Inspection on 21/09/06 for Stuart House

This inspection was carried out on 21st September 2006.

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

Stuart House 17/09/07

Stuart House 07/02/06

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

CARE HOMES FOR OLDER PEOPLE Stuart House 12 - 14 Eastbourne Road Hornsea East Yorkshire HU18 1QS Lead Inspector Diane Wilkinson Unannounced Inspection 21st September 2006 09:45 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 Stuart House DS0000065228.V313063.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. Stuart House DS0000065228.V313063.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stuart House Address 12 - 14 Eastbourne Road Hornsea East Yorkshire HU18 1QS 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) 01964 534011 Ian Bernard James Margaret James Johanne Thorley Care Home 19 Category(ies) of Dementia - over 65 years of age (19), Old age, registration, with number not falling within any other category (19) of places Stuart House DS0000065228.V313063.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. On completion of Phase 1 alterations to the premises and subject to confirmation by the CSCI that evidence of compliance with all necessary regulations and standards has been received, the service may provide accommodation for a maximum of 14 (fourteen) persons in the permitted registration categories. On completion of Phase 2 alterations to the premises and subject to confirmation by the CSCI that evidence of compliance with all necessary regulations and standards has been received, the service may provide care and accommodation for a maximum of 17 (seventeen) persons in the permitted registration categories. On completion of Phase 3 alterations to the premises and subject to confirmation by the CSCI that evidence of compliance with all necessary regulations and standards has been received, the service may provide care and accommodation for a maximum of 19 (nineteen) persons in the permitted registration categories. 7th February 2006 2. 3. Date of last inspection Brief Description of the Service: Stuart House is a privately owned care home that is situated in the seaside town of Hornsea. It is registered to provide care and accommodation for nineteen older people, including those with dementia. Information about the home is provided to service users and others in the home’s statement of purpose and service user guide. Fees paid range from £328.80 to £375.30 per week and there is an additional charge for hairdressing and chiropody. On the day of the inspection there were 12 service users accommodated at the home. It is expected that occupancy levels will increase gradually as newly refurbished accommodation comes into use. Communal accommodation is provided in two lounges, a dining room and a conservatory. All private accommodation is provided in single bedrooms. The home is close to the centre of the town and the sea front, and shops and other local amenities are within easy reach. At the rear of the property, there is a landscaped garden that includes a patio area, flowerbeds and a raised pond. This provides a very safe area for service users to sit out in the fresh air or to take a walk. On street parking is available at the front of the home. Stuart House DS0000065228.V313063.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced site visit is part of a key inspection and was undertaken by one inspector over one day; the site visit commenced at 9.45 am and finished at 3.45 pm. This inspection report is based on information obtained from the pre-inspection questionnaire completed by the registered manager, information received by the Commission for Social Care Inspection (CSCI) since the last inspection of the home and from the site visit on the 21st September 2006. The site visit consisted of a tour of the premises and examination of documentation, including three care plans. On the day of the site visit the inspector spoke on a one to one basis with three residents and two care staff, as well as the registered manager. Surveys were sent out to six GP’s and seven health and social care professionals. One was returned from a GP and three were returned from health and social care professionals; the responses were all positive. Comments were fed back to the registered manager (anonymously). On the day of the site visit, four surveys were left at the home to be completed by staff and returned to the inspector: one has been returned. Four relatives were contacted following the day of the site visit, either via telephone or a survey, and all responded. Again, all responses were positive. Comments from discussions with staff and service users, and respondents in surveys, will be included throughout the report (anonymously). The inspector would like to thank service users, staff and the registered manager for their assistance on the day of the site visit, and to all respondents to surveys and telephone calls. What the service does well: A thorough assessment is undertaken for each service user prior to their admission to the home and admission is only agreed if it is felt that the service user’s needs can be met. Staff are well trained and have the skills to care for the varying needs of service users. Service users express satisfaction with the care provided by staff at the home and say that they are encouraged to maintain their level of independence. A relative said, ‘In my view Stuart House is first class’. Service users report that their privacy is respected. Stuart House DS0000065228.V313063.R01.S.doc Version 5.2 Page 6 The communal and private areas of the home are pleasant and bright – the home is furnished and decorated to a high standard and there is a variety of areas where service users can spend the day. Service users and staff express satisfaction with meals provided by the home. A staff member told the inspector that food at the home ‘is brilliant, as everything is fresh’, and a service user said, ‘the food is hot, fresh, tasty and nicely presented’. What has improved since the last inspection? 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. Stuart House DS0000065228.V313063.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 Stuart House DS0000065228.V313063.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Standard 6 not applicable, as the home does not provide intermediate care. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users are provided with the information they need to make an informed choice about where to live, and are only offered accommodation at the home if their assessed needs can be met. EVIDENCE: The records for a newly admitted service user were examined. These evidence that an admission form and a thorough needs assessment have been completed for this service user. However, the assessment form is dated after the service user was admitted to the home and the gathering of information to commence the needs assessment should commence prior to the service user being admitted. The inspector was informed by the registered manager that the service user visited the home prior to any decision being made about admission, and that negotiation took place between hospital staff, district nurses, the GP, the Stuart House DS0000065228.V313063.R01.S.doc Version 5.2 Page 9 service user, the service user’s family and Stuart House staff at the assessment stage, both before and after the service user was admitted to the home. A care plan was obtained from nursing services to assist with this process. Other service users told the inspector that they had looked around the home prior to their admission, and had been given a copy of the service user’s guide. Most staff have recently undertaken training on dementia awareness and this has increased their knowledge of this aspect of care, and further equipped them to care for service users accommodated at the home. Stuart House DS0000065228.V313063.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 at least once during a 12 month period. 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 from evidence gathered both during and before the visit to this service. The health and personal care needs of service users are met in a way that respects their privacy and dignity. EVIDENCE: Three care plans were examined by the inspector. These include information about a service user’s specific physical, emotional and social care needs and are based on information gained from thorough initial assessments. Appropriate risk assessments are in place for such areas as pressure care, nutritional needs and the risk of falls. A service user’s strengths and needs are recorded, as well as any goals for the future. Daily records are in place for each service user and monthly summaries and key worker three monthly summaries are recorded; some of these were not up to date. Care plans had been reviewed via the local authority Social Service Department or by the home. Some review documentation had been signed by service users to indicate that they attended the review and/or agree with the review outcome. The documentation used to formulate care plans varies from file to file and the Stuart House DS0000065228.V313063.R01.S.doc Version 5.2 Page 11 inspector recommends that this be reviewed to provide some consistency. A member of staff told the inspector that they do not have regular access to service user care plans and this needs to be addressed by the registered manager. A relative/friend told the inspector that staff at the home provide excellent care and that service users ‘get quite a lot of attention’, and that their relative/friend is very happy at the home. Another relative said, ‘In my view, Stuart House is first class’. A monitoring form is used to record continence needs and pressure care needs. There is evidence that ‘turn charts’ are used when service users are at risk of developing pressure areas, and that weight charts are used as part of nutritional screening. Pressure care equipment is in place where this is needed. Emotional wellbeing is monitored as well as physical wellbeing and there is a record of contact with GP’s and other health professionals. The registered manager informed the inspector that all service users are discussed at the time of ‘handover’ to ensure that staff are up to date with the current situation, including activities undertaken, visitors seen, medication changes and ‘mood’. A health care professional said, ‘I have been particularly impressed with the care, continuity and support offered to one of my clients who has complex, variable mental health needs, sustaining her in the placement where many establishments would have not’. Medication is stored, administered and recorded appropriately and there are satisfactory policies and procedures in place. A photograph for each service user is attached to medication administration record sheets to aid staff with identification. Staff that administer medication have undertaken accredited medications training and there are training certificates in place to confirm this. There is a list of names at the front of administration records for staff that are trained to administer medication, including a sample signature, to enable records to be checked. Service users informed the inspector that they are treated with respect and that their right to privacy is upheld. Staff receive training on the importance of treating service users with respect as part of their induction training; a Skills for Care induction programme is used by the home. The inspector observed that staff knock on bedroom doors before entering. Service users said that, when they are assisted with personal care, this is done sensitively. All service users have a single room where they can see visitors and health care professionals, and there are private areas of the home where meetings can be held. An additional private area will be provided when the refurbishment is completed. Stuart House DS0000065228.V313063.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 at least once during a 12 month period. 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 from evidence gathered both during and before the visit to this service. Service users are supported to take part in activities both inside and outside of the home, and visitors to the home are made welcome. Meal provision at the home is good. EVIDENCE: Care plans record the lifestyle and leisure interests that service users had prior to their admission to the home. Most of the current service users prefer to spend time in communal areas of the home although some spend most of the day in their bedroom. Communal accommodation is much improved and on the day of the inspection service users were sitting in both lounges and in the conservatory, although they all came together to take part in an activity in the afternoon. One or two of the service users went to sit on the seat in the garden at various times throughout the day, sometimes to have a cigarette and sometimes to enjoy periods of sunshine. Service users are supported to keep in touch with family and friends – a visitor called into the home quickly on the day of the inspection and was obviously known to all staff and service users. Stuart House DS0000065228.V313063.R01.S.doc Version 5.2 Page 13 Any activities that service users take part in and any visitors (or visits out) are recorded in the activities book and this information is cross-referenced to daily diary records. Service users told the inspector that they had enjoyed visits out to Scarborough and to Hornsea Carnival, and that they enjoy playing lotto, dominoes, scrabble and chess (a staff member’s young son calls into the home to play chess with one of the service users). Two service users were playing dominoes when the inspector arrived at the home. Choices about daily living activities are made by residents, and these include getting up and going to bed when they wish and decisions about where to take their meals. One of the service users has been asked to speak to other service users on a regular basis to ask them if they have any concerns or comments, and to feed this back to managers. This service user is happy to take on this role, and informed the inspector that she had done this the previous day and everyone had said that they are happy with the care provided by the home. Another service user told the inspector that she had been asked by this resident if she was happy at the home, and that she has reported that she was. Information about advocacy services is available in the home for service users and others. The inspector observed on the day of the site visit that service users are encouraged to live their chosen lifestyle and that bedrooms reflected the individual’s personality and choices. The registered manager told the inspector that service users have chosen the new carpet and chair covers that are due to be fitted in the lounge. The inspector was informed that the weekly menu is kept in the main lounge and that one of the service users ensures that the correct menu for the week is displayed. There is a record in the kitchen of any special dietary needs of service users and menus are adjusted accordingly; some service users are prepared a ‘soft’ diet. The menu does not record that there is a choice of meal at lunchtimes, although service users told the inspector that they could have something different if they requested it. Service users told the inspector that there is a choice of meal at teatime. The inspector recommends that the menu records a choice of meal every lunchtime, and that staff ensure that service users are made aware of this. A staff member told the inspector that food at the home ‘is brilliant, as everything is fresh’, and a service user said, ‘the food is hot, fresh, tasty and nicely presented’. Stuart House DS0000065228.V313063.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 inspected at least once during a 12 month period. 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 from evidence gathered both during and before the visit to this service. The complaints procedure is understood and used by service users and others. Service users are protected from abuse by the policies and procedures that are in place, and the planned staff training on adult protection will further increase staff awareness. EVIDENCE: The registered manager informed the inspector that there is a copy of the complaints procedure in the service user’s guide, and that every service user has a copy of the guide in their bedroom. A copy was also displayed on the notice board near the front door. A form has been devised to enable complaints to be recorded easily – the inspector recommends that a supply of these forms should be kept with the policy near the front door. Service users told the inspector that they would talk to the registered manager or the care manager, or any other member of staff, if they had a concern or complaint, but all said that they had had no cause to complain. One of the service users has been asked to talk to other service users on a regular basis to check that they are happy with the service provided by the home and she told the inspector that she is happy to take on this role. The inspector checked complaints and comments records held at the home and found these to be a satisfactory record of the complaint, the investigation and any action taken. Stuart House DS0000065228.V313063.R01.S.doc Version 5.2 Page 15 There are appropriate policies and procedures in place that are designed to protect vulnerable service users from abuse. The registered manager recorded on the pre-inspection questionnaire that managers are due to attend Adult Protection ‘Manager’s Awareness’ training in January 2007 and that training has been booked for care staff in November 2007. Evidence of this was seen on the day of the site visit. The registered manager informed the inspector that all staff have been told that they must read the adult protection policies and procedures developed by the home, and that these are then discussed at supervision sessions. The inspector met with two staff on the day of the site visit and both had an understanding of the terms POVA (or adult protection) and whistle blowing. Staff have attended an informal in-house training session with a community psychiatric nurse about dealing with aggressive behaviour, and other informal sessions have been arranged for staff about the specific behaviours of some service users. Stuart House DS0000065228.V313063.R01.S.doc Version 5.2 Page 16 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, 21 and 26 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Service users live in a comfortable and well-maintained environment. The home was clean and hygienic on the day of the inspection, with the exception of one bedroom. On occasions the home has not been made safe for service users and staff whilst building work was taking place. EVIDENCE: The registered manager told the inspector that staff report any faults or repairs needed that they notice throughout their shift and that these are recorded in a maintenance book. The maintenance person then records in the book when these have been rectified. There is a refurbishment programme in place and this is reflected in the conditions of registration recorded in this report. Two single bedrooms are now available for occupation but work is continuing on the new part of the home. The registered providers have notified the inspector that they hope to have ‘a few months break’ before they continue with the Stuart House DS0000065228.V313063.R01.S.doc Version 5.2 Page 17 refurbishment programme, primarily to give service users and staff a period of respite from the disruption of building work. On the day of the site visit, work had commenced on installing the passenger lift. This is being installed in the area occupied by two empty bedrooms so there is minimum disruption to service users. However, the landing area of the first floor was covered in rubble – this was ‘sectioned off’ and made safe at the request of the inspector. This work was expected to last just one day – the access to one bedroom was affected and staff had ensured that the work did not commence until the service user had left their bedroom for the day, and had been reassured by the builders that the work would be finished by the end of the day. Other areas of the building were clean, bright, well furnished and pleasantly decorated. The new conservatory offers ample access to sunlight, as does the landscaped patio and garden area. The new bathroom is now completed and is being used by service users, in addition to the existing bathroom. The new bathroom is large and is well equipped - it provides ample space for staff to assist service users with a wheelchair and/or hoist should this be needed. It is in the part of the building that is still being refurbished so at present service users are only able to access this area of the home when accompanied by a member of staff. Most bedrooms now have en-suite facilities (some of these include a shower) so there are now sufficient bathing facilities to meet the needs of service users. There is an alcove situated outside of the bathroom and this is going to be used as a hairdressing area. Staff said that they ‘will be pleased when refurbishment is finished’. One service user said that they would be pleased when the workmen leave the home, but others said that the refurbishment work had not bothered them at all, and that they liked watching the improvements take place. A new laundry room has been provided at the home. Laundry facilities meet required standards, but there are no facilities for staff to wash their hands to help control the risk of the spread of infection. The registered providers were contacted on the day of the inspection and agreed to have a washbasin fitted as a matter of urgency. The home was clean and hygienic on the day of the inspection and free from strong odours, apart from one bedroom. The inspector asked for the carpet to be replaced in this bedroom and the registered providers agreed to have a new carpet fitted as a matter of urgency. The inspector received a telephone call on the 4th October 2006 to say that the washbasin had been fitted in the laundry room and a new carpet had been fitted in the bedroom concerned. The registered manager informed the inspector in the pre-inspection questionnaire that staff have attended training on infection control during the last 12 months – this was confirmed by staff, and the inspector saw training certificates in staff records. Stuart House DS0000065228.V313063.R01.S.doc Version 5.2 Page 18 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, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. There are sufficient numbers of experienced and qualified staff on duty to meet the diverse needs of service users. Recruitment practices protect service users from the potential to be abused. EVIDENCE: The staff rota records that there are three staff on duty each am, and three staff on duty pm (apart from a short period mid afternoon when there are only two staff on duty). There are two night staff on duty; one ‘waking’ and one ‘sleeping’. A domestic assistant is employed for three mornings per week and a handyman is now employed. Care staff are currently preparing meals as there is no cook employed at the home. The registered providers should monitor this situation as more service users are admitted to the home, taking into consideration the risk of cross infection when staff undertake the role of carer and cook. The staff rota records the role of each person employed at the home. The registered manager informed the inspector that two staff have recently achieved NVQ Level 2 in Care. This means that between 70 – 80 of the care staff group have achieved this award. A Skills for Care induction package has recently been purchased by the home and this prepares staff to commence NVQ training. Stuart House DS0000065228.V313063.R01.S.doc Version 5.2 Page 19 The recruitment records were examined for a newly appointed member of staff. These evidenced that two written references and a satisfactory CRB check had been obtained prior to the person commencing work at the home. The application form in use by the home records the applicant’s employment history. Copies of identification information are retained by the home. All new staff receive an employee handbook and a code of practice. The registered manager informed the inspector on the pre-inspection questionnaire that various training sessions had been held during the previous twelve months. These include moving and handling, health and safety, dementia awareness, food hygiene, infection control, safe handling of medication and first aid. Evidence was seen on the day of the site visit that adult protection training had been arranged for managers and staff; managers are due to attend training in January 2007 and staff are due to attend training in November 2006. Staff records include information about a person’s training history, including induction training undertaken at the time of their employment and any NVQ training that has been achieved or is being undertaken. Records include dates that training has been undertaken so that a check can be kept on when refresher training is required. The inspector recommends that this information is recorded on a training and development plan for the whole staff team as a record of training achievements and training needs. In particular, this should identify the training needed by staff to meet the diverse needs of service users accommodated at the home. The registered manager informed the inspector that some training has taken place informally and ‘in house’ to meet specific service user needs; this training should also be recorded on the training and development plan. Stuart House DS0000065228.V313063.R01.S.doc Version 5.2 Page 20 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): 31, 32, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The home is well managed but managers should consider a more consultative approach. The quality monitoring system needs to improve to enable service users and others to affect the way in which the home operates. Service user monies are held securely and the home is managed in a way that protects the health and safety of service users and staff. EVIDENCE: The deputy manager recently applied to the Commission for Social Care Inspection to become the registered manager of the home. This was approved by the registration panel just two days before this site visit. The previous registered manager decided that she did not wish to undertake the required qualifications, and will become the care manager at the home. Management Stuart House DS0000065228.V313063.R01.S.doc Version 5.2 Page 21 duties will be shared between the registered manager and the care manager. The new registered manager has achieved NVQ Level 4 in Care and Management and intends to ensure that her practice is kept up to date by attending in-house training sessions with care staff and via access to information on the Internet. She is due to attend Adult Protection Manager’s Awareness training in January 2007. The management approach of the registered providers creates an open atmosphere where consultation takes place with service users, managers and staff. Some staff members told the inspector that they attend staff meetings and that they are able to make suggestions and comments at the meetings, and that these are listened to. They are able to raise issues anonymously if they wish to do so. However, one staff member stated, ‘Sometimes I think that management could be a bit more professional - they are a bit on the self defence when anyone tells them about putting jobs right or if it is to do with a resident’. The home has achieved QDS (the local authority quality award) Parts 1 and 2. A survey was given to service users in July 2006 and responses have been collated. These have not yet been published but the registered manager intends to discuss the outcome of the survey at the next resident’s meeting. A staff questionnaire has been devised but this has not been used since May 2005. There is also a questionnaire in place for visitors to the home but this is not yet in use. An annual service report is prepared for QDS purposes that includes plans for the following year, but this does not constitute an annual development plan. One of the service users has agreed to consult with other service users about satisfaction levels at the home – see ‘Complaints and Protection’. Monies are held at the home on behalf of service users. The records and monies held were checked by the inspector and were found to be accurate. Some savings are held and the inspector advised the registered manager to check the amount that the insurance company state can be held in the safe. The care manager is appointee for one service user who does not have the capacity to open a bank account – this should be further explored, as monies held at the home are not attracting interest payments. Any valuables held for service users are recorded in their individual care plan. The inspector agreed to send some guidance on holding service user monies to the home. In-house weekly tests and monthly drills of the fire alarm system and monthly checks of the call system are being maintained consistently. An annual test of the fire alarm system had been undertaken by a contractor and there is a gas safety certificate in place. Fire extinguishers have been tested and there are maintenance certificates in place for all mobility equipment. There are arrangements in place, including risk assessments, to promote safe working practices. Portable appliances are due to be tested during October Stuart House DS0000065228.V313063.R01.S.doc Version 5.2 Page 22 and will now be carried out by the handyman, who has undertaken training on portable appliance testing. The registered manager informed the inspector that water temperatures in bathrooms and bedrooms are tested by the handyman on a regular basis and that these tests are recorded – these could not be located on the day of the inspection. The water supply has been tested to detect the presence of Legionella and the result was negative. COSHH information is retained and is readily available to staff. Stuart House DS0000065228.V313063.R01.S.doc Version 5.2 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 X X 3 X X N/A 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 3 X X X X 1 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X 3 X X 3 Stuart House DS0000065228.V313063.R01.S.doc Version 5.2 Page 24 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. 1 Standard OP26 Regulation 16 (2) Requirement The carpet in the bedroom identified as having a strong odour must be replaced, and a washbasin must be fitted in the laundry room. (This work has since been carried out). Timescale for action 21/10/06 Stuart House DS0000065228.V313063.R01.S.doc Version 5.2 Page 25 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. Refer to Standard OP7 OP15 OP19 OP27 Good Practice Recommendations Care planning documentation should be used consistently throughout the home. Care plans should be readily accessible to all staff. The menu should record a choice of meal every lunchtime, and staff should ensure that service users are aware of this. All areas of the home should be made safe for service users and staff during the period of refurbishment. The registered providers should reconsider the need to employ a cook as occupancy levels increase, to take into account the risk of cross infection by someone undertaking catering and caring tasks. A training and development plan should be produced that records the training needs and achievements of the full staff group. Managers should listen to staff and act upon suggestions made/concerns re: care practices. Information gathered via service user questionnaires should be published and should be used to produce an annual development plan. Relatives and other visitors to the home should be included in the quality assurance process. One service user with savings does not have a bank account and this should be explored further. 5. 6. 7. OP30 OP32 OP33 8. OP35 Stuart House DS0000065228.V313063.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 Stuart House DS0000065228.V313063.R01.S.doc Version 5.2 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. 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