Care Home: Stanwell Rest Home

Similar services:

• St Vincents
• The Cotswold Home
• Winton House
• Rush Court
• Hillyfield Rest Home
• The Maypole Nursing Centre
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What the care home does well The home has a comprehensive pre-admission procedure, which ensures that the home only admits people whose needs it can meet. All evidence indicates that the home ensures that people`s health and care needs are met. The home has an activities organiser and provides a range of activities including outings.The home employs appropriate numbers of care staff that ensure that people`s needs are met. Staff receive the necessary training including NVQ`s and training specific to the needs of the people living at the home. The registered manager has the necessary skills and experience to ensure the home is run in the best interests of the people who live there. What has improved since the last inspection? The previous inspection was undertaken in March 2008. At that time no judgements or requirements were made as the home was under enforcement action by the commission. The home is no longer under enforcement action as the previous report identified that improvements had been made and many previous requirements had been wholly or partially met. The home now needs to demonstrate that the improvements made are sustainable. The home`s manager is now registered with the commission. Further decoration is planned and the provider has obtained quotes with a view to double glazing parts of the home not yet double glazed and how off road parking can be provided. The home has continued to work hard to ensure that it meets the majority of national minimum standards and build on the progress made previously. CARE HOMES FOR OLDER PEOPLE Stanwell Rest Home 72/76 Shirley Avenue Southampton Hampshire SO15 5NJ Lead Inspector Janet Ktomi Unannounced Inspection 12th September 2008 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Stanwell Rest Home DS0000012167.V371122.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. Stanwell Rest Home DS0000012167.V371122.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stanwell Rest Home Address 72/76 Shirley Avenue Southampton Hampshire SO15 5NJ 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) 023 8077 5942 stanwellcarehome@btinternet.com Stanwell Rest Home Ltd Ms Kim Marie Sutherland Care Home 34 Category(ies) of Dementia (0), Mental disorder, excluding registration, with number learning disability or dementia (0), Old age, not of places falling within any other category (0) Stanwell Rest Home DS0000012167.V371122.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home only - PC to service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (OP) Mental Disorder, excluding learning disability or dementia ( MD) maximum number 26 2. 3. Dementia (DE) maximum number 26. The maximum number of service users who can be accommodated is 34. The 8 service users to be accommodated in the separate apartments must be in the category of OP and in need of personal care only. 25th March 2008 Date of last inspection Brief Description of the Service: Stanwell Rest Home is a care home that is registered to provide personal care and accommodation for a maximum of thirty-four older people. The home is situated in a residential area of Southampton close to Shirley shopping centre and within easy access of public transport. Accommodation is split between two buildings. Twenty-six people can be accommodated within the main building. This building consists of three former residential properties that are linked internally. Accommodation is spread over two floors with all areas accessible via stair lifts. Accommodation is provided in single and twin bedrooms. Eight further people who only require assistance with personal care needs can be accommodated in self-contained apartments situated at the rear of the main property. All apartments are accessible via a stair lift. The home is owned by Stanwell Rest Home Limited and managed by the Stanwell Rest Home DS0000012167.V371122.R01.S.doc Version 5.2 Page 5 registered manager Ms Kim Marie Sutherland. The cost of living at the home ranges from £335 to £440 per week dependant on assessed needs and room occupied. Additional costs are charged for newspapers, hairdressing and chiropody. The home could provide day or respite/short stay accommodation if a suitable room is available. Stanwell Rest Home DS0000012167.V371122.R01.S.doc Version 5.2 Page 6 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. This report contains information gained prior to and during an unannounced visit to the home undertaken on the 12th September 2008. All core standards and a number of additional standards were assessed. The visit to the home was undertaken by one inspector and lasted approximately eight hours commencing at 9 am and being completed at 5.00 p.m. The inspector was provided with free access to all areas of the home, documentation requested, visitors, staff and people who live at the home. The registered manager had completed the homes Annual Quality Assurance Questionnaire (AQAA) in February 2008 and was therefore not due to complete a new assessment at this time. Information from the Aqaa was used in the previous inspection report completed in March 2008. Information was also gained from the home’s service file containing notifications of incidents in the home. Surveys were sent to the home for distribution to staff and people who live at the home. At the time of writing the report one had been received from a health professional and two from people who live at the home. During the inspection the inspector was able to meet and talk to a visiting social care professional and several people visiting people who live at the home as well as a number of people who live at the home. What the service does well: The home has a comprehensive pre-admission procedure, which ensures that the home only admits people whose needs it can meet. All evidence indicates that the home ensures that people’s health and care needs are met. The home has an activities organiser and provides a range of activities including outings. Stanwell Rest Home DS0000012167.V371122.R01.S.doc Version 5.2 Page 7 The home employs appropriate numbers of care staff that ensure that people’s needs are met. Staff receive the necessary training including NVQ’s and training specific to the needs of the people living at the home. The registered manager has the necessary skills and experience to ensure the home is run in the best interests of the people who live there. What has improved since the last inspection? What they could do better: The following requirements are made following this inspection. The home must ensure that the storage cupboard for controlled medication meets the standards as stated in the Misuse of drugs (safe custody) Regulations 1973. The medications trolley, in which most medication is stored, must be kept clean. The inspector noted that three upstairs WC’s did not have washbasins or facilities for hand cleansing. The manager stated that she had recently realised this and will consider how suitable infection control procedures/equipment can be provided. The home must ensure that people can cleanse their hands following use of WC’s. Stanwell Rest Home DS0000012167.V371122.R01.S.doc Version 5.2 Page 8 The flooring in the laundry has worn in parts and no longer provides an impermeable surface. The home must ensure that the laundry floor is impermeable and can be kept hygienically clean, so that residents laundry is cleaned in an hygienic environment. 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. Stanwell Rest Home DS0000012167.V371122.R01.S.doc Version 5.2 Page 9 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 Stanwell Rest Home DS0000012167.V371122.R01.S.doc Version 5.2 Page 10 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): 2, 3, 4 and 5 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. All people are assessed prior to moving into the home to determine that their individual needs can be fully met. People, or their representatives, are able to visit the home prior to admission to assess the quality, facilities and suitability of the home. People or their representatives receive a written contract/statement of terms and conditions of the home. Standard 6 is not applicable, as the home does not provide intermediate care. EVIDENCE: The registered manager explained the homes admission procedure and the pre-admission assessments for two people admitted shortly before the inspection visit were viewed. The inspector discussed admissions with care staff and with some people who live at the home. The contracts/statement of terms and conditions of the home were seen in the files of the people whose Stanwell Rest Home DS0000012167.V371122.R01.S.doc Version 5.2 Page 11 pre-admission assessments were viewed. Information from completed surveys is also considered. The registered manager explained the homes admission procedure. If an initial enquiry from either social services or from a person or their family indicates that the home would be able to meet the persons needs the manager will arrange to visit the person, either at their home or in hospital. A comprehensive pre-admission assessment is completed including where appropriate members of the persons family and professionals involved in their care. The person is provided with information about the home and where practicable is invited to visit the home before making the decision as to whether to move in on an initial trial basis. When the person is unable to visit the home a relative is invited to view the available room and facilities at the home. The home has a number of shared bedrooms and discussions with the manager indicated that consideration is given as to compatibility with the existing person who is using the bedroom when assessing a person for a twin room. The home has an assessment tool that covers all the relevant areas necessary for the home to decide if it is able to meet a prospective persons needs. The registered manager was clear about the level of care needs the home can accommodate. Also viewed in people’s files were copies of assessments completed by care managers. There was also evidence that the placement had been reviewed after approximately six weeks to ensure that people’s needs were being met at the home. Discussions with people who live at the home confirmed that people or their relatives have visited the home prior to a person moving in. Discussions with care staff confirmed that they felt they had enough information about new people admitted to the home and that they had the training and time to meet people’s needs. People living at Stanwell tend to be long term, however the home could provide respite or short stay accommodation if a suitable room were available. The same admission procedures would be used for respite or short stay admissions as for long-term admissions. Two surveys were completed by people who live at the home. One stated that they had received a contract the other that they had not. The inspector requested and was shown copies of contracts/statements of terms and conditions of residency for people whose pre-admission assessments were viewed. The home does not provide dedicated accommodation for, intermediate care or specialised facilities for rehabilitation. Stanwell Rest Home DS0000012167.V371122.R01.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The health and personal care, which a person receives, is based on their individual needs. The home must ensure that the storage of controlled medication meets the legal standards, other medication is correctly stored, and administered with full records maintained. People are treated with respect and their dignity and privacy is maintained. EVIDENCE: Four care plans were viewed, two for a people admitted to the home in the three months prior to the inspection visit and the other’s for people who have been living at the home for a longer time. Care plans in both the main house and the apartments were viewed. The inspector discussed with staff, and people who live at the home how care needs are met. The inspector spoke with visitors and a social care professional. Stanwell Rest Home DS0000012167.V371122.R01.S.doc Version 5.2 Page 13 At the time of the previous inspection in March 2008 the home was introducing a new care-planning format, incorporating care plans, risk assessments and reviews. All care plans are now in the new format. People have a detailed plan of care that related to the persons assessment. The care plans follow a comprehensive format and are individualised and person centred being written in plain language providing detailed information as to how needs should be met. Plans are reviewed on a monthly basis, where possible with the person whose plan of care it is. People spoken with confirmed that they had been involved in their care plans and reviews. Care plans contained relevant risk assessments and management plans including nutrition, manual handling, falls and any individual risks. Risk assessments viewed appeared appropriate to the persons needs. The home monitors peoples weight on a monthly basis with records being seen. Care staff spoken with said that communication about peoples needs was good. The inspector was present for the handover between the morning and afternoon care staff. The home uses a key-worker system. The inspector was able to talk with people who live at the home who stated that they felt they received the care and support (including medical care) they need. A social care professional visiting the home at the time of the unannounced inspection confirmed that he felt peoples health and care needs were met. Surveys received from two of the people who live at the home confirmed that they felt they always/usually receive the care and support, including medical care they need. Adding ‘staff quick to act upon problems and organise appropriate help’ and ‘staffing has improved especially in the evenings’. A health professional also completed a survey and stated that the home always seeks advice and acts upon it to manage and improve individual’s health care needs. Records were available to demonstrate that people have access to a range of services such as GP’s, Dentists, Chiropodists and District Nurses. On the day of the unannounced inspection a Chiropodist was visiting the home and on the previous day a visiting optician had been at the home. Daily records indicated that care staff noted health needs and responded to these. Care plans contained individual manual handling assessments. Most people who live at the home do not require manual handling. The manager stated that she had requested and the provider agreed to purchase a standaid. The registered manager has completed a manual handling train the trainer course and training for care staff has been provided. People stated that they felt that staff always treated everyone who lives at the home with dignity and respect. Observations of staff interactions indicated that people are treated with respect and their right to dignity maintained. The home has both single and twin bedrooms. Curtain screens were noted in twin rooms viewed. Stanwell Rest Home DS0000012167.V371122.R01.S.doc Version 5.2 Page 14 Care staff confirmed that they had sufficient time to meet people’s needs and discussions indicated that they had a good understanding of individual peoples needs and how these should be met. Care staff have received training to meet the specific needs of people including dementia care. At the time of the inspection visit nobody was self administering his or her medication. Should people wish to self administer an assessment of their ability to do so would be undertaken and they would be provided with secure storage in their rooms for any medication. Care staff confirmed that they have undertaken medication training. The home has a staff office where medications are stored. With the exception of controlled medication all medication is stored correctly. With the exception of liquids and some medications that cannot be stored in blister packs the local pharmacist dispenses tablet medication into blister packs. The home uses medication administration record sheets supplied by the pharmacist. These were viewed. The home has the necessary recording books for controlled medications and medication that should be treated as controlled medication was being stored in the homes controlled medications cupboard however the cupboard does not meet the correct requirements for controlled medications. The home must ensure that the storage cupboard for controlled medication meets the standards as stated in the Misuse of drugs (safe custody) Regulations 1973. The medications trolley, in which most medication is stored, was viewed. The base of the doors in which bottles of liquid medication is stored was dirty and requires a thorough cleaning and thereafter must be kept clean. Stanwell Rest Home DS0000012167.V371122.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The routines for daily living and activities made available are flexible and varied to suit people’s individual needs. Family and friends are able to visit. People receive a balanced diet in pleasing surroundings at times convenient to them. EVIDENCE: The inspector spent time talking with people, observed part of the lunchtime and evening meals and met with a relative. The inspector discussed activities with people who live at the home, staff, activities organiser and viewed information about activities undertaken in daily logs and activities file. People living in the home are able to spend their time in the home where they wish, people were seen sitting in three of the homes lounge’s and others chose to spend time in their bedrooms. The fourth lounge was being used for training for much of the inspection visit. The home has pleasant gardens to the rear. Stanwell Rest Home DS0000012167.V371122.R01.S.doc Version 5.2 Page 16 The rear gardens provide safe paths and seating is available. People stated that when the weather permits they enjoy spending time in the homes garden. People confirmed to the inspector that they are given choice over what time they get up and go to bed, as well as choice as to how and where they spend their time and what they have for their meals. Bedrooms seen contained personal items brought into the home. Care plans and assessments include information about leisure activities, hobbies/interests, catering and religious needs. The home has recently employed an activities organiser for twenty hours per week. The home organises a range of group and individual activities. There are also opportunities for people to have outings in the homes own transport. People informed the inspector about a recent trip they had enjoyed. The manager stated that as a result of a quality assurance exercise it had been identified that people with mobility needs were unable to access the homes vehicle and that alternatives suitable for these people had been identified. The inspector was able to meet several visitors. Visitors are able to visit at any time and complete a visitor’s book on entering the home. The home does not have a private room for visitors however as the home has four lounges it is likely that one could be made available for a private visit. Care plans contained nutritional assessments and people are regularly weighed. In one care plan where a weight loss had been identified more frequent weighing had been instigated and medical advice sought. Each lounge has a dining area and dining table. People living at the home informed the inspector that they enjoyed the food at the home. People stated that if they did not like what was available they would say and stated instances when alternatives had been provided. People confirmed that they are provided with fresh fruit and vegetables, supplies of fresh fruit being seen in the homes kitchen. The inspector was present for the main lunchtime and also the evening meal. Drinks and snacks are also available throughout the day with people confirming this as well as the inspector observing people being given morning and afternoon hot drinks and biscuits. The need for special diets or supplements is recorded pre-admission. The pre-admission form included information about people’s food likes and dislikes. The cook was aware of the dietary needs of people. Snacks are also available should people want food at times other than meals times with a staff member informing the inspector that people can have snacks before going to bed. The manager stated that the menus have recently been changed and two options are now available at lunchtime. Some people had chosen fish and others chicken on the day of the inspection. The evening meal comprised of hot options (chicken nuggets and sausage rolls) and/or a selection of sandwiches. Cakes/fruit were also provided. Care staff serve this from a trolley they take around the home, enabling people to select what they want to have at the time of the meal. Stanwell Rest Home DS0000012167.V371122.R01.S.doc Version 5.2 Page 17 People living in the apartments can choose to have meals from the main house, or meals delivered by a home delivery service. Care staff assist people living in the apartments with making their own breakfast and evening meal/snacks and drinks as required. Individual shopping lists were seen. Stanwell Rest Home DS0000012167.V371122.R01.S.doc Version 5.2 Page 18 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. People are protected from abuse. EVIDENCE: The home has a clear complaints policy and procedure. Visitors and people the inspector spoke with stated that they did not have any concerns or complaints, however they stated they would raise any concerns if they had any and were confident that the home would sort out any issues. Discussions with staff confirmed they were aware of what to do if a person or their relative complained or raised an issue. In the homes hall there is a supply of compliments/complaints forms and envelopes that people can use should they wish to make a complaint. Two people completed surveys and both stated that they were aware of how to make a complaint. One adding ‘new forms by the front door – manager/owner always available everyday – but all staff try to sort out problems anytime day or night’. The survey completed by a health professional stated that the home had responded appropriately if they had raised any concerns. The home has a policy and procedure relating to safeguarding adults and ensuring that people are not at risk of abuse. Care staff have safeguarding adults training as part of their induction and have also undertaken specific Stanwell Rest Home DS0000012167.V371122.R01.S.doc Version 5.2 Page 19 update training, evidence of which was seen on the training programme and confirmed by staff. The manager has undertaken safeguarding train the trainer course and on the day of the inspection care staff were providing mental capacity act training for a group of care staff. Discussions with care staff indicated they had an understanding of safeguarding and what they should do if they suspected abuse may have occurred. People stated to the inspector that they felt safe at the home. Since the previous inspection in March 2008 there have been no safeguarding referrals made to the commission concerning the home. Stanwell Rest Home DS0000012167.V371122.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People live in a generally clean, safe, well-maintained home. The home must ensure that people are able to cleanse their hands following use of the first floor WC’s and that the laundry room floor is repaired. EVIDENCE: The inspector had not previously visited the home so requested a senior staff member to show her the home towards the start of the unannounced inspection. All areas of the home viewed were found to be clean. The home employs a cleaner who stated that she has sufficient time to complete the cleaning and has all the necessary products and equipment. It was identified in the previous report that a window had been fitted with bars and that the home should ensure that the local fire department were happy Stanwell Rest Home DS0000012167.V371122.R01.S.doc Version 5.2 Page 21 with this arrangement. The registered manager stated that this had been done and that this was one of the windows that was due to be double glazed. Over the past year the home has greatly improved the environment with people who live at the home stating that its ‘now very posh’. There continues to be some areas that still require redecorating and modernising. The manager stated that the provider has further plans including providing double glazing to one part of the home currently without double glazing, further redecoration of communal areas and is also considering how off road parking may be provided. Bedrooms are provided on the ground and first floor with all parts of the home accessible by stair lift. Bathrooms were seen to be fitted with bath seat hoists and the manager stated that baths have been fitted with thermostatic valves to reduce the risk of scolding from hot water. Care staff stated that bath water is also checked before each bath using a thermometer. Thermometers were seen in bathrooms viewed. Signs have been provided on bathroom and WC doors with doorframes painted red to aid orientation for people with dementia. The inspector noted that three upstairs WC’s did not have washbasins or facilities for hand cleansing. The manager stated that she had recently realised this and will consider how suitable infection control procedures/equipment can be provided. The home must ensure that people can cleanse their hands following use of WC’s. The home has four separate lounges each containing a dining area and dining table and chairs. Most of the lounges have been redecorated in the past year and new carpeting provided throughout communal areas and some bedrooms. The home provides both single and twin bedrooms, some having ensuite facilities. People confirmed that they were able to bring in personal items when they moved into the home and bedrooms viewed contained personal items. Most bedroom doors did not have locks. The home has provided aids to people’s memories as to which is their bedroom with pictures and names on all bedroom doors. Externally the home has pleasant rear gardens providing safe paths. People confirmed that they have enjoyed using the garden. There is level access to the home via the front with parking restricted to the road outside the home. The manager stated that the provider is exploring how off road parking may be provided. The home has a laundry that was viewed. The flooring in the laundry has worn in parts and no longer provides an impermeable surface. The home must ensure that the laundry floor is impermeable and can be kept hygienically clean. Stanwell Rest Home DS0000012167.V371122.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home employs appropriate numbers of care staff that should ensure that the needs of people living at the home are met. Staff receive the necessary training. Full recruitment procedures are completed prior to new staff commencing work at the home. EVIDENCE: All comments from people who live at the home were positive about care staff. People stated that there were sufficient staff and that staff are available when they need them. Interactions observed during the inspection were warm and friendly with care staff clearly having a good knowledge of the individual people who live at the home. Surveys completed by people who live at the home stated that staff listen and act on what they say adding ‘staff treat everyone individually’, ‘good mix of staff’ and ‘staff very kind – from owner to cleaners’. External professionals who completed a survey or who spoke to the inspector felt that staff usually have the right skills and experience to support people who live at the home. Duty rotas were seen during the visit to the home. Duty rotas stated that in the main house three care staff and a senior are provided throughout the morning and two care and a senior in the afternoon and at night two care are Stanwell Rest Home DS0000012167.V371122.R01.S.doc Version 5.2 Page 23 provided. An additional carer is provided in the apartments throughout the day and night. The home also employs a cook, housekeeper and administrator. The manager is additional to these staff as is the activities organiser who is employed twenty hours per week. During the inspectors visit staff on duty corresponded to those on the duty rota. Care staff stated that they have sufficient time to meet people’s needs and throughout the inspection care staff appeared to have time to meet people’s needs. Care staff also stated that they cover additional shifts when required due to other staff holidays or sickness. Information provided by the registered manager confirmed that over fifty per cent of the care staff have at least an NVQ level 2 in care with additional care staff undertaking an NVQ in care. Care staff confirmed to the inspector that they were undertaking NVQ or had achieved this qualification. Care staff stated that they felt they had the necessary skills to meet people’s needs and were not expected to undertake activities for which they had not been trained. Care staff stated they have lots of training. The inspector saw training certificates and also viewed the individual and general training matrix and planner. The registered manager has undertaken a range of train the trainer courses including dementia, safeguarding, mental capacity and manual handling. The manager stated that the new deputy manager will undertake the train the trainer course for infection control. On the day of the inspection care staff were undertaking training on mental capacity act. Care staff are paid when they come in for training. Further training planned was seen on the office wall with names of staff due to attend. All evidence indicates that staff have all mandatory training. The recruitment records for three people recruited shortly before the inspection visit were viewed. These contained all the required information and confirmed that all staff are fully checked including references, Criminal Records Bureau and Protection of Vulnerable Adults checks prior to commencing employment at the home. A senior member of staff explained the homes induction procedure and the inspector was shown the induction workbooks new staff complete. These conform to the common induction standard. Records of induction for new staff were seen in their training files. A new member of care staff confirmed that the above recruitment procedures and induction had occurred including working supernumerary for the first few shifts shadowing another staff member. Stanwell Rest Home DS0000012167.V371122.R01.S.doc Version 5.2 Page 24 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 and 38 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The registered manager has the necessary skills and experience to ensure that the home is appropriately managed. People’s financial interests are safeguarded. Care staff are supervised. Records are well maintained. The health, safety and welfare of people and staff are promoted. EVIDENCE: Since the previous inspection the manager has been registered with the commission. The manager has an NVQ level 4 in care and is doing the Registered Managers Award. The manager has previous experience of managing care homes. Shortly before the unannounced inspection the home Stanwell Rest Home DS0000012167.V371122.R01.S.doc Version 5.2 Page 25 had recruited a deputy manager to support the manager. The registered manager stated that although she does not have budgetary control the provider will purchase items, such as the standaid, that she identifies as being required to meet peoples needs. Although not at the home on the day of the unannounced inspection visit the provider is regularly at the home. The registered manager stated that the provider completes regulation 26 reports. The inspector was shown the homes quality assurance file and this was discussed with the registered manager. The registered manager stated that there had been a good response to the quality assurance questionnaires completed either by people who live at the home or by their relatives. The registered manager stated that she had responded individually to any issues raised in the responses and the inspector saw letters confirming this. As a result of the quality assurance surveys the manager had identified options for people who are unable to use the homes transport due to mobility needs and also placed an activities board in the homes hall to inform people of anything happening at the home. People also confirmed that there have been service user and relative meetings. Care staff and visitors were clear that they felt able to discuss any issues/concerns with the manager. Care staff confirmed that they have regular supervision and a supervision list was seen on the office wall. The home does not become the appointee or directly manage people’s personal finances with people being supported by relatives or representatives. The home will hold small amounts of personal money for people who live at the home. This is held under secure conditions. The arrangements and records in respect of this were viewed and were well recorded with full information as to what people’s money had been spent on. Various records were viewed during the inspectors visit. All records were appropriately stored with access only available to people who should have access. Records were well maintained and stored securely. The home is generally well maintained and clean, with staff having relevant training to meet people’s needs. Some issues re the environment have been identified in the relevant section of the report with requirements made in respect of the lack of washbasins in some WC’s and the need to repair the laundry floor. The home undertakes weekly checks of the fire detection equipment. Fire drills are also undertaken. The records of both were viewed as were certificates for gas, electric supplies the hoist and standaid. Cleaning substances are stored safely and COSHH risk assessments have been undertaken. Stanwell Rest Home DS0000012167.V371122.R01.S.doc Version 5.2 Page 26 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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 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 3 3 3 Stanwell Rest Home DS0000012167.V371122.R01.S.doc Version 5.2 Page 27 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 OP9 Regulation 13 (2) Requirement The home must ensure that the storage cupboard for controlled medication meets the standards as stated in the Misuse of drugs (safe custody) Regulations 1973. The medications trolley, in which most medication is stored, must be kept clean. The home must ensure that people can cleanse their hands following use of WC’s. The flooring in the laundry has worn in parts and no longer provides an impermeable surface. The home must ensure that the laundry floor is impermeable and can be kept hygienically clean. Timescale for action 12/12/08 2. 3. OP9 OP26 13 (2) 16(2)(j) 12/12/08 12/12/08 4. OP26 23 (2)(b) 12/12/08 Stanwell Rest Home DS0000012167.V371122.R01.S.doc Version 5.2 Page 28 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Stanwell Rest Home DS0000012167.V371122.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. 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