Inspection on 31/01/06 for Strathmore House

This inspection was carried out on 31st January 2006.

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 no outstanding requirements from the previous inspection report, but made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

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 30/07/05

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 Queen’s Park Avenue Dresden Stoke-on-Trent Staffordshire ST3 4AU Lead Inspector Katie Claffey Unannounced Inspection 31 January 2006 11:00 Strathmore House DS0000008255.V278920.R01.S.doc Version 5.1 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 Strathmore House DS0000008255.V278920.R01.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 Adults 18-65. 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. Strathmore House DS0000008255.V278920.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Strathmore House Address 27 Queen’s Park Avenue Dresden Stoke-on-Trent Staffordshire ST3 4AU 01782 596849 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) Strathmore Care Services Mrs Maureen Malpass Care Home 16 Category(ies) of Learning disability (16) registration, with number of places Strathmore House DS0000008255.V278920.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th January 2005 Brief Description of the Service: Strathmore House is part of Strathmore Care Services, which is part of the Craegmoore 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 DS0000008255.V278920.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection where a majority of residents where spoken to. The manager was not there however the inspector spoke to various members of the care team and a senior member of the care team in great length. The building was inspected with another inspector. During the inspection the residents returned home after attending an external activity organised by the home and the residents readily interacted with the inspectors and the staff team. What the service does well: What has improved since the last inspection? Previous recommendations and requirements have been addressed. Staff members are now being given more responsibilities at the home by taking on new extended roles. The general environment of the home has improved by the staff including tile decorations in the bathroom. Strathmore House DS0000008255.V278920.R01.S.doc Version 5.1 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 DS0000008255.V278920.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Strathmore House DS0000008255.V278920.R01.S.doc Version 5.1 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 the following standard(s): 2 Needs are appropriately assessed. EVIDENCE: Assessments: Every resident has a plan covering all aspects of his/her care, which is reviewed on a regular basis. Strathmore House DS0000008255.V278920.R01.S.doc Version 5.1 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 the following standard(s): 6,7,8,9 Residents have routine opportunities for decision-making, however, greater attention should be taken on how the decisions are made and then offering more varied options. Residents are routinely encouraged to take risks as part of an independent lifestyle. EVIDENCE: Decision-making: Residents are encouraged to make decision. This was evidenced in practice during the inspection. However it was not evident during the inspection that greater care was taken to ensure the decision making process was not done with closed questioning. Also the inspector felt that the options available were restrictive. To further support this one member of staff felt that the decision making process could have been carried out better with a wider variety of options for the residents to choose from, e.g. regarding holidays. Strathmore House DS0000008255.V278920.R01.S.doc Version 5.1 Page 10 Personal plans: The previous recommendation to keep care plans up to date and the new format has been fully implemented. This appears to be working well with residents having greater involvement in their plan. Risk taking: Residents are encouraged and facilitated to maximise their involvement with the community, including competing in organised sports and attending local events independently of the home. Risk assessments are compiled so that the likelihood of harm is reduced. Residents being encouraged to be more productive around the home further evidenced this and any difficulties were being addressed, reflected on and adapted Strathmore House DS0000008255.V278920.R01.S.doc Version 5.1 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 the following standard(s): 14,15 Residents pursue a wide variety of leisure activities. Staff supports appropriate relationships both inside and outside the home. EVIDENCE: Leisure: Residents reported enthusiastically about their attendance at the football. It was evident a lot thought had been taken for each activities residents were pursuing. For example on their return from football the residents had new football shin pads and staffed talked enthusiastically about the forthcoming coming training they where going to take to train them as football couches. The record keeping done did not always reflect all activities and missed the smaller but still significant leisure pursuits the residents did. Relationships: Resident and staff also talked about the engagement between residents and people from outside the home. These relationships were being handled positively by staff. Liaison with other parties such as parents was also in hand. Strathmore House DS0000008255.V278920.R01.S.doc Version 5.1 Page 12 Meals: Food was not inspected on this occasion. However, residents were observed routinely helping themselves to drinks and food. Strathmore House DS0000008255.V278920.R01.S.doc Version 5.1 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 the following standard(s): 19,20 Health care issues are addressed sensitively, safely and thoroughtly. EVIDENCE: Healthcare: Residents were reported to be good general health. Specific issues that arouse were discussed with staff. It was clear that close attention is provided when necessary and those residents are helped to participate fully in decision-making. Staffed ensured that any necessary health care appointments where attended by the resident, and staff involved themselves in advocating resident’s views to other professionals in order to achieve the best outcomes. Medication: Records of the medication in the home were maintained accurately including the residents who were self medicating. However it was advised that a separate bound book for the recording of controlled drugs is needed to prevent the possibility of tampering. Also the storage of the medication including controlled drugs was not satisfactory and this was rectified at the time of the inspection. The home was obtaining a new supplier of their medication who was going to site a more satisfactory storage unit at the home. Strathmore House DS0000008255.V278920.R01.S.doc Version 5.1 Page 14 Some thought has been given to data sheets on a variety of medications for easy access for staff of the side effects and contraindications of these medications. However, it was felt by the inspector, that these should be more detailed and would require some further work by staff. Strathmore House DS0000008255.V278920.R01.S.doc Version 5.1 Page 15 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 the following standard(s): 23 Staff are aware of the complaints procedures but the complaints record should be improved. EVIDENCE: Complaints: There is currently one complaint, which is being investigated by the management team. Although the complaints procedure is being followed and actioned appropriately, the inspector was concerned about the pressure that this appeared to be putting on the manager in particular. The manager was not on duty during the inspection and the inspector pursued this with the area manager subsequently. It was also identified that the resident involved in the complaint did not have an advocate to assist in representing his or her views. It was recommended by the Inspector that an advocate be arranged as soon as practicable. The complaint record did not follow a clear format and was not signed-off by the area manager; these matters should be addressed. Protection: Protection was not inspected in detail. However all relevant training was up to date and satisfactory. Strathmore House DS0000008255.V278920.R01.S.doc Version 5.1 Page 16 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 the following standard(s): 24,25,27,30 The house is generally well presented with individual residents rooms reflecting the personality and taste of the resident. 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. In general, it was presentable, clean and tidy. Residents participated in keeping communal areas tidy and other domestic chores. The conservatory is now completed however, is still unusable as there is no heating installed. Management staff are aware of this and are addressing the issue. The relocation of the office downstairs and the changing of the existing office into a bedroom have not been completed as yet. The inspector discussed with staff of the need for a thorough risk assessment for the resident who may get the new bedroom because of its location. Bathrooms: Significant improvement has been made to the bathrooms to make them more comfortable and hygienic. Clean towels and soap were available in every bathroom. However, the over-ride on one W/C was broken and the main bathroom light was not working. This was addressed at the time of inspection. Strathmore House DS0000008255.V278920.R01.S.doc Version 5.1 Page 17 Bedrooms: A sample of the bedrooms where inspected. These where satisfactory in most respects. The bedrooms reflected the residents personal tastes and where fitted with some of the residents own belongings making them individual and comfortable. Residents are involved in cleaning and keeping their bedrooms tidy, with staff support if needed. Issues raised in previous inspection had been addressed satisfactorily. Strathmore House DS0000008255.V278920.R01.S.doc Version 5.1 Page 18 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35 Staff training was not inspected in detail but it was identified that behaviour management training is necessary for all staff. EVIDENCE: Staffing. This area was not inspected in detail. At the time of inspection, there were three staff on duty and this was sufficient to meet the needs of residents. Staff training. Staff reported on various training they had undertaken recently including Makaton and fire safety. NVQ-assessments are occurring for most staff. This was not inspected in detail. However, it was reported that the training on managing challenging behaviour (CPI) had been cancelled. This is important and necessary for all staff and must be rearranged. Strathmore House DS0000008255.V278920.R01.S.doc Version 5.1 Page 19 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37; 41; 42 There are concerns about the management of the home which are being addressed by the organisation. Computer record management is unsatisfactory as they cannot be accessed by all staff and the inspector. Fire safety measures are satisfactory but improvements are needed to recording and other matters. EVIDENCE: Management. This report highlights some areas of concern that the inspectors felt represented a deterioration of standards. There have been some managerial issues which the organisation are currently addressing and these will be reported on in more detail next time. In the meantime the organisation must keep the inspector up-to-date with developments. The inspectors understand that a resident from another home was admitted to Strathmore House in the Christmas holidays and used the bedroom of an Strathmore House DS0000008255.V278920.R01.S.doc Version 5.1 Page 20 absent resident. This is not acceptable and must be investigated by the manager. The manager must submit an application to CSCI for the change in use of two rooms. This will allow the workstation in the hallway to be removed as mentioned in previous reports. Records. Most records are appropriately stored and are accessible to residents. However, the inspectors found that some staff could not access computer records. This must be addressed so that staff and the inspectors can access appropriate records. Health and safety. Fire safety records were inspected but the attention to detail had deteriorated. The following issues require attention: a) the risk assessment by a contractor on 14.7.05 must be fully implemented, b) the fire drill record should clearly show who attended and what the drill entailed: a matrix of staff names and attendance is recommended, c) bell tests should be by weekly checks of the break glass points in rotation, d) the record should be checked and signed by the manager. Accident records are being used but not filed appropriately. Sheets should be filed and a log created for auditing purposes. An accident had occurred with an iron and a resident had received a minor burn but there was no indication that a risk assessment had occurred or that the location used for the ironing (in a corridor) was satisfactory; this must be addressed forthwith. The inspector understands from the deputy manager that radiator covers have not been installed where assessed as necessary. This has been outstanding for some years and must be addressed immediately. Strathmore House DS0000008255.V278920.R01.S.doc Version 5.1 Page 21 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 X 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 2 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 2 X 2 X X X X 2 X Strathmore House DS0000008255.V278920.R01.S.doc Version 5.1 Page 22 No 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 2 3 4 5 6 Standard YA24 YA24 YA20 YA37 YA35 *RQN Regulation 13(4)a 13(4) 17(1)a 9 18 9 Requirement Fix light fitting in upstairs bathroom W/C lock override must operate correctly Obtain a controlled drugs bound book and lock medication in a more appropriate unit The organisation must keep the inspector up-to-date with managerial developments. CPI-training must be rearranged. Use of an allocated bedroom by another person is not acceptable and must be investigated by the manager. The manager must submit an application to CSCI for the change in use of two rooms. A risk assessment of ironing arrangements must occur following the recent accident. (Computer) records must be available for inspection. Radiator covers are necessary in some places. THIS REQUIREMENT IS OUTSTANDING FROM PREVIOUS INSPECTIONS Timescale for action 31/03/06 31/03/06 31/03/06 31/03/06 31/03/06 31/03/06 7 8 9 10 YA37 YA42 YA41 YA42 9 23(4) 17(3)b 13(4)c 31/03/06 31/03/06 31/03/06 31/03/06 Strathmore House DS0000008255.V278920.R01.S.doc Version 5.1 Page 23 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 4 5 6 7 8 Refer to Standard YA8 YA14 YA41 YA36 YA41 YA20 YA36 YA42 Good Practice Recommendations Greater variety of holiday options tailored more to individuals is recommended More detailed daily activities sheets are necessary to reflect activities particularly for residents with specific needs All record taking/monitoring should not be filled in pencil Supervision of staff should be more stimulating and shard with other senior staff to make supervision a more productive and useful tool Accident/incident matrix is recommended to record any trends or patterns Expand existing medication data sheets (medication profiles) to make this a more useful tool in safeguarding medication administration Training matrix recommended to easily identify individual team member training needs The following fire safety issues require attention: a) the risk assessment by a contractor on 14.7.05 must be fully implemented, b) the fire drill record should clearly show who attended and what the drill entailed: a matrix of staff names and attendance is recommended, c) bell tests should be by weekly checks of the break glass points in rotation, d) the record should be checked and signed by the manager. The complaint record should follow a clear format and be signed-off by the area manager. Accident sheets should be filed and a log created for auditing purposes. 9 10 YA23 YA42 Strathmore House DS0000008255.V278920.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Stafford Office 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 DS0000008255.V278920.R01.S.doc Version 5.1 Page 25 - 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. 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