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Inspection on 16/06/05 for The Homestead Residential Home

Also see our care home review for The Homestead Residential Home for more information

This inspection was carried out on 16th June 2005.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Good standard of care provided at the home residents said they were well cared for and content at The Homestead. The District Nurse confirmed that good professional relationships exist between the home and the Primary Health Care team. Relatives visiting this morning spoke very highly of the care they observed taking place in the home. Friendly relaxed atmosphere residents were moving freely around and chatting to staff and each other. Good recording and administration procedures are in place records reviewed were up to date. Full monthly activity programmes are in place resident said always doing something. Menu offers wholesome diet with choices available.

What has improved since the last inspection?

Call bell installed in the laundry. New lighting in the lounge and extra bed lighting has been provided. Alginate bags and laundry trolleys have been provided. Hot water supplies to resident`s bedrooms have been addressed. Restructured care plans now in resident`s bedrooms.

What the care home could do better:

Complete the work on the new extension.

CARE HOMES FOR OLDER PEOPLE The Homestead Residential Home Wolverhampton Road Prestwood Near Stourbridge West Midlands DY7 5AN Lead Inspector Kath Marks Unannounced 16 June 2005 09:45 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 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. The Homestead Residential Home E51 E09 S42500 The Homestead V232273 160605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Homestead Residential Home Address Wolverhampton Road Prestwood Near Stourbridge West Midlands DY7 5AN 01902 335749 01384 873642 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Knoll House Nursing Home Limited Ms Pamela Lynne Watkins Care Home 30 Category(ies) of OP 30 registration, with number PD(E) 1 of places The Homestead Residential Home E51 E09 S42500 The Homestead V232273 160605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: N/A Date of last inspection 08 March 2005 Brief Description of the Service: The Homestead is a thirty- bedded care home for independent elderly persons of pensionable age requiring minimal help with personal care and daily living tasks. The Homestead promotes independent living and offers a wide variety of activities and menus to suit all personally assessed needs. The Homestead is not registered for nursing care but will endeavour to care for residents as long as possible within its category of registration. The frontage of the home provides the main outside sitting area for residents, as this can become a suntrap during the summer months. However there are gardens with lawns, fruit trees, and flowered borders to the rear of the building. Set in a semi rural location yet within easy reach of neighbouring Kinver, Stourbridge, and Kingswinford. Accommodation at the home is of a high standard and offers both shared and single bedrooms with the majority having en/suite facility. There are assisted bathrooms and a hairdressing salon. A passenger shaft lift is located off the main hall, there are two lounges, one has a television and the second is used as a quiet lounge with the dining room located, at the rear of the television lounge. The home operates a no smoking policy. As at previous inspection work is currently taking place on a nine- bedroom extension to the home enabling the proprietors to reduce double bedroom and provide an office. The Homestead Residential Home E51 E09 S42500 The Homestead V232273 160605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out over half a day on the 16th June 2005. During the course of the inspection the inspector received comments from a visiting district nurse and relatives visiting the home, all comments were of a positive nature. The district nurse confirmed that good relationships exist between the home and the health care team. Residents when spoken to confirmed to the inspector that they are cared for appropriately and content with life at The Homestead. During the course of this inspection written information was provided with regard to staffing, staff training, and dietary provision. On arrival at The Homestead Inspector was welcomed into the home by a resident who opened the front door. Some residents were just sitting down to a full English breakfast others were reading the daily newspapers or chatting. Discussions were taking place about daily event a quiz was to take place later this morning about the 1930/1940 when it did take place lots of residents were involved and shouting out the answers. Resident’s accommodation is located on the ground and first floor and personalised as individuals wish. Observations of the inspector were that areas of the home visited were clean and maintained to a good standard. The Homestead has in place a Statement of Purpose and Service Users Guide to inform residents and their relatives of the services and facilities provided. Both documents will be updated on completion of the new extension. All service users have a full assessment of their needs carried out prior to admission to the home. Arrangements are in place for meeting the health and personal care needs of residents and details are recorded in care records. Regular social opportunities are available for individuals who wish to be involved. The Homestead Residential Home E51 E09 S42500 The Homestead V232273 160605 Stage 4.doc Version 1.30 Page 6 Observations of menu were that residents are provided with a choice of wellbalanced and nutritious food the cook consulting with residents on a daily basis. The home has a complaints procedure in place that residents were aware of and is given and explained to the resident and their relatives on admission to The Homestead. The complaints procedure is displayed in the hallway along with details of how to contact the Commission for Social Care Inspection. Staff at the home are experienced and competent to care for older people and were familiar with the diseases associated with old age. Appropriate recruitment procedures are in place and all staff prior to employment has Criminal Records Bureau and Pova checks carried out. What the service does well: What has improved since the last inspection? Call bell installed in the laundry. New lighting in the lounge and extra bed lighting has been provided. Alginate bags and laundry trolleys have been provided. The Homestead Residential Home E51 E09 S42500 The Homestead V232273 160605 Stage 4.doc Version 1.30 Page 7 Hot water supplies to resident’s bedrooms have been addressed. Restructured care plans now in resident’s bedrooms. 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 Homestead Residential Home E51 E09 S42500 The Homestead V232273 160605 Stage 4.doc Version 1.30 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection The Homestead Residential Home E51 E09 S42500 The Homestead V232273 160605 Stage 4.doc Version 1.30 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4,5. Standard 6 is not applicable to the home The homes statement of purpose and service users guide provides prospective residents with details of the services the home has to offer enabling an informed choice about admission to be made. The Statement of Purpose and Service Users Guide will both be updated on completion of the new extension. EVIDENCE: The homes Statement of Purpose and Service Users Guide is given to residents and relatives clearly describing the services and facilities the home is able to offer. All residents have contracts of terms and conditions of residence at the home a copy of which is on resident’s files. A full assessment of individual needs is carried out prior to admission to The Homestead to ensure that the needs of residents can be met. The Homestead Residential Home E51 E09 S42500 The Homestead V232273 160605 Stage 4.doc Version 1.30 Page 10 The prospective resident or their relative would visit the home where possible and staff would visit the individual in their own home or current surroundings. The outcome of the assessment is confirmed to individuals in writing. The Homestead Residential Home E51 E09 S42500 The Homestead V232273 160605 Stage 4.doc Version 1.30 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10,11 The health, personal and social care needs of residents is well met. The systems for the administration of medication were observed by the inspector to be good with clear arrangements being in place to ensure residents medication needs are met. EVIDENCE: All residents had an individual plan of care that has been restructured and is now kept in bedrooms. Risk assessments are carried out as necessary and form part of the care records. Any contacts regarding health and personal care are recorded in care records, with the visiting district nurse confirming that good professional working practices take place. At the time of this visit there were no residents self-medicating how ever lockable facilities are provided in resident’s bedrooms. The Homestead Residential Home E51 E09 S42500 The Homestead V232273 160605 Stage 4.doc Version 1.30 Page 12 Detailed records were in place for the administration of medication and were seen by the inspector. All medication is securely stored in a locked metal trolley that is secured to the wall. Policies are in place to inform staff of systems and procedures. Residents spoken to said they are cared for in a respectful way this was also the observation of the inspector during this visit. Two residents were case tracked; care plans were followed through both residents spoken to and personal accommodation seen. The Homestead Residential Home E51 E09 S42500 The Homestead V232273 160605 Stage 4.doc Version 1.30 Page 13 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 standard(s) 12,13,14,15. The Homestead provided a relaxed and friendly atmosphere with residents moving freely in and around the home. The systems for consultation with residents are good with evidence that resident’s views are listened to and acted upon. The meals offered in the home were traditional and wholesome new menu in place that provides residents with choices at all mealtimes. EVIDENCE: Discussions with residents identified that they were content with the lifestyle they experience at The Homestead; there is a varied activities programme in place that offers residents social opportunities as they wish to be involved. Specific hobbies identified are encouraged and community/relative involvement is good. Observations were made of individuals being encouraged to make choices about their daily lives. Food provided for residents was nicely presented to them and portions were generous residents said they enjoyed their food and that they could have something else if they did not like what was on the menu. The Homestead Residential Home E51 E09 S42500 The Homestead V232273 160605 Stage 4.doc Version 1.30 Page 14 Fresh vegetables and fresh meat are delivered to the home twice weekly. The home is recruiting a kitchen assistant for teatime period. The Homestead Residential Home E51 E09 S42500 The Homestead V232273 160605 Stage 4.doc Version 1.30 Page 15 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 standard(s) 16,17,18. The home has a satisfactory complaints system with some evidence that service users views are listened to or acted upon. EVIDENCE: The home has in place a complaints procedure that is displayed in the hallway and contained in the Statement of Purpose and Service Users Guide. Service users the inspector spoke to were aware of the complaints procedure and said they would talk to relatives or staff if they had any concerns. At the last inspection visit residents raised the subject of lighting to read by in the lounge area and in some bedrooms, this was discussed with the care manager at the time and addressed to the satisfaction of residents. New lighting has been provided in the lounge and extra lighting in bedrooms. All residents have family support and are assisted by families to maintain their legal rights. The Homestead Residential Home E51 E09 S42500 The Homestead V232273 160605 Stage 4.doc Version 1.30 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 standard(s) 19,26. The standard of the environment generally within the home is good providing residents with a comfortable homely place to live. EVIDENCE: The home generally is well maintained and suitable for its stated purpose. Programmes of routine maintenance are in place and work identified having been carried out. Externally there are attractive grounds with level walkways and seating for residents. A new nine-bedded extension is being built to the side of the main building and on completion will provide en/suite bedrooms and extra toilet/bathing, and office facility. The Homestead was clean comfortable and free from offensive odour. The Homestead Residential Home E51 E09 S42500 The Homestead V232273 160605 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29,30. At the time of inspection staff on duty were competent and satisfactory in number to meet the needs of individuals in their care. There are robust procedures in place for the recruitment of staff. EVIDENCE: At the time of this visit to The Homestead observations of staff identified that staff on duty were as the rota and were sufficient in number to meet the observed needs of individuals in their care. There are robust procedures in place for the recruitment of staff Criminal Records Bureau checks are carried out along with POVA checks prior to permanent employment being offered. There is a staff-training programme in place with records being maintained. The Homestead Residential Home E51 E09 S42500 The Homestead V232273 160605 Stage 4.doc Version 1.30 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,33,35,38. The manager is supported well by the proprietors in providing clear leadership throughout the home with all staff demonstrating an awareness of their roles and responsibilities. EVIDENCE: The Registered Manager is qualified and competent to run the home and meet its stated purpose, she has A1 & A2 assessors award and is a moving and handling trainer. The Manager is NVQ Level 4; she was Care Link Manager at a nursing home prior to moving to The Homestead and has completed the Registered Managers Award. As Care Manager she is responsible for The Homestead only. The Homestead Residential Home E51 E09 S42500 The Homestead V232273 160605 Stage 4.doc Version 1.30 Page 19 Policies and procedures are in place for the management of residents finances, a number of residents look after their own finances assisted by relatives. Secure facilities are provided for all monies or valuables handed over for safekeeping and receipts are issued. The Homestead Residential Home E51 E09 S42500 The Homestead V232273 160605 Stage 4.doc Version 1.30 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 4 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 x 3 x 3 x x 3 The Homestead Residential Home E51 E09 S42500 The Homestead V232273 160605 Stage 4.doc Version 1.30 Page 21 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 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. Refer to Standard 19 Good Practice Recommendations Work on extension be completed. The Homestead Residential Home E51 E09 S42500 The Homestead V232273 160605 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Stafford - Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Homestead Residential Home E51 E09 S42500 The Homestead V232273 160605 Stage 4.doc Version 1.30 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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