Inspection on 07/07/05 for The Steppes Residential Care Home

This inspection was carried out on 7th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Steppes Residential Care Home 26/11/08

The Steppes Residential Care Home 13/12/06

The Steppes Residential Care Home 02/03/06

The Steppes Residential Care Home 30/12/04

The Steppes Residential Care Home 03/08/04

The Steppes Residential Care Home 03/02/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE The Steppes Cossack Square Nailsworth Gloucestershire GL6 0DB Lead Inspector Sharon Hayward-Wright Unannounced 7 July 2005 10:15 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 Steppes Version 1.10 Page 3 SERVICE INFORMATION Name of service The Steppes Residential Care Home Address Cossack Square, Nailsworth, Gloucestershire, GL6 0DB 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) 01453 832406 Mr Julian Ashbee To be considered for registration Care Home 21 Category(ies) of Old Age (21) registration, with number of places The Steppes Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 30/12/04 Brief Description of the Service: The Steppes is a care home registered to provide personal care for twenty-one older people. The home is an older style property that has been extended over time and adapted for its current purpose and accommodates fifteen service users. Adjacent to the main house is a smaller and more recently constructed house with six service users accommodated there. Both parts of the home provide a domestic style environment and easy access with a stair lift in the small house and a shaft lift in the main house.The main house has a small communal lounge and dining room on the ground floor. Service users accommodation is provided on the ground and first floor.All service users accommodation is provided in single rooms, most have en-suite facilities. A communal bathroom providing an assisted bathing facility is situated in each house. The amenities of the local town are in close proximity. The Steppes Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 4.5 hours one day in July 2005. Four service users were spoken with, to gain their views on the home and the care they receive. Three staff members and the Manager were also spoken with. Staff were observed going about their duties and interacting with each other and service users. Duty rotas, staff supervision, quality assurance, care and food records were inspected as was the medication procedure used by the home. One requirement issued at previous inspection remains outstanding but the home has nearly completed this. What the service does well: What has improved since the last inspection? The home is in the process of improving the environment for the service users by decorating areas of the home to make it an attractive and homely place to live. The medication in the home is well managed, ensuring that medication is handled and administered safely to prevent any service users from being put at risk. The Steppes Version 1.10 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Steppes Version 1.10 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 Standards Statutory Requirements Identified During the Inspection The Steppes Version 1.10 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 standard(s) 3 Arrangements are in place to ensure service users needs are assessed prior to admission to ensure the home can meet their needs. EVIDENCE: One new service user has been admitted to the home since the last inspection. A comprehensive assessment of their needs was seen including information about their likes and dislikes. The Steppes Version 1.10 Page 9 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 The home has clear and consistent care planning systems in place. But the information provided does not give staff the individualised care information needed to satisfactorily meet the needs of the service users. The medication at this home is well managed promoting good health. Personal support in this home is offered in such away as to promote and protect service users’ privacy and dignity. EVIDENCE: The home has recently upgraded the computer programme used to devise assessments of service users needs and care plans. The layout is easy to read and lists the problems associated with old age. Two service users were case tracked. The care plans listed the tasks required to address the problems identified, however the care plans were not individualised to each service user. The terminology used was not plain English and staff spoken with said they had difficulty in reading some of the words used. Care plans must reflect the individual needs of the service users and it is recommended that plain English be used. At the present time the The Steppes Version 1.10 Page 10 home has a copy of service users care plans in their rooms and in the homes files, it is recommended that only one copy is kept to ensure that all the changes are documented. The home uses the words ‘regular’ and ‘frequently’, these terms need to be explained in more detail. The home also uses statements like ‘report changes’ but does not list the type of changes they are looking for. Evidence was seen in the care plans inspected of health professionals visits; this included a care plan completed by a Community Psychiatric Nurse (CPN). The home records health professional visits in both the service users daily records and the handover book. This is duplication of records. Records of medication were seen. At the last inspection a number of recommendations were made and the home has addressed all but one. The medication process was seen where the staff transport the medication around the home in a lockable box and use the Medication Administration Records (MAR) as part of the process. From discussions with a member of staff they have completed a safe handling of medication course with a local college. Service users spoken with said the staff maintains their privacy and dignity; examples given were, knocking on their door prior to entering, addressing them with their preferred term of address and receiving their post unopened. The Steppes Version 1.10 Page 11 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 Links with the community are encouraged as well as an activities programme to provide service users with stimulation and to assist in enriching their lives. Dietary needs of service users are well catered for with a balanced and varied selection of food available that meets service users tastes and choices. EVIDENCE: The home maintains an activities list as evidence of the activities provided. Day trips are planned to local attractions and the home is looking to arrange two trips out a month for all service users who wish to participate during the summer. Outside entertainers also visit the home. The home has planned a Fete for the end of August. Service users said they are able to choose if they participate in the activities. Service users and staff confirmed that visiting to the home is open and one service user spoken with said her family take her out. Service users’ rooms inspected had their personal possessions on display. The Steppes Version 1.10 Page 12 Lunchtime was observed; from reading the records of food kept and from speaking to service users, choices are offered and service users expressed their delight at the food offered. The quality of the food looked good and the meal smelt very appetising. Staff offered assistance discreetly where needed. Service users are able to eat their meals in their own rooms if they are unable to get to the dining room. The home must record all food given to service users at teatime. The Steppes Version 1.10 Page 13 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) EVIDENCE: No standards were assessed in this section. A requirement issued at the last inspection has been addressed. The Steppes Version 1.10 Page 14 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) EVIDENCE: No standards were assessed in this section, however redecoration of the main entrance has been completed with further plans to redecorate other areas. The Steppes Version 1.10 Page 15 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 At this inspection staff morale was high resulting in an enthusiastic workforce that works positively with service users to improve their whole quality of life. EVIDENCE: The duty rotas were examined as evidence of staffing levels. On an early shift the home has four carers with one going off duty at 1pm. Three carers are on duty until 9pm then two waking night staff. Additional staff covers other duties. From discussions with staff they all said they enjoy working at the home. The Registered Provider was on holiday and the Manager did not have access to staff personnel files. The Manager is going to ensure she has access to this information. The Steppes Version 1.10 Page 16 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, 36 & 37 The home has some systems in place for consultation with service users, but at this inspection there is little evidence to prove service users have used the systems. The Manager is aware of the areas that need improvement; and she effectively communicates well with the service users and staff. Systems are in place to safeguard service users monies and to ensure the staff are able to meet their needs. EVIDENCE: The Manager is waiting to be interviewed by the Commission for Social Care Inspection as part of the registration process; she is in the process of undertaking the NVQ 4 training. Supernumerary hours are provided to enable her to undertake the role as Manager. The Steppes Version 1.10 Page 17 Service users said the Manager is friendly and approachable and from observation she communicates well with the staff. The home has quality assurance systems in place to encourage service users to share their views. The Manager said a questionnaire has recently been sent to service users and to date one response has been returned. It is recommended that the systems the home has in place for service users to give their views about the home, be reviewed to ensure service users can use them. Audits were seen of maintenance, accident and food records. It is recommended that the Manager devise an audit tool so she is able to audit the care provided. The Registered Provider obtains new polices and procedures in light of any new legislation. Secure facilities are provided to store service users monies or valuables and lockable facilities are provided in service users rooms. At the time of the inspection the home is not storing any monies or valuables on the behalf of service users. The Manager is not an appointee or agent for any service user. The Manager has a programme for staff supervision and records of one supervision session were seen. The Manager is aiming for the recommended 6 times per year. The home stores service users care files in a cupboard in the dining room, however this is not secure, as these files contain confidential information they must be stored in a secure manner. The Steppes Version 1.10 Page 18 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 2 x 2 x 3 3 2 x The Steppes Version 1.10 Page 19 yes 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 7 Regulation 15 Requirement Timescale for action 20/9/05 2. 15 17, Schedule 4(13) 3. 37 17(b) The Registered Person must ensure service users care plans are individualised to ensure that staff meet their needs. 20/9/05 The Registered Person must maintain records of food provided for service users in sufficient detail to enable any persons inspecting the records to determine whether the diet is satisfactory, in relation to nutrition and otherwise, and of any special diets prepared for individual service users. Timescale of the 30/1/05 was not met, however the home is part way to addressing this. The Registered Person must 10/8/05 ensure that care files are stored securely. 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 7 Good Practice Recommendations The home should use plain english when devising service Version 1.10 Page 20 The Steppes 2. 3. 4. 5. 6. 7. 8. 7 7 7 9 9 33 33 users care plans. The home should not use the terms regular and frequently in care plans as they need to be more specific. The home should record what changes they are looking for in care plans to assist staff. If the home is going to have more that one copy of service users care plans they need to ensure that staff up date both copies. The home should get another carer to check and sign any handwritten entries on the MAR sheets. The home should update their medication policy with the latest legislation. The Manager should devise a quality assurance tool to audit care and care records as part of the homes qulaity assurance systems. The home should review the systems in place for service users to give their views about the home to ensure they are user friendly. The Steppes Version 1.10 Page 21 Commission for Social Care Inspection Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester GL3 4AB 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 Steppes Version 1.10 Page 22 - 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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