Inspection on 25/04/07 for Stronvar

This inspection was carried out on 25th April 2007.

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

Stronvar 06/06/06

Stronvar 11/10/05

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 Neal Cranmer Key Unannounced Inspection 25th April 2007 9:30 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.V340923.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. Stronvar DS0000017945.V340923.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stronvar Address Strangers Corner Church Road Brightlingsea Essex CO7 0QT 01206 304007 F/P 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 Jacqueline Dixon Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places Stronvar DS0000017945.V340923.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 16 persons) To provide day care for one named service user Date of last inspection 6th June 2006 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. Fees for this home are £420.00 per week for all residents, with additional charges being made for hairdressing and chiropody, this information was provided by the registered manager at the time of the field site visit. Stronvar DS0000017945.V340923.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection which took place on the 25th April 2007, which lasted 6 hours, the inspection included a review of evidence provided by people living in the service and staff, two surveys were received from relatives of people living in the home. In addition a range of records were sampled. During the site visit the premises were inspected, including an inspection of the grounds, the home was found to be clean and well maintained. The overall focus of the inspection was the care and the well being of people living in the service, and both they and the staff were welcoming and happy to speak to the inspector. During the course of the inspection all of the key standards were inspected, as well as a number of the remaining standards. The manager and staff approached the inspection in a positive manner that was focused on achieving best practice to meet the needs of the people living in the home. What the service does well: What has improved since the last inspection? Of the requirements from the previous inspection of the service, there is little evidence of any significant improvement, although it was recognised that a number of systems have been put in place, these have yet to be used in an active way. It was recognised that the registered manager is still fairly new in post, and remains committed to moving things forward. Stronvar DS0000017945.V340923.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. The summary of this inspection report can be made available in other formats on request. Stronvar DS0000017945.V340923.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 Stronvar DS0000017945.V340923.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 6. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People looking to move into the home can expect to be provided with the necessary information to enable them to make an informed choice about the home. People living in the home can expect to be provided with a contract relating to their stay in the home. The home has a process for assessing the needs of people prior to their admission to the home. The home does not provide intermediate care. Stronvar DS0000017945.V340923.R01.S.doc Version 5.2 Page 9 EVIDENCE: At the previous inspection the need was identified for the Statement of Purpose and Service Users Guide to be updated, discussion with the registered manager indicated that to date this has not been addressed. The manager spoke of other factors having taken priority over this. Only one of the three files sampled contained a copy of a contract of residency for the person living in the home. There has been no new admissions to the home recently, however there is a comprehensive assessment document in place which contained all of the relevant information necessary to enable a valid judgement to be made about the home’s suitability to meet people’s needs. Intermediate care continues not to be provided by this home. Stronvar DS0000017945.V340923.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, and 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans continue to require further development to ensure that they adequately reflect people’s health and social care needs. People living in the home are protected by the home’s policies and procedures for dealing with medicines. People living in the home can expect that their privacy and dignity will be upheld at all times. EVIDENCE: Discussion with the registered manager indicated that care plans continue to be poor, with few people having any recognisable care plan although it was recognised that they continue to be in the development phase. The manager continued to demonstrate a commitment and enthusiasm to get this change Stronvar DS0000017945.V340923.R01.S.doc Version 5.2 Page 11 right, and make the documents user friendly, she recognised with hindsight that trying to address all sixteen care plans in one go was perhaps an error. All of the people residing at the home are registered with a General Practitioner of their choice, and records pertaining to people’s healthcare needs were maintained well. On the day of the site visit District Nurses were seen visiting the home. Medication records sampled were found to be in order, with no evidence of any omissions, sample signatures of all staff administering medicines were held. Medication storage was good in the home, and overall practice was good at ensuring that people are safely medicated. There were no people living in the home who were self medicating at the time of the fieldwork visit. Observation of staff interacting with people living in the home demonstrated an unhurried and pleasant attitude, two people living in the home who were spoken to, both spoke of the home being lovely, one suggesting that the inspector should “put their name down for a room” adding that it was more like a hotel than a care home. In addition two survey’s received from relatives of people living in the home indicated that people’s privacy and dignity was always met. The atmosphere in the home continued to be “restful, pleasant and homely”. Stronvar DS0000017945.V340923.R01.S.doc Version 5.2 Page 12 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. 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 this service. People living in the home can expect that opportunities for them to take part in social and recreational interest of their choosing will be made available. People living in the home are supported to maintain links with their families and friends. People living in the home can expect to be provided with a diet that is healthy and nutritious, and which is provided in pleasant surroundings. EVIDENCE: The home does not employ an activities co-ordinator, however the manager arranges activities as part of her role, a number of people attend a local luncheon club where they go to play cards (people were seen going out to this club on the day of the visit). Three people living in the home attend the local church, and a representative of the Church visits the home every Month to provide Communion for those who wish it. Stronvar DS0000017945.V340923.R01.S.doc Version 5.2 Page 13 People living in the home continue to be supported to vote, if they wish to do so. Local and national newspapers a brought into the home daily, along with parish magazines. The registered manager spoke of members of the public calling into the home regularly to visit people. The home also provides a variety of in-house activities e.g. Scrabble, Television, cards, bingo and a member of staff was seen sitting with a gentlemen playing a game of scrabble, the interaction was evidently genuine, as evidence by the jovial banter going on between them. The home also provides a small library of books, which is updated monthly by the travelling library service (dates for the libraries visits were seen posted on the notice board). During the course of the fieldwork visit it was noted that there was a constant flow of visitors to the home, who were welcomed and made comfortable during their stay at the home. Discussion with people living in the home evidenced that the food was very good, and that choice of meals was provided, the cook goes round each morning and speaks to people about their choice of meal. Meals were seen to be taken in a very pleasant and homely atmosphere, with table pleasantly laid out. As mentioned in the summary of this report vegetables used in the home are home grown by the proprietor of the home. Stronvar DS0000017945.V340923.R01.S.doc Version 5.2 Page 14 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. 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 this service. People living in the home can be assured that their complaints will be listened to, and acted upon. People living in the home are protected by the home’s practice from the risk of harm and/or abuse. EVIDENCE: There have been no complaints made to the home or the Commission for Social Care Inspection since the last inspection of the home. People living in the home spoken with spoke of feeling able to speak to the registered manager if they had any concerns. The home maintains a complaints log for the recording of any complaints received. All staff have received training in Adult protection, and there has not been any referrals since the last inspection. Stronvar DS0000017945.V340923.R01.S.doc Version 5.2 Page 15 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. 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 this service. People living in the home can be assured that it is safe and well maintained. The home provides in adequate numbers suitable lavatory and washing facilities. People living in the home can be assured that specialist equipment necessary for them to maximise their independence will be made available dependant on their individual needs. Rooms are equipped to meet the individual needs of people, and evidence was seen of personal possessions. On the day of the visit the home was found to be clean and pleasantly kept. Stronvar DS0000017945.V340923.R01.S.doc Version 5.2 Page 16 EVIDENCE: There has not been any change to the fabric of the building since the last inspection. Tour of the premises found them to be pleasantly kept, and the home was clean and tidy throughout, with no signs of any unpleasant odours. The decoration of the home throughout was pleasant and homely. All rooms look out over the grounds and gardens, and were well maintained People spoken with were very complementary about the home. The proprietor continues to take responsibility for all necessary maintenance around the home and garden. The stair lift and lift in the home were both last serviced in August 2006. Stronvar DS0000017945.V340923.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living in the home can be assured that their needs will be met by a staff team who are skilled and competent to meet their needs. The home’s recruitment policies and practice are not sufficiently adequate to ensure that people living in the home are protected. EVIDENCE: Sampling of duty rosters showed there to be for staff on duty in the morning, which comprised of the registered manager, 2 senior carers and 1 care member of staff, the registered managers hours tend to be worked flexibly across a seven day week, of which usually 50 of her rostered hours is operational care (discussion took place around whether this was sufficient to enable them to dispense their management responsibilities, the registered manager was of the view that it was not, this had been discussed with the proprietor of the home who had agreed, subsequently the registered manager will now be reducing her operational hours by a further 25 ). The afternoon shift is covered by 3 members of staff, made up by 1 senior and 2 care staff, there are no domestic staff employed in the home. There are 2 cooks employed who between them cover a 7 day week. Nights are covered by one Stronvar DS0000017945.V340923.R01.S.doc Version 5.2 Page 18 waking night staff, which is supported via on-call. The registered manager spoke of staffing levels being kept under review, dependent on people’s changing needs. The home employs 15 care staff, of whom 2 are qualified at N.V.Q level 2 in care, the manager spoke of a further 4 being in the process of undertaking the award, in addition the kitchen staff are also undertaking an N.V.Q award in Support Services. Recruitment practice at the home had improved a little, the three staff files sampled now all contained copies of current Criminal Records bureau Checks, however overall the recruitment files continued to have some deficiencies, these were discussed with the manager at the time, who was referred to the Care Homes Regulations specifically Regulation 19, Schedule 2 for further guidance. Evidence of training undertaken since the last inspection was generally good, evidencing the following as having taken place since the previous inspection: N.V.Q level 2, food hygiene, manual handling, adult protection, fire safety, medication administration. The registered manager spoke of their looking to develop an on-going rolling programme of development. Stronvar DS0000017945.V340923.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36, 37 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living in the home can be assured that it is managed by a person competent to do so. The home needs to further develop its process for reviewing the quality of its service provision, which is based upon the views of people living in the home. People living in the home can be assured that the home’s accounting processes protect them. The registered person must ensure that staff receive appropriate formal supervision. Record keeping needs to be further developed to ensure that people living in the home are appropriately safeguarded. Stronvar DS0000017945.V340923.R01.S.doc Version 5.2 Page 20 The home’s practice ensures that people’s health and welfare needs are protected and promoted. EVIDENCE: The manager of the service is now registered with the Commission for Social Care Inspection, and continues to demonstrate a good understanding of the role, along with an enthusiasm to move the service forward. One relative’s survey received, when asked what the service did well responded by saying “Stronvar makes people feel that it is their home. They treat people as individuals and give them respect, they care”. Discussion with people living in the home would suggest that they do benefit from the management ethos, feeling that the registered manager was readily approachable. Some work has now been commenced on developing the home’s quality assurance process, although further development is required, this was discussed with the manager at the time of the visit. Only seven people living in the home have money maintained on the premises on their behalf, two of the records were sampled and found to be in order. A separate notebook is maintained for each person, which details all expenditure, invoices and bills are maintained individually with each notebook. Discussion with the registered manager evidenced that a Performa is now in place for staff’s formal supervision, although to date this has not yet been implemented. The manager was aware of the need to ensure that all policies and procedures were written and reviewed as necessary. The home’s safe working practices were sampled through the viewing of the following safety certificates, which were current and in order: Gas safety certificate, Portable appliance testing, electrical installation certificate, Hydraulic power lift inspection report, Stair lift, Bath hoist, Mobile hoist. Stronvar DS0000017945.V340923.R01.S.doc Version 5.2 Page 21 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 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 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 2 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 3 3 2 3 3 Stronvar DS0000017945.V340923.R01.S.doc Version 5.2 Page 22 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, 13 (4b-c), Schedule 3(1b) Requirement The registered person must ensure that care plans are detailed and address all the identified needs of individual residents. (previous timescales set were not met) The registered manager must ensure that the statement of purpose is current and contain all required information. (previous timescale set was not met). The registered person must ensure that all resident care plans are regularly reviewed. (This would normally be on a monthly basis.) The registered person must ensure that staff undertake NVQ training to ensure resident needs are met. (Timescale of 05/01/06 not met.) (previous timescale set was not met). Timescale for action 31/07/07 2. OP1 4 31/07/07 3. OP7 15(2b-c), Schedule 3(1b) 31/07/07 4. OP28 18(1), Schedule 2(4) 31/07/07 Stronvar DS0000017945.V340923.R01.S.doc Version 5.2 Page 23 5. OP29 19, Schedule 2. The registered person must ensure that a robust recruitment process is maintained which ensures that all of the documentary evidence required under Regulation 19, Schedule 2 of the Care Home’s Regulations are maintained. The registered manager must complete a quality assurance plan for the improvement of the service. (The previous timescale set was not met). The registered manager must ensure that all staff receive regular supervision. (The previous timescale set was not met). The registered person must ensure that risk assessments are carried out throughout the home. (The previous timescale set was not met). 31/07/07 6. OP33 24(1-3) 31/07/07 7. OP36 18(2) 31/07/07 8. OP38 12 31/07/07 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 The registered manager should make sure that all staff understand and use resident care plans to direct their care. The registered manager should make sure that all individual risk assessments are contained in the care plans and reviewed regularly. DS0000017945.V340923.R01.S.doc Version 5.2 Page 24 2. OP7 Stronvar 3. OP27 The registered person must ensure that night staff levels are regularly reviewed to meet the needs of the current resident group. The registered person should enable care staff to undertake National Vocational Qualification training so that 50 of care staff are trained to level 2 or above. The registered manager should sort and tidy all personnel files. The manager should ensure that each member of staff has supervision on a minimum of six occasions a year. The manager should ensure that policies & procedures are reviewed at least yearly. 4. OP28 5. 6. 7. OP29 OP36 OP37 Stronvar DS0000017945.V340923.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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.V340923.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!