Inspection on 30/07/05 for Strathmore House

This inspection was carried out on 30th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Strathmore House 25/11/08

Strathmore House 28/11/07

Strathmore House 12/12/06

Strathmore House 08/05/06

Strathmore House 31/01/06

Strathmore House 25/01/05

Strathmore House 21/07/04

Strathmore House 11/02/04

Strathmore House 02/12/03

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Strathmore House 27 Queens Park Avenue Dresden Stoke-on-Trent Staffordshire ST3 4AU Lead Inspector David Morgan Unannounced 30 July 2005 10:30 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 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Strathmore House E51-E09 S8255 Strathmore (YA) 29.7.05 v.242593 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Strathmore House Address 27 Queens Park Avenue Dresden Stoke-on-Trent Staffordshire ST3 4AU 01782 596849 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Strathmore Care Services Mrs Maureen Malpass CRH 16 Category(ies) of LD 16 registration, with number of places Strathmore House E51-E09 S8255 Strathmore (YA) 29.7.05 v.242593 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 25 January 2005 Brief Description of the Service: Strathmore Hs is part of Strathmore Care Services which is part of the Craegmoor group. Primarily, it provides long term care for up to 15 younger adults who have learning disabilities. During the week, there is a day care service for up to three people. Currently the age range is 21 to 37 years. The home is centrally located in a suburban area close to local amenities and with easy access to the city. It is also opposite a park. Strathmore House E51-E09 S8255 Strathmore (YA) 29.7.05 v.242593 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection undertaken on a Saturday. The majority of residents were seen and some spoken to in detail. As the manager was on duty covering for another member of staff, part of the inspection was taken-up discussing the previous recommendations. Certain managerial issues were also discussed in detail. During the inspection, activities were ongoing and residents interacted readily with staff. The majority of the building was inspected with the manager and some of it with residents. What the service does well: What has improved since the last inspection? Previous recommendations have been addressed and the requirements are inhand. More independent accommodation has been identified for one resident and increased attention is being paid to moving people on, where it is appropriate. Bedroom privacy has been improved by use of net curtains. The new conservatory is almost complete and plans have been drafted to transfer the office onto the ground floor. Strathmore House E51-E09 S8255 Strathmore (YA) 29.7.05 v.242593 Stage 4.doc Version 1.40 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. Strathmore House E51-E09 S8255 Strathmore (YA) 29.7.05 v.242593 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Strathmore House E51-E09 S8255 Strathmore (YA) 29.7.05 v.242593 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 Needs are appropriately assessed. EVIDENCE: Assessments: Every resident has a plan covering all aspects of his/her care. The format has been reviewed and is being gradually implemented for everyone. This work should be complete by end of August 2005. Strathmore House E51-E09 S8255 Strathmore (YA) 29.7.05 v.242593 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 Greater attention is needed to individual residents’ plans, both to addressing specific issues and recording implementation. Residents have routine opportunities for decision-making and taking reasonable and assessed risks. EVIDENCE: Personal plans: Plans are in place for all residents and a sample of these was case tracked. During the inspection it became clear that residents were familiar with key parts of their own plans. This was reflected in their responses to staff guidance. The files that have been reviewed recently showed accurate and comprehensive attention to detail. However, as was evident during the last inspection, some of the files showed gaps regarding important behavioural issues. It is important that negative behaviours are not accepted and that action plans are implemented to address them. This may require specialist input. Strathmore House E51-E09 S8255 Strathmore (YA) 29.7.05 v.242593 Stage 4.doc Version 1.40 Page 10 Also, it was not evident in every case how plans/goals had been implemented. The inspector agreed a plan for implementation of goals as follows: 1. existing plans will be kept up-to-date by senior staff so that no more gaps appear in recording 2. the new format will be fully implemented by the end of August for all residents 3. staff will be trained (in-house) in the new format 4. key workers will maintain the new formats to evidence implementation of plans Decision-making: Residents are encouraged to make decisions. This was evidenced in practice during the inspection. Staff provide assistance in decision-making and advocates are obtained, as necessary. Previous inspections have addressed this, and participation by residents, in more detail. Risk taking: Residents are encouraged and facilitated to maximize their involvement in the community, e.g. by taking jobs and competing in sports, and this automatically involves a degree of risk. Risk assessments are compiled so that the likelihood of harm is reduced via, for example, training. Strathmore House E51-E09 S8255 Strathmore (YA) 29.7.05 v.242593 Stage 4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 14, 15 Residents pursue a wide variety of leisure activities. Staff support appropriate relationships both inside and outside the home. EVIDENCE: Leisure: Residents reported enthusiastically about their attendance at the recent Special Olympics where some won medals. This was a major achievement for all concerned. They also told the inspector about a holiday in Cornwall that five had attended. Individual pastimes are also pursued. Residents are also undertaking training courses including manual handling and food safety; this is good practice and more residents will attend in the future. Relationships: Residents told the inspector about two engagements between residents and people from outside the home. These announcements were being handled positively by staff and appropriate training about relationships was being reviewed. Liaison with other parties such as parents was also in hand. Strathmore House E51-E09 S8255 Strathmore (YA) 29.7.05 v.242593 Stage 4.doc Version 1.40 Page 12 Relatives are routinely welcomed by staff, as occurred during the inspection. Meals: Food was not inspected on this occasion. However, residents were observed assisting with their lunches and routinely helping themselves to drinks. Strathmore House E51-E09 S8255 Strathmore (YA) 29.7.05 v.242593 Stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 Health care issues are addressed sensitively and thoroughly. EVIDENCE: Healthcare: Residents were reported to be in good general health. Specific issues that arose were discussed with the manager. It was clear that close attention is provided when necessary and that residents are helped to participate fully in decision-making. Staff also involve themselves in advocating residents views to other professionals in order to achieve the best outcomes. Other professionals are used as necessary. Medication: Medication was not inspected on this occasion. Strathmore House E51-E09 S8255 Strathmore (YA) 29.7.05 v.242593 Stage 4.doc Version 1.40 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 Liaison with other agencies is in place. Further staff training is required regarding Guardianship. EVIDENCE: Complaints: This was not inspected in detail. The inspector understands there have been no complaints since the last inspection. An issue has been raised by a placing authority about which the manager is compiling a report to the inspector. Protection: Protection was not inspected in detail. However, several relevant matters were discussed. The manager reported that she has made contact with the local police and that the community police officer visits occasionally. This is good practice because it means that the police are familiar with the home and residents should an issue arise. Guardianship orders apply to residents from time to time. It was recommended last time that appropriate information be available to staff. The manager has obtained some information but insufficient to properly inform staff about their rights and responsibilities. This should be revisited, e.g. obtaining, and acting upon, a copy of the Mental Health Act guidance. Strathmore House E51-E09 S8255 Strathmore (YA) 29.7.05 v.242593 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 27 The house is generally well presented and improvements are underway. Attention is required to several health and safety issues that should have been identified in routine auditing. EVIDENCE: Accommodation: All areas of the house were inspected except the cellar, which includes the laundry. In general, it was well presented, clean and tidy. Residents participated in keeping communal areas tidy. Although the conservatory is not yet complete, the manager has identified that the threshold is too high and poses a tripping hazard; this must be addressed. Quotes have been obtained for certain radiators to be covered and this work will be completed in the near future. The staff workstation near the conservatory will soon move into a bedroom (and the bedroom will move to the existing office). Bedrooms: A sample of bedrooms was inspected. These were satisfactory in most respects. Partial net curtains had improved privacy in those rooms that required them. Residents are involved in cleaning and keeping their bedrooms tidy, with staff support if needed. Strathmore House E51-E09 S8255 Strathmore (YA) 29.7.05 v.242593 Stage 4.doc Version 1.40 Page 16 Bedroom number 1 had a strong smell of damp and this must be addressed as a priority as it may pose a health risk. Previous efforts to address the problem have been unsuccessful. The manager said that it would be addressed within a fortnight. In fact the problem should have been reported sooner as staff were aware that it had not been resolved. Routine auditing should address such issues. Shelving had been made secure in one bedroom since last time. However, lower shelves in the same room were fully stocked and presenting a risk of falling over; this should be addressed. Bathrooms were satisfactory. One was particularly bare and could be improved by residents and staff, possibly by use of mirrors and other wall fittings. Sealants around bath and sinks must be reviewed because several have deteriorated to the point that they are ineffective and potentially unhygienic. Toilet seats must also be reviewed because several were loose. The manager reported that this is an ongoing problem. If this is the case, then they must be routinely checked. Strathmore House E51-E09 S8255 Strathmore (YA) 29.7.05 v.242593 Stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Staffing levels and training are sufficient to meet the needs of residents. EVIDENCE: Staffing levels: Three staff are on duty in the day; this is adequate to meet the needs of residents. The manager keeps the overall dependency levels of residents under review and arranges higher staffing levels if needed. The manager is supported by two seniors who have some managerial tasks. The home is fully staffed and recently two male members of staff have been employed. This helps to balance the team and is an asset to residents. Staff training: The manager reported that all staff are undertaking NVQ 3; this is good practice. Induction training for new staff has been completed. The organisation uses its own induction training programme rather than LDAF. A distance-learning course is used for medicine administration training. Training in autism and epilepsy is due soon for all staff and will form part of routine training for all staff. Strathmore House E51-E09 S8255 Strathmore (YA) 29.7.05 v.242593 Stage 4.doc Version 1.40 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39 The home is appropriately run. Recommendations were made regarding management issues such as auditing and delegation. Safety issues are addressed correctly. EVIDENCE: Management: The manager runs the home effectively and largely independently of the organisation; this is to her credit. There is a pleasant and open atmosphere in the home in which information is readily shared and from which residents benefit. The manager is undertaking the registered managers award and should complete it later this year; this will be followed by the NVQ 4 in care. The inspector has discussed delegation of tasks to senior staff with the manager on several occasions and this has started to occur. This will help with the professional development of senior staff and also allow sharing of Strathmore House E51-E09 S8255 Strathmore (YA) 29.7.05 v.242593 Stage 4.doc Version 1.40 Page 19 responsibilities. The manager will then audit compliance, e.g. in supervision and by checking practices. This will require the manager to develop a role that is more strategic than at present. These skills are also compatible with those required of an effective leader. Issues were discussed with the manager that highlighted the need for attention to this matter so that staff are appropriately guided and standards and conduct are maintained at the required levels. The manager should consider devising a simple strategy to address issues of leadership, auditing and delegation that can then be shared with staff as appropriate. Quality assurance: Monthly checks are completed by the area manager and are copied to the inspector. Standard 39 also places a responsibility on the manager to monitor quality and Regulation 24 requires that any such report is also copied to the inspector. This issue should be reviewed by the manager. Certain issues arose regarding the accommodation (above) that should have been noticed in routine auditing either by the manager or the area manager. This is related to the quality assurance mentioned here. Safety: Routine safety checks and measures are understood to be in place. Fire safety records were inspected and found to be satisfactory. It is understood that the organisation has undertaken a fire risk assessment. The manager reported that water safety checks have been completed again recently. Radiator safety is mentioned above. Strathmore House E51-E09 S8255 Strathmore (YA) 29.7.05 v.242593 Stage 4.doc Version 1.40 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 2 x 3 x x x Standard No 11 12 13 14 15 16 17 x x x 3 3 x x Standard No 31 32 33 34 35 36 Score x 3 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Strathmore House Score x 3 x x Standard No 37 38 39 40 41 42 43 Score x 2 2 x x 3 x E51-E09 S8255 Strathmore (YA) 29.7.05 v.242593 Stage 4.doc Version 1.40 Page 21 yes Are there any outstanding requirements from the last inspection? 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 6; 23.5 Regulation 15 Requirement All significant behavioural issues must be addressed in care plans. This matter is outstanding from the last inspection Staff must record how individual residents goals have been addressed Appropriate guidance must be available to staff regarding Guardianship The threshold to the conservatory is too high and poses a tripping hazard; this must be addressed. Bedroom number 1 had a strong smell of damp and this must be addressed as a priority Bathrooms must be routinely checked to ensure that standards are being maintained. Waterproof sealant must be renewed where necessary and toilet seats made secure. The manager must establish a system for reviewing and improving the quality of care. Timescale for action 14.8.05 2. 3. 4. 6.1 23 24 15 18(1) 13(4)a 30.8.05 30.8.05 14.8.05 5. 6. 25 27 13(4)c 13(4) 14.8.05 30.8.05 7. 39 24 30.9.05 Strathmore House E51-E09 S8255 Strathmore (YA) 29.7.05 v.242593 Stage 4.doc Version 1.40 Page 22 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. 3. Refer to Standard 25 27 37 Good Practice Recommendations Shelving in one bedroom should be reviewed and possibly secured to prevent risk of injury if it falls over. Residents and staff should consider how to improve the presentation of one bathroom. The manager should consider devising a simple strategy to address issues of leadership, auditing and delegation that can then be shared with staff as appropriate. Strathmore House E51-E09 S8255 Strathmore (YA) 29.7.05 v.242593 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Stafford - Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Strathmore House E51-E09 S8255 Strathmore (YA) 29.7.05 v.242593 Stage 4.doc Version 1.40 Page 24 - 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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