Inspection on 24/04/07 for Stroud House

This inspection was carried out on 24th 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 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

Stroud House 05/12/06

Stroud House 07/11/05

Stroud House 12/05/05

Stroud House 21/01/05

Stroud House 21/05/04

Similar services:

Flint House

St Vincents

The Cotswold Home

Fairways

Newbeech House

Winton House

Treloar College

Rush Court

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

CARE HOMES FOR OLDER PEOPLE Stroud House Rothercombe Lane Stroud Petersfield Hampshire GU32 3PQ Lead Inspector Liz Palmer Unannounced Inspection 24th April 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Stroud House DS0000032866.V334598.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. Stroud House DS0000032866.V334598.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stroud House Address Rothercombe Lane Stroud Petersfield Hampshire GU32 3PQ 01730 262657 01730 260689 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) Western Health Care Limited Mrs Irene Patricia Morton Care Home 25 Category(ies) of Dementia - over 65 years of age (12), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (12), Old age, not falling within any other category (25), Physical disability over 65 years of age (6) Stroud House DS0000032866.V334598.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. A total of 12 service users may be admitted in the categories MD(E) & DE(E) at any one time. 13th February 2003 Date of last inspection Brief Description of the Service: Stroud House is a large house on the main road through the village of Stroud, approximately 3 miles from the market town of Petersfield. The home is registered for up to twenty-five older people, some of who may have dementia, mental disorders and/or physical disabilities. Fifteen single and five double rooms are provided. The fees for the home range from £385 to £575, according to assessed needs. Stroud House DS0000032866.V334598.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection included a site visit to the home over a period of five hours. During this time staff and people who live in the home were spoken to and observed. Care plans; medication records, policies and health and safety records were sampled. Other information used to make judgements about the standard of care in the home included eight relatives’ comment cards, two letters from relatives, a visiting professional’s survey and letter and a letter from another visitor to the home. Also returned to the commission were two surveys from people who live in the home. All the surveys were positive and spoke highly of the home. The commission had requested an improvement plan from the home to inform us how they intend to address the shortcomings found at the last inspection. This was viewed during the inspection and was seen to have addressed all the areas highlighted for improvement within the timescales set. The registered manager and general manager assisted throughout the inspection. What the service does well: What has improved since the last inspection? Stroud House DS0000032866.V334598.R01.S.doc Version 5.2 Page 6 Improvements have been made to the process for assessing people who would like to live in the home. This makes sure the home has enough information to guarantee they can meet people’s needs. Files holding information on people who use the service have been restructured to make information easier to find. The storage and paperwork for giving out prescribed medicines has been changed to make it clearer and safer for people who live in the home. 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. Stroud House DS0000032866.V334598.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 Stroud House DS0000032866.V334598.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): 3 (standard 6 does not apply) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service are assessed prior to admission to ensure their needs can be met in the home. EVIDENCE: Four people have been admitted to the home since the last inspection. Assessments were looked at for three of the four. The registered manager undertakes all initial assessments. The home uses a comprehensive form for assessing people and the three seen had been fully completed. Information recorded included details of physical care needs, emotional needs and a pen portrait describing the person, their religious preferences, next of kin, their history, their likes and dislikes including food and hobbies and interests. Stroud House DS0000032866.V334598.R01.S.doc Version 5.2 Page 9 There was evidence of people visiting the home prior to moving in. One person’s records showed they had visited three times, another visit showed they had stayed for a meal. Records of how these visits went were seen. Evidence that families and relevant professionals for example, care managers, were involved in the process was also on record. A requirement was made at the last inspection for all prospective service users to have a full needs assessment prior to admission to the home. The home’s improvement plan states that a full assessment is carried out and reviewed to ensure changing needs are recorded and addressed. The files have been restructured to ensure this information is easily accessible. The evidence seen during the inspection shows that this requirement has been met. Stroud House DS0000032866.V334598.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 good. This judgement has been made using available evidence including a visit to this service. Improvements to the care plans and the arrangements for storing and recording medication promotes consistency in meeting the health and personal care needs of people who use the service. EVIDENCE: Three care plans were looked at. These were drawn up from the initial assessments also seen by the inspector. Care plans followed on from the assessments and were comprehensive in detailing the care required and how people’s needs would be met. The plans included details of people’s social interests and hobbies and preferences were noted with details of how these needs and wishes could be met. People who use the service are all registered with a local General Practitioner (GP). The care plans looked at had details for Stroud House DS0000032866.V334598.R01.S.doc Version 5.2 Page 11 healthcare needs recorded, including any mental health issues. Care plans were reviewed monthly and changes noted. As a result of the requirements made at the last inspection the home has revamped the storage and administration procedure for medication. The care plans, which were stored with the medication are now kept in a locked filing draw beside the new ‘nurses station’. The medication cupboard now has individual named boxes for each person containing any medication not held in pharmacy prepared blister packs. A new safe for storing ‘controlled drugs’ (CD) has been fitted and is secured to the inside of the medication cupboard. A new CD register has also been set up. The home is now recording when ‘as required’ medication is not given; this was a requirement from the last inspection. Records sampled showed that for one person prescribed fortified drinks ‘as required’ this had not been completed. The person’s care plan showed they were eating well and staff confirmed this. There was no negative outcome for the person however; the manager agreed that as this was the new procedure for recording ‘as required’ items then it should be completed in all cases. No other errors or omissions were seen on the records. The comment cards received from relatives all said they were satisfied with the care provided and people who use the service all said they felt well cared for and that staff treat them with respect and respected their privacy. During the inspection staff were observed interacting with people in a positive and respectful way at all times. Those people spoken to on the day said that staff were kind and respectful and respected their privacy. Stroud House DS0000032866.V334598.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. Arrangements for social and leisure activities in the home ensure that people have enough to do and are engaged in activities of their choice. EVIDENCE: People spoken to said they had enough to do. There was evidence of regular activities taking place, arts and crafts, fitness, outings and entertainment in the home. One person spoke about a musical evening that had been held recently where staff and service users had joined in a singsong of ‘old time’ music. People said they could have a newspaper and books and videos were seen around the home. There was documented evidence of people’s hobbies and interests being supported and encouraged. Religious and cultural preferences are recorded and people are supported to attend their place of worship if they wish. The home has a mini bus and people said they often go to the near by town of Petersfield and can request other trips out. People were observed being supported to go into the town during the inspection. Stroud House DS0000032866.V334598.R01.S.doc Version 5.2 Page 13 All eight of the relative comment cards received stated that they were always made welcome in the home and could visit their relative in private. People who use the service confirmed this during the inspection. People who use services are supported to have control over their own money and are generally supported by relatives. People who live in the home said the food was good and there was always enough. The cook was spoken to; he was able to give examples of any special dietary requirements and personal preferences of individuals. He said it was always possible to have an alternative and meal times. Stroud House DS0000032866.V334598.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. The procedures for complaining and dealing with abuse protect the people who use the service. EVIDENCE: People who use the service are all provided with a complaints procedure. Those asked said they knew how to complain and expected their concerns and complaints to be listened to and addressed. Four of the relatives comment cards said they were aware of the complaints procedure and all eight said they had never had to make a complaint. One relative gave an example of a concern they had had regarding their relatives money. They stated that the manager dealt with it immediately and they were satisfied with the handling of it. There have been no formal complaints since the last inspection. Staff are trained in Adult Protection. No allegations have been made. Stroud House DS0000032866.V334598.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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The premises are cleaned and maintained to a standard that promotes the health and safety of service users. EVIDENCE: A tour of the premises was made during the inspection. The home was clean and hygienic throughout. People’s rooms were personalised and the communal areas were homely and comfortable. A requirement made at the last inspection regarding risk assessing call bells has been met and one inaccessible call bell is now accessible. One person spoken to said they did not need to use their call bell but it was always put within her reach just in case. Stroud House DS0000032866.V334598.R01.S.doc Version 5.2 Page 16 Another requirement regarding access to bathrooms has been addressed. A downstairs bathroom, which had previously been used as a staff changing room and storage area, has been refurbished and now there is suitable uncluttered space for people who live in the home to use. A separate room has been created so that staff have their own toilet, hand basin, lockers and space for changing. A small lounge used for people to receive visitors if they wish or as a quiet area has been refurbished since the last inspection and is awaiting a new carpet. Stroud House DS0000032866.V334598.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 good. This judgement has been made using available evidence including a visit to this service. Improvements to the arrangements for recruiting staff protect the people who use the service. The training and support for staff enables them to carry out their roles confidently and competently. EVIDENCE: The three staff spoken to during the inspection were seen to be confident and competent at their jobs. They said they really liked their jobs and were able to describe in detail the care given to individual service users. They spoke highly of the on going training provided including mandatory courses such as, first aid, food hygiene, infection control, health and safety and fire training which are provided to all staff. Other courses undertaken include; dementia, falls, diabetes, medication and adult protection. One staff member said she had asked for bereavement training and the manager was looking in to this for all staff. Staff are supported to undertake National Vocational Qualifications (NVQs). Eight of the twenty staff have achieved level 2, six have achieved level 3. Stroud House DS0000032866.V334598.R01.S.doc Version 5.2 Page 18 A requirement regarding recruitment was made at the last inspection, for Criminal Record Bureau (CRB) checks and Protection of Vulnerable Adult (POVA) checks to be undertaken before staff start working in the home, evidence of this being addressed was seen. Staff were observed interacting in a positive and respectful manner at all times. Two relative comment cards received said they felt safe in the home. A service user spoken to said she felt safe and well cared for. All people met were well dressed, clean and looked well looked after. One relative comment card said that the ‘management and staff were very approachable’ and ‘they always treat her with respect’ All relative comment cards said they were satisfied with the overall care provided. Stroud House DS0000032866.V334598.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, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run and improvements in the areas of care planning and recording of health and safety tests ensure people who use this service are protected. EVIDENCE: The manager has many years experience in managing the home. She has achieved NVQ levels 2, 3 and 4 and the City and a Guilds management qualification. Staff and people living in the home said they thought the home Stroud House DS0000032866.V334598.R01.S.doc Version 5.2 Page 20 was well run and had confidence in the manager. Staff spoke highly of all the management team, in particular the registered manager who they said was ‘a great support’ and they ‘could talk to her if I have a problem’. People living in the home were observed speaking to the manager in a relaxed and friendly way. All the requirements made at the last inspection have been addressed in line with the home’s improvement plan that was submitted to the commission. Some of the requirements made at the last inspection related to one particular service user who is no longer in the home. Through discussion with the manager and general manager it was evident that lessons have been learnt from that and a clear willingness to address any shortcomings was seen. No cash is kept at the home on behalf of people who live there. People who are unable to manage their own money have a relative to support them. The manager stated that in the case of one person who did not have any relatives to support them they involved an advocacy service. Relatives have the option of giving a cheque to the home so they can purchase personal items for people. This cheque is paid into a general account and a running total and details of purchases is kept for the relatives. These records were not looked at during this inspection. The manager stated that this account also holds money fundraised by the home and is used to pay for trips and outings for everyone in the home. Health and safety is maintained in the home via staff training and ongoing testing and maintenance of equipment. A requirement stating records of fire safety tests and maintenance checks must be kept up to date has been met. Records were sampled and seen to be in order. The home has sent out surveys to people who live in the home in the past. They are currently developing a new survey and are planning to publish the results in one of the two yearly newsletters that are sent out to people and their relatives. This is very much a work in progress at the moment; however, the manager is aware of her responsibilities in this area and has agreed to develop the quality assurance systems in the home. The manager stated that relatives are consulted informally and that good and close relationships are maintained between the home and relatives as well as professionals involved in the home. This is evident from the relatives surveys received and the letters of support written to the commission by other visitors to the home. Stroud House DS0000032866.V334598.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 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 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 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Stroud House DS0000032866.V334598.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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 Refer to Standard OP9 OP33 Good Practice Recommendations Medication records should be maintained in line with the home’s procedures at all times. Effective quality assurance should be developed and results made known to those whose opinions are sought. Stroud House DS0000032866.V334598.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Stroud House DS0000032866.V334598.R01.S.doc Version 5.2 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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