Inspection on 11/10/05 for Stronvar

This inspection was carried out on 11th October 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 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

Stronvar 25/04/07

Stronvar 06/06/06

Stronvar 29/11/04

Stronvar 07/07/04

Stronvar 04/03/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Stronvar Strangers Corner Church Road Brightlingsea Essex CO7 0QT Lead Inspector Kay Mehrtens Final Unannounced Inspection 11th October 2005 11:30 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 Stronvar DS0000017945.V256068.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 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. Stronvar DS0000017945.V256068.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Stronvar Address Strangers Corner Church Road Brightlingsea Essex CO7 0QT 01206 304007 01206 304007 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) Mr Edward Nigel Edwards Mrs Vera Patricia Edwards Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places Stronvar DS0000017945.V256068.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Stronvar is a residential care home for 16 people over the age of 65 and is situated in a residential area of Brightlingsea in the county of Essex. The home is on bus routes both to the local amenities in Brightlingsea and to the town of Colchester. The home provides single accommodation throughout with 9 rooms offering en-suite facilities and the remainder of the rooms have hand-washing facilities. There are two lifts to the first floor, one being a stair lift. Communal areas include a large dining area and a comfortable lounge. Outside there is a well maintained garden. The home has parking facilities to the front of the property. Stronvar DS0000017945.V256068.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 that took place on the 11th October 2005, lasting 6.5 hours. The inspection process included: discussions with the owner, new manager, senior carer, and eight care staff, ten residents and six relatives. The premises were inspected, including the grounds. Samples of records and residents care plans were inspected. The inspection covered fourteen standards. The home was clean and well maintained. The newly appointed manager approached the inspection in a positive and cooperative manner that was focused on achieving best practice to meet the needs of the residents. The inspector also had the opportunity to meet with the registered owner and discuss issues with regard to night staff training, the need to register the provision of day care services and give positive feedback regarding the input into the inspection by the new manager. The inspector was made welcome throughout the inspection and would like to thank the residents, manager and staff for their hospitality. What the service does well: Stronvar is a small, family run home that provides residents with a caring and friendly environment. The residents and their visitors spoke very highly of the staff and the care provided. They liked the family atmosphere and the location of the home, as it tends to be used by local residents in the Brightlingsea area. The home does benefit from a caring committed staff group, with close links to the owner, under the positive management of a recently appointed manager. Stronvar DS0000017945.V256068.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: There was little evidence of a planned programme of staff training especially with regard to National Vocational Qualification (NVQ) level 2. The home is well below the required standard of qualified staff up to NVQ level 2. The level of staff training, in other areas relevant to the resident group, was also below standard. The standard of assessments and care plans was poor. The new manager was aware of these shortfalls and hoped to develop staff training on these topics after and audit of the care files. This will be monitored at future inspections. Whilst the home is well staffed, during the day, there was little evidence of any planned activities, trips and outings for residents. Some residents commented this upon and the new manager was aware of the need to increase the level of activities for residents. Please contact the provider for advice of actions taken in response to this Stronvar DS0000017945.V256068.R01.S.doc Version 5.1 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Stronvar DS0000017945.V256068.R01.S.doc Version 5.1 Page 8 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 Stronvar DS0000017945.V256068.R01.S.doc Version 5.1 Page 9 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 and 3 The home’s Statement of Purpose does not reflect the care services provided. Assessments did not provide sufficient detail and information. EVIDENCE: The inspection highlighted the provision of day care services for a limited number of service users. The owner and new manager were advised to make an application to add a condition to their registration in order to continue to offer the service to the current service users. They were aware of the need to ensure that adequate staffing levels are maintained in the home to meet the needs of the residential and say care service users. The Statement of Purpose will need to be amended to reflect any changes to the homes’ registration. The care files sampled indicated that poor information, about residents, was gathered prior to their admission to the home. When areas of concern and needs were highlighted there was no evidence of appropriate or adequate risk assessments. For example, one resident was admitted with several, clearly diagnosed, physical health needs that were not recorded or noted in sufficient Stronvar DS0000017945.V256068.R01.S.doc Version 5.1 Page 10 detail. This in turn led to poor care plans and identified actions to meet their needs. The inspector was concerned to see some recording about a residents’ personality that was clearly inappropriate, subjective and judgemental in content. The member of staff concerned had made a medical judgement, without any professional qualification and there comments were also very dismissive and offensive in content. The new manager was advised to reassess some residents and ensure than their records were written in a professional manner. Stronvar DS0000017945.V256068.R01.S.doc Version 5.1 Page 11 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, 9 and 10 Care plans did not provide enough information to assist staff in meeting the needs of residents. The administration of medication was not satisfactory. Residents are treated with respect. EVIDENCE: Several care plans were sampled. The standard of the plans was very poor. The new manager informed the inspector that she was aware of the poor standard of the current care plans. She had recognised the need to review the plans and develop staff training in this area. The sampled plans contained insufficient information to enable the staff to meet the individual needs of the residents. They did not address the social and emotional needs of the residents. One plan contained inappropriate recording, by a senior staff member, about one residents’ mental health and spiritual Stronvar DS0000017945.V256068.R01.S.doc Version 5.1 Page 12 needs. The inspector noted that some information was written on scraps of paper and not transferred to a working care plan. This included information about resident’s health and mobility difficulties. For example, there was no care plan or monitoring records about one residents’ recent eye operation, or the need to monitor their diabetes. There was no evidence of risk assessments with regard to residents’ mobility. For example, one residents’ assessment stated the need for special equipment to support them but there was no record of this on their care plan or manual handling assessment. Reviews of residents’ care plans and needs were not regular. Information seen, in daily records, regarding changes in residents’ health needs was not added to the care plans so staff were not aware of the changing needs of residents. There was no evidence of residents’ or their representatives input into the care plans or reviews. Daily recording was poor. The records sampled did not reflect the life of the residents in the home especially with regard to their health and social wellbeing. For example, there were many instances of staff just recording “no problem” in residents’ individual records. This gave a very poor picture of the residents’ daily activities, health needs and the effect of staff action on the identified needs of each resident. Charts recording residents’ health and dietary needs were not being used correctly. Staff were not completing them regularly so the information gathered was of little use. The inspector observed the administration of residents’ medication during lunchtime. Senior staff administer medication and the manager informed the inspector that they had received training. However, staff were observed to put medication into pots and place them on tables in front of residents without ensuring that residents had taken their prescribed drugs. The staff were signing the medication administration record (MAR) without ensuring the drugs had been taken. They were not following the homes’ medication procedures or safe practice. The storage of medication was not adequate as there were insufficient lockable drugs trolleys to accommodate the medication. This meant that staff were leaving medication on top of unlocked trolleys which again is not safe practice. The manager recognised the need to ensure that safe practices are maintained and that staff receive refresher training in the administration of medication. The residents commented positively about the staffs’ attitude towards them. They felt that their dignity and privacy were respected. The inspector observed good practice with regard to staff ensuring residents privacy. For example, they were observed to knock on doors before entering a room and ensured that doors were closed when attending to residents’ personal care needs. Stronvar DS0000017945.V256068.R01.S.doc Version 5.1 Page 13 Stronvar DS0000017945.V256068.R01.S.doc Version 5.1 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 and 15 The opportunity for residents to participate in activities is limited. The home is very welcoming of visitors and privacy is respected. Mealtimes are relaxed and pleasant occasions. EVIDENCE: The entrance hall contained information about local events and activities. The majority of the residents come from the local area and told the inspector that they liked to keep in touch with local people and events. They liked the frequent visits from local friends as well as their families. However, they also said that they would like the opportunity to get out more and have more activities on offer in the home. The staff were observed to sit and chat with the residents throughout the day and the residents clearly enjoyed their company. The manager informed the inspector that she felt that activities and events in the home needed to be more varied and hoped to develop training opportunities for staff in this area. Stronvar DS0000017945.V256068.R01.S.doc Version 5.1 Page 15 Relatives and residents were very complementary regarding the hospitality offered whenever they visit. They informed the inspector that they are always made welcome. Residents spoke very highly about the meals at the home. They particularly enjoyed the home cooked biscuits and puddings. The meal served, during the inspection, was well presented and enjoyed by the residents. It was a pleasant, relaxed occasion and residents chatted with staff and amongst themselves. Those residents that needed help with eating were assisted in a respectful manner by the staff. The menu was varied and offered the residents a good choice. Individual wishes and requests were respected. Stronvar DS0000017945.V256068.R01.S.doc Version 5.1 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These standards were not inspected at this inspection and will be monitored at the next inspection. Stronvar DS0000017945.V256068.R01.S.doc Version 5.1 Page 17 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, 24 and 26 Residents are provided with a safe, well maintained and pleasant home. EVIDENCE: The home fits in well with the surrounding area. It provides residents with a cosy and warm environment. The home is well maintained and pleasantly decorated throughout. The garden and grounds are attractive and well maintained. The residents and their visitors were very complimentary about the gardens, much enjoyed during the good weather. The residents are encouraged to bring in their own possessions when moving into the home. Several had clearly personalised their bedrooms and appreciated the support provided in putting up pictures and other personal items. Stronvar DS0000017945.V256068.R01.S.doc Version 5.1 Page 18 The standard of cleanliness was generally good and there was no evidence of any bad odours. Residents and relatives were pleased with the cleanliness of the home. The residents commented positively about the standard of the laundry services. They told the inspector that their clothes were always returned clean and fresh. The residents certainly looked well dressed and presented on the day of the inspection. Stronvar DS0000017945.V256068.R01.S.doc Version 5.1 Page 19 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 and 30 The night staffing procedures need to be reviewed to ensure safe practice and support for residents. The level of staff training is not sufficient to promote current good practice in care. EVIDENCE: Examination of the staff rota and observation during the inspection indicated that the staffing levels are sufficient to meet the needs of the current resident group. There are four staff on duty for the morning shift and three care staff on duty for the afternoon/evening shift. The care staff undertake the domestic duties. The home has one awake night staff carer and one sleep-in carer. In addition, the manager is available during the week and the home employs catering staff. The care plans and manual-handling records of some residents stated that two carers are required to move residents for toileting and other mobility needs. However, there is only one awake carer on duty. The inspector was not clear about the homes’ procedures for using the sleep-in carer, as comments from staff were varied with regard to the contact and use of sleep-in staff. The inspector requested that the provider and manager review the night staffing levels and the procedures for staff with regard to contact and use of the sleepin member staff. Stronvar DS0000017945.V256068.R01.S.doc Version 5.1 Page 20 The home benefits from a stable staff group. The staff were observed to be polite and pleasant when in the company of the residents. The inspector observed many occasions when the staff sat and chatted with the residents, responding to requests for assistance in a discreet and appropriate manner. Residents and relatives spoke very highly of the new manager and staff at the home. They said that they were respectful, helpful and kind. The residents told the inspector that the staff were polite and kind. They said that they felt safe in the home and liked being there as it was full of local people and old friends. The manager and her senior carer were very open and honest with regard to the need to develop staff training. They recognised the lack of sufficient training with regard to National Vocational Qualification (NVQ) level 2, as well as induction and statutory courses. Evidence gathered from the manager and some staff records indicated that only three of the sixteen staff had achieved NVQ level 2. The staff had a poor understanding of the National Minimum Standards and this was not helped by a lack of a copy of the standards for the staff team to access. Examination of residents’ care files and records highlighted the need for staff to receive training with regard to care of people with diabetes. The records showed a lack of understanding, by some staff, about aspects of care practices for people with diabetes. The new manager also recognised the need to assess the competencies of her staff group as part of the process for developing a staff training programme. These issues will be monitored at the next inspection. Stronvar DS0000017945.V256068.R01.S.doc Version 5.1 Page 21 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): 38 Some practices do not ensure that the health and safety of residents are protected. EVIDENCE: Standard 31, with regard to the management of the home, was not fully inspected. The homes’ manager has recently taken up her post. The inspector was impressed by her positive approach to the inspection process. She demonstrated a good understanding of the shortfalls at the home, especially with regard to staff training. This standard and other management standards will be monitored at future inspections. Health and safety issues were well recorded. The new manager was aware of the standard and relevant legislation. The inspection did highlight the need for the manager to undertake a risk assessment of the fire escape stairs/balcony and the external access to them. Stronvar DS0000017945.V256068.R01.S.doc Version 5.1 Page 22 The inspector did observe poor practice by some staff with regard to manual handling procedures. For example, some staff were observed to lift residents under the arms and not use appropriate hoist and equipment. This highlighted the need for all staff, including night staff, to receive the required training in this area. The manager informed the inspector that she had begun to look at staff training, with regard to statutory health and safety issues, and highlighted the need for refresher and additional training for some staff. The staff were observed to be using wheelchairs without the required footrests in place. Stronvar DS0000017945.V256068.R01.S.doc Version 5.1 Page 23 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 2 X 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X X X X 3 X 3 STAFFING Standard No Score 27 2 28 X 29 X 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X 2 Stronvar DS0000017945.V256068.R01.S.doc Version 5.1 Page 24 Are there any outstanding requirements from the last inspection? N/A 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 OP1 Regulation 4 Requirement The registered person must ensure that the home is registered to provide a service for day care service users and that this is reflected in the homes’ Statement of Purpose The registered person must ensure that service users needs are fully assessed and reviewed. The registered person must ensure that care plans are detailed and address all the identified needs of individual residents. The registered person must ensure that medication administration and storage practices are safe and follow the homes’ procedures. The registered person must ensure that residents are provided with a variety of activities to meet their needs. The registered person must ensure that night staff levels are reviewed and meet the needs of the current resident group. The registered person must ensure that all staff, including DS0000017945.V256068.R01.S.doc Timescale for action 05/01/06 2 3 OP3 OP7 14 15 05/01/06 05/01/06 4 OP9 13 05/01/06 5 OP12 16 05/01/06 6 OP27 18 05/01/06 7 OP30 13 05/01/06 Stronvar Version 5.1 Page 25 8 OP30 18 9 OP30 18 10 OP38 23 night staff, receive Manual Handling training and follow safe practice guidelines. The registered person must ensure that staff undertake NVQ training so that the required level of 50 qualified staff is achieved. The registered person must ensure that staff receive training in understanding and working with people with diabetes. The registered person must ensure that risk assessments are undertaken with regard to the fire escape/balcony and external staircase. 05/01/06 05/01/06 05/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Stronvar DS0000017945.V256068.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Stronvar DS0000017945.V256068.R01.S.doc Version 5.1 Page 27 - 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!