some situations more detail was required for example, where a resident was being ‘aggressive’ the behaviour should be recorded so that an assessment could be made as to whether there was an increased level of aggression and what form it was taking. The home had introduced action plans however these needed to be developed in their use to ensure that where issues such as monitoring of moods was required it was clear what behaviour was being monitored, how often and when referral to health professionals such as the CPN was to be made. Health needs of the residents were met well and there was good liaison with health professionals. There were documented visits by GP’s, CPN, dentists and chiropodists as well as visits to hospitals where required. The home had a system whereby critical incidents were recorded to ensure that the reason and outcomes of medical visits were clear. The management of medicines was good. There was a seven day monitored dosage system in use and staff had undertaken the appropriate training to administer medicines safely. Medicines were generally recorded on receipt into the home however there was a minor discrepancy where the prescriptions were being issued on a monthly basis but the medicines were being released by the pharmacist on a weekly basis. Ways to overcome this were discussed with the manager at the time of the inspection. There was appropriate management of controlled medicines in the home. All bedrooms had en-suite facilities, there was an item of lockable furniture in all bedrooms and bedroom and bathroom doors had the appropriate locks in place. Residents had access to a pay phone in a quite area of the home or they could receive telephone calls privately in their bedrooms via the portable Stratford Court DS0000016788.V302362.R01.S.doc Version 5.2 Page 12 phones. Medical examinations were undertaken in the residents’ bedrooms and chiropody took place in a bathroom. Residents stated that they were happy with care they were given and that the staff were very kind. Stratford Court DS0000016788.V302362.R01.S.doc Version 5.2 Page 13 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): 12,13,14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. There were no rigid rules or routines in the home and residents could spend their time as they chose. There were some organised activities for those residents who wished to take part. The residents were satisfied with the catering arrangements at the home. EVIDENCE: One of the residents told the inspector that a member of staff undertook activities with the residents if they wanted to take part. This included sewing, knitting and quizzes. Residents confirmed that there were no rigid rules in the home and that they were able to go out with their friends and relatives or they could be visited in the home but that they were requested to return to the home by 8pm at the latest. Another resident stated that the home had provided very good food and activities over the Christmas period. Stratford Court DS0000016788.V302362.R01.S.doc Version 5.2 Page 14 The inspector was able to take a meal with the residents. The meal was found to be well cooked and presented and it was enjoyed by the residents. The residents said they were asked earlier in the day what they wanted and they could choose an alternative if they wanted. They also stated that they got plenty of drinks throughout the day. Records were kept of the food eaten by the residents and there was a rolling programme of menus that was adjusted seasonally. Residents were able to sit in a variety of lounges, watch the television in the lounge or the television in their bedrooms that was provided by the home, or listen to the radio in the lounge. There was a third lounge that could be used by residents with their visitors. Residents were observed to go and sit out in the garden and asked for hats to wear in the sun. It was noted that some residents said that the garden furniture was hard and as there were a limited number of cushions available to sit on, this could be a little uncomfortable. Residents’ bedrooms indicated that they were encouraged to personalise them with personal belongings and the care plans encouraged independence in respect of the care they were given and the clothes they wore. Stratford Court DS0000016788.V302362.R01.S.doc Version 5.2 Page 15 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): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents were protected by policies and procedures in the home and were aware of how to raise concerns. EVIDENCE: There were adequate complaints and adult protection procedures in the home. The home had not had any complaints about the service provided and no complaints had been lodged with the Commission regarding the service. Residents said they would know who to speak to if they were unhappy with anything but that generally staff would pick up if you were feeling down and make you aware that they were there if you wanted to speak to them about anything. Stratford Court DS0000016788.V302362.R01.S.doc Version 5.2 Page 16 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): 19,20,21,22,23,24,25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The standard of the environment within this home was very good offering residents an attractive, safe, comfortable and homely place to live. EVIDENCE: The home was purpose built and met all the National Minimum Standards in terms of space and facilities. There was ample communal space for the residents giving them a choice of three lounges where they could sit. The garden had had a path put in to enable the residents to walk around. Two of the residents commented on how they walked around the garden on the path. The furniture and decor of the communal areas was of a good standard and there were pictures and ornaments giving it a homely feel. Stratford Court DS0000016788.V302362.R01.S.doc Version 5.2 Page 17 The communal bathing facilities in the home consisted of two fully assisted baths and a floor level shower. There were communal toilets of a suitable size that could be used to assist residents, if required. In addition, all bedrooms had a minimum of a wash hand basin and toilet in the en-suite facilities and fifteen of them also had a shower facility. Bedrooms varied in size and shape but all met the needs of the residents and were suitably furnished with wardrobe, chest of drawers, bedside cabinet, easy chair and small table. There was secondary lighting available to the residents and an emergency call system was in place. The emergency call system was not always accessible and although extension leads could be attached none of the bedrooms were seen to have one in them. Where these leads would not be beneficial to the residents because they would not be able to use them or it would pose a further risk to them this needed to be recorded in the residents file as part of a risk assessment. The heating, lighting and ventilation throughout the home were safe and domestic in character and met with the needs of the residents. In some bedrooms only the upper part of the windows could be opened and may not be accessible to the residents but this was a condition of the building regulations. The home was found to be clean, light and airy and odour free. The laundry was appropriately sited and equipped with a sluice cycle washing machine. There were appropriate systems for the disposal of clinical waste and protective equipment after being used by the staff. The kitchen was found to be clean and well equipped. Stratford Court DS0000016788.V302362.R01.S.doc Version 5.2 Page 18 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): 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Staffing levels and competencies were such that the needs of the residents could be safely met. EVIDENCE: Adequate staffing levels were being maintained at the home with five staff on duty during the morning and three in the afternoon. There were two waking night staff and one sleeping in. There were additional ancillary staff on duty to undertake cleaning and cooking. There was a core staff group at the home that maintained continuity of care for the residents. Since the last inspection there had been two new staff appointments. The home did not use agency staff and relied on bank staff to cover any gaps. Residents commented on the excellent cooking abilities of the proprietors and that the staff were kind and helpful. The two staff files sampled contained all the relevant information except one reference and a POVA first check. The manager stated that these had been obtained but as the office manager was not available did not know where they were. Stratford Court DS0000016788.V302362.R01.S.doc Version 5.2 Page 19 The manager had trained as a moving and handling trainer and almost all the staff had had this training. Staff had also undertaken health and safety training, some had undertaken first aid training and some had started infection control training. Some staff had also undertaken abuse and diabetes awareness training. Only staff that had undertaken safe handling of medicines were able to administer medication. The cook and manager were looking into updating their food hygiene training to intermediate or higher levels. The majority of the staff had undertaken NVQ level 2 training. There was nothing observed or heard during the inspection that indicated that the residents were not in safe hands. Stratford Court DS0000016788.V302362.R01.S.doc Version 5.2 Page 20 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): 31,32,33,36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The manager ensured the smooth running of the home in a competent manner. The health and safety of the residents and the staff was well managed. EVIDENCE: The manager was a qualified nurse and had undertaken the Registered Managers Award. She had several years experience of managing a care home and caring for elderly residents. The manager demonstrated a good knowledge of the needs of the residents and a willingness to keep her knowledge updated. Stratford Court DS0000016788.V302362.R01.S.doc Version 5.2 Page 21 The home was managed well with the assistance of a deputy manager and office manager and was evidenced by the well-managed physical environment, continued improvements of care planning and servicing of equipment in the home ensuring that the health and safety of the staff and residents was safeguarded. The home did not have a formal quality assurance system however did have methods and checks in place to monitor issues such as hot water temperatures, medication audits and residents questionnaires. The manager discussed ways in which this information would be collated to feed into a business and on-going development plan for the home. Two of the residents told the inspector that there were no residents meetings where they could raise issues. There was evidence on site that staff were being appropriately supervised and the home was on target to meet the required levels of supervision. There was evidence that the weekly fire alarm and monthly emergency lighting tests were undertaken along with fire drills and training. The lift, gas appliances, hoists and portable electrical appliances were being appropriately serviced. The home needed to ensure that the results of testing for Legionella were available for inspection. Stratford Court DS0000016788.V302362.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 3 X 2 Stratford Court DS0000016788.V302362.R01.S.doc Version 5.2 Page 23 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 OP7 Regulation 15(1) Requirement Care plans must include all the personal care needs of the residents and details of how these are to be met by staff. Care plans must be updated with changes in care needs identified in reviews. Daily recordings must be detailed regarding issues such as aggression to ensure that it is clear what is meant by ‘aggressive’ to help monitoring of the behaviours. There must be two written 01/08/06 references and evidence of the Pova 1st check available for inspection for all staff. Evidence of the testing for 01/08/06 Legionella must be available for inspection. Timescale for action 01/09/06 2. OP29 19(1)(b) (i) 13(3) 3. OP38 Stratford Court DS0000016788.V302362.R01.S.doc Version 5.2 Page 24 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. Refer to Standard OP7 Good Practice Recommendations It is strongly recommended that read and sign sheets are included with risk assessments to confirm staff have read and agree to follow any risk assessments. It is recommended that where extension leads are not required by the residents this is recorded in their files as part of a risk assessment. 2. OP22 Stratford Court DS0000016788.V302362.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Stratford Court DS0000016788.V302362.R01.S.doc Version 5.2 Page 26 - 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!