Care Home: Stanfield House

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What the care home does well What has improved since the last inspection? At the last inspection a requirement was made for the registered manager to ensure that CRB are obtained for all those who are not employees but have regular contacts with the residents. The manager informed the inspector that this matter has been addressed. CARE HOMES FOR OLDER PEOPLE Stanfield House Joicey Square Stanley Co Durham DH9 0PG Lead Inspector Sam Doku Unannounced Inspection 26th August 2008 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Stanfield House DS0000031245.V370612.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. Stanfield House DS0000031245.V370612.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stanfield House Address Joicey Square Stanley Co Durham DH9 0PG 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) 01207 232546 P/F anne.bennett@durham.gov.uk www.durham.gov.uk Durham County Council Mrs Florence Anne Bennett Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Stanfield House DS0000031245.V370612.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th August 2006 Brief Description of the Service: Stanfield House provides residential care services for up to 21 people in the Category of Older Persons (OP). The home is owned by Durham County Council and managed on their behalf by Adult and Community Services. Stanfield House is located in a residential area of Stanley, close to local amenities. It is a large two-storey building with the benefit of a passenger lift to the firstfloor. All bedrooms are single accommodation without the benefit of en suite facilities. There are a number of different communal lounges and dining areas throughout the home. The home has a well-kept and well-used garden area for use by residents and visitors at the front of the building. The scale of charges for living in the home is £432.32 per week. Stanfield House DS0000031245.V370612.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The inspection was unannounced and started on 26 August 2008 and completed on the same day. Before the visit the inspector looked at: Information we have received since the last key inspection visit on 8 August 2006; • • How the home dealt with any complaints & concerns since the last visit; Any changes to how the agency is run; The provider’s view of how well they care for people, as highlighted in the details provided in the Annual Quality Assurance Assessment (AQUAA); During the visits the inspector: • • • • • • • talked to the people who use the service, the manager and care staff; looked at information about the people who use the service and how well their needs are met; looked at other records which must be kept; checked that staff had the knowledge, skills & training to meet the needs of the person they care for; looked around the home to make sure it was safe & secure; checked what improvements had been made since the last visit; the inspector told the manager what he found. All of these activities contributed to the inspection findings. What the service does well: The care plans are regularly reviewed and the new care plans often reflect the current care needs of the residents. In some cases, risk assessments have been counter-signed by the residents, indicating their involvement in the assessment process. Stanfield House DS0000031245.V370612.R01.S.doc Version 5.2 Page 6 The home provides activities, which are enjoyed by the residents. The activities coordinator described the social and recreational activities organised for the residents. The residents made positive comments about the home and the care that they receive. These include: • “It is very nice here and we are well looked after.” • “The carers are very kind. Nothing is too much for them.” • “The food is really good. There is good choice and plenty to eat.” • “My carer is very helpful and always there to talk to.” • “This is the best place for me, apart from my own home”. • “This place is like home from home”. The staff treat the residents with respect. The interaction between the residents and staff was cordial and there was mutual respect on both sides. Staff showed good levels of professionalism when interacting with the residents. The home provides good written information in the form of a service user guide. There is a note in the service user guide in seven other languages telling people how a translated version of the guide can be obtained by phoning a special number. What has improved since the last inspection? What they could do better: Currently the files are poorly organised and information is difficult to access. The manager should review the current filing system to ensure that access to information is easy to get. The process for updating the care plans and risk assessments should be reviewed. At the moment, the staff tend to cross out details of previous care plans and write against it the new care plan. This is extremely untidy and makes the new care plans difficult to read and follow. The review of this recording system should also include the Care Plan Review forms, which some of them do not follow logical sequence, making it difficult to follow. Stanfield House DS0000031245.V370612.R01.S.doc Version 5.2 Page 7 One to one supervision and appraisals are not taking place in the frequency that would meet the national minimum standard. A number of the supervision and appraisal sessions have been planned but did not take place. The service user guide needs to be updated to reflect the current address and contact details of the local office of the Commission. The current arrangements for carrying out Regulation 26 visits is that the registered manager completes the form herself and sends it to her line manager. It is strongly recommended that the line manager or someone who is not involved in the day-to-day manager of the home carry out these visits. 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. Stanfield House DS0000031245.V370612.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Stanfield House DS0000031245.V370612.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4, 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents and/or their relatives are provided with the good information about the home and the opportunity for them to assess the home for themselves, before making their decision about coming to live there. Assessments are carried out before admission is arranged, ensuring that the care needs are clearly identified and care plans put in place to meet the needs of the individual. EVIDENCE: Stanfield House DS0000031245.V370612.R01.S.doc Version 5.2 Page 10 The residents and relatives commented that they found the assessment process and visits to the home before admission beneficial. One resident described the visit by the social worker and how it was arranged for her to visit the home with her daughter. This gave them the opportunity to ask questions about residential care in general and have explanations given to them during the visit. Other residents and relatives confirmed that they had the opportunity to visit the home when they considered going into a care home. The manager and staff stated that it is the policy of the home to ask prospective residents and their relatives to visit the home and assess the place for themselves before making up their minds. In discussions with staff, they acknowledged that it is not always possible for the prospective residents to visit the home and see it for themselves before admission is arranged. In these cases families or advocates are encouraged to do so on their behalf. A full assessment of prospective residents is carried out by social workers and copies made available to the home as part of the admission process. The home also carries out their assessments of the individual in their own home or shortly after admission to make sure Stanfield House has the necessary skills and facilities to meet the resident’s needs. Residents’ files show evidence of assessments being carried before admissions were arranged. All residents are provided with copies of the service user guide. Residents confirmed this and copies were noted in the bedrooms that were visited. However, the guide would need to be revised to include the current address and contact details of the local office of the Commission. Stanfield House DS0000031245.V370612.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal and healthcare needs of the residents are fully met. The home has good procedures in place for the safe administration of medicines. This promotes and health and welfare of the service users. The residents are treated with respect and dignity, thus enhancing their sense of wellbeing. EVIDENCE: Stanfield House has suitable arrangements in place for meeting the healthcare needs of the residents. The residents’ files show evidence of contacts with healthcare professionals, including GPs, psychiatrist, nurses, chiropody service, Stanfield House DS0000031245.V370612.R01.S.doc Version 5.2 Page 12 dentist, optician and other healthcare services. Care plans set out how each individual’s personal care needs are to be met. The daily records of events show that the healthcare needs of the residents are fully met. There are suitable arrangements in place for the storage and administration of medicines in the home. The drugs administration system was examined and there were no discrepancies. Records relating to the administration of medicines have been properly maintained. Copies of prescriptions are kept in the home to ensure that medicines can easily be accounted for and traced back to the chemist. The manager stated that the staff who are responsible to the administration of medicines have all received appropriate training. Comments from the residents and visitors confirmed that the staff treat the residents with respect and dignity. Staff were noted to treat service users with respect and dignity. Where assistance with personal and intimate care was needed, the staff provided this in a discreet and dignified manner. Staff had very caring and positive working relationships with the residents. Stanfield House DS0000031245.V370612.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff support the residents to remain in touch with their friends and families. Furthermore, opportunities are provided for residents to exercise control and choice, which promote independence and self-determination. The residents are offered good variety of wholesome and nutritious meals in comfortable and pleasant surroundings, which promote their health and wellbeing. EVIDENCE: The home works towards ensuring that the residents experience varied activities to meet their social and recreational needs. The manager, the activities coordinator and the residents confirmed that social and recreational activities are organised and residents are encouraged to join in. Residents are Stanfield House DS0000031245.V370612.R01.S.doc Version 5.2 Page 14 free to join in social and recreational activities if they wish. Some of the activities provided include board games, bingo, exercises, sing-a-long and other forms of entertainment. The activities coordinator maintains a record of all recreational and social activities that the residents have been engaged in, as well as of those organised and supported by the local authorities CREATE programme. A number of the residents have regular visits from their relatives as the visitors’ sign-in book shows. Relatives stated that they can see their loved ones in the privacy of their own room or in the homes lounges or dining room if they wish. Evidence of this was witnessed during the time of the inspection. Mealtimes are flexible and relaxed, and residents are offered a choice of healthy and nutritious meals. The home has in place a 4 week menu, which is planned with residents. Meals are generally served in the two dining areas, which are nicely decorated and benefits from plenty of space to enable staff and residents to sit together and for the residents to enjoy their meals. The manager stated that if residents prefer not to eat in the dining room staff would support them to have their meals in their preferred area, including their rooms. Stanfield House DS0000031245.V370612.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their relatives have information about how to make a complaint. This promotes their right to complain about the service if they feel they need to. All Staff are aware of the Protection of Vulnerable Adults procedure, and suitable training has been provided. This protects the residents from abuse. EVIDENCE: Durham County Council provides a corporate policy on complaints and safeguarding matters. The staff who work at the home are familiar with the council’s policies and most staff have received appropriate training in Protection of Vulnerable Adults. Durham County Council provided these corporate policies, and a copy of this multi-agency document was available in the home for use by staff. Staff were able to describe instances in which they would alert the manager on any abuse situation. They were also clear about the Council’s whistle blowing Stanfield House DS0000031245.V370612.R01.S.doc Version 5.2 Page 16 policy and showed an understanding of how they would follow the local authorities policy and procedures if they suspect any form of abuse. The staff training records show that they have received training on dealing with the Protection of Vulnerable Adults. Relatives confirmed that they are aware of the complaints procedure and would know how to go about it if they have any need to use the complaints procedure. Information on how to complain was displayed on the notice boards in the home as well as being contained in the service user guide. The home has a book, which contains the details of complaints and compliments. Most of the comments in the book were about food. There were also positive comments about the staff and the care that they provided. Record of the residents’ finances was examined. Each resident has a record of finance, showing the transactions made on behalf of the individuals. Two signatures are provided for each transaction and supported by receipts. The manager has a system of regular auditing of the accounts. Stanfield House DS0000031245.V370612.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 23, 24, 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home offers an accommodation and an environment that is safe, clean and well maintained. EVIDENCE: The home is generally a well-maintained environment. There are provisions for appropriate aids and adaptations to support the residents and to promote their independence. The layout and design of the home is suitable to meet the current needs of the residents living there. Stanfield House DS0000031245.V370612.R01.S.doc Version 5.2 Page 18 Bedrooms are individually decorated and residents have furnished their room to reflect their personal taste. Residents are encouraged to furnish their rooms with personal items, thus providing familiar environment for them. There are good arrangements in place for regular maintenance work in the building. The maintenance book shows that the handyman has kept on top of any safety work that is needed to ensure a safe environment. These include minor repairs, fire safety checks and drills. Residents, relatives and other visitors commented that the home was always spotlessly clean and free from unpleasant odours. The home has suitable infection control policies in place. Staff have had training in infection control and records show that the home has adhered to effective infection control procedures. The kitchen was noted to be clean and maintained to good standard. There is a cleaning rota showing how the domestic staff keep up with the cleaning activities in the kitchen. Records relating to food temperatures and other food hygiene measures are maintained. Stanfield House DS0000031245.V370612.R01.S.doc Version 5.2 Page 19 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, 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staffing numbers are satisfactory and promote the safety and welfare of the residents. The local authority adheres to good recruitment practices, which safeguards the welfare of the residents. EVIDENCE: The home employs sufficient number of staff to meet the needs of the residents. The residents commented that there are always sufficient staff on duty to meet their needs. Care staff also stated that they feel that there are sufficient staff on duty at all times. However, the manager indicated that there had been staff shortages in recent weeks due to holiday commitments. Consequently, the manager is on rota and therefore she is part of the care staff in order to make up the care hours on the floor. Stanfield House DS0000031245.V370612.R01.S.doc Version 5.2 Page 20 The staff have had appropriate training to equip them for their job roles. The manager confirmed that the staff training includes moving and handling, first aid, protection of vulnerable adults, fire safety, food hygiene and health and safety training. This was confirmed by the staff training log that was available in the home. Discussions with the manager and the staff show that the home has been following the Council’s policy on recruitment. There is sufficient information on files to show that the Council’s policy is being followed. Over 70 of the staff have NVQ Level II or above. Staff are highly motivated and conduct themselves in a very professional manner. Stanfield House DS0000031245.V370612.R01.S.doc Version 5.2 Page 21 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, 36, 37, 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 managed by a qualified and experienced person, and runs the home for the benefit of the residents. The home has procedures in place for staff supervision arrangements. However, this is not being followed as required by the council. The safety and welfare of residents is protected fully by the regular servicing arrangements that are in place. EVIDENCE: Stanfield House DS0000031245.V370612.R01.S.doc Version 5.2 Page 22 The registered manager has a long experience of managing a residential care home. Staff commented positively on her ability as a manager and feel that she is approachable and supportive of them. Residents and visitors also commented on her management style and described her as a “good boss”. One carer described her as “she would not ask you to do something she would not do herself”. There are suitable arrangements for staff to receive one-to-one supervision from the manager. However, the records show that this has not been taking place as regularly as they should, and some staff have not had supervision for some months. A number of the supervision and appraisal sessions have been planned but did not take place. The service user guide needs to be updated to reflect the current address and contact details of the local office of the Commission. The County Council’s Health and Safety policies remain in place. These cover policy areas such as fire prevention and Care of Substances Hazardous to Health (COSHH). There is evidence that staff adhere to the policies as set by the company. Servicing records confirm that all portable appliances have been tested. A record is maintained of regular water temperature tests in the home. Regular servicing of fire equipment, gas and electrical appliances have been carried out by the contracted companies. All the servicing records that were examined were up to date. These included servicing of passenger lift, hoists, water treatment, electrical installation and gas servicing. Records examined indicate that fire precautions relating to weekly fire alarm testing and record of inspection takes place. There are records in the home indicating fire drills and fire instructions with staff. Stanfield House DS0000031245.V370612.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 3 X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 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 Standard No Score 16 3 17 X 18 3 3 3 X X 3 3 X X 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 3 X 3 1 2 3 Stanfield House DS0000031245.V370612.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 OP36 Regulation 18(2)(a) Requirement The manager must put systems in place to ensure that all staff receive regular supervision and annual appraisal. Timescale for action 01/12/08 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 Refer to Standard OP1 Good Practice Recommendations The service user guide should be amended to reflect the current telephone and contact details of the local office of the Commission. Residents’ files should be properly organised to make it easier for information relating to care plans to be easily accessed by staff. Details of care plan reviews should be legible and staff should stop crossing out past reviews. These should be maintained in its original form and kept as true record of previous plans of care. OP37 OP37 Stanfield House DS0000031245.V370612.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Stanfield House DS0000031245.V370612.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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