Care Home: Station House Nursing Home

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What the care home does well The home is very well managed by a well qualified and experienced management team. Staff, residents, and their visitors are given opportunities to express their views about the home. This helps to make sure the home is run in a way that suits residents` needs and preferences. Any complaints received are investigated fully and are used as a way of learning how the service can improve. Station House specialises in providing a home for people with a high level of care needs and enables these people to live in a comfortable and homely environment rather than staying in hospital. People`s needs are carefully assessed before they go to live at Station House to make sure that it is the right home for them and that the staff will be able to meet their needs. People living at Station House have choices about how and where they spend their time and a good range of social activities is provided for those people who like to take part so they can stay active. Good recruitment procedures are followed to make sure new staff are suitable to work with vulnerable older people. All new staff complete a thorough induction programme to make sure they know how they should provide care for the people who live at the home. Most of the care staff have an NVQ qualification in care so they have the knowledge and skills to provide care for the people who live there. Staff have regular one to one meetings with their manager to ensure that they have the opportunity to discuss any concerns they have and are given the support they need. Regular auditing shows where staff are not achieving the required standard so that the managers can address this with them to make sure that residents receive good quality care. All parts of the home were clean and there were no unpleasant odours, so Station House is a pleasant place for people to live. There is a five year expenditure programme to ensure that the environment, and the equipment provided, are kept in good condition. What has improved since the last inspection? The number of care staff with an NVQ in care has increased to more than 80%. Unit managers have completed training in supervisory management. Nurses and care staff have completed foundation training in palliative care. This ensures that staff have the knowledge and skills to look after the residents well. Coppenhall unit has been redecorated and re-carpeted. There is a new family room and kitchenette on Victoria unit. The deputy manager has a new office. A lot of bedrooms have been redecorated and recarpeted or fitted with washable flooring. The fire alarm system has been replaced, which helps to make sure the home continues to be safe for the people who live and work there. What the care home could do better: No requirements or recommendations have been made as a result of this inspection.We saw evidence that the management are always looking at ways to improve the service they provide. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Station House Nursing Home Victoria Avenue Crewe Cheshire CW2 7SF     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Wendy Smith     Date: 1 1 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Station House Nursing Home Victoria Avenue Crewe Cheshire CW2 7SF 01270250843 01270250845 manager.stationhouse@careuk.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Carole Wardle Type of registration: Number of places registered: Community Health Services Limited care home 69 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: This home is registered for a maximum of 69 service users to include:- * Up to 39 service users in the category DE(E) (Dementia over the age of 65 years) may be accommodated in Coppenhall Mews * Within the 39 DE(E) beds up to 6 service users in the category DE (Dementia under 65 years of age) may be accommodated * Up to 30 service users in the category OP (Old age, not falling within any other category) may be accommodated in Victoria Mews * Within the 30 OP beds up to 6 service users on the category PD (Physical disability) may be accommodated Date of last inspection Brief description of the care home Station House is a care home providing nursing care for a maximum of 69 people. It is owned by Community Health Services, a subsidiary of Care UK. The home is half a mile from Crewe town centre. It is a single storey, purpose built facility and comprises two Care Homes for Older People Page 4 of 27 6 0 6 Over 65 39 30 0 Brief description of the care home separate residential units and a day care centre (which does not require registration with the Commission for Social Care Inspection). Victoria Mews has 30 beds for people who are physically frail and Coppenhall Mews has 39 beds for people with dementia. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is three stars. This means that the people who use tjis service experience excellent quality outcomes. We (the Commission for Social Care Inspection) visited Station House unannounced on 4 November 2008 as part of this inspection. Two inspectors carried out the visit. A second visit to complete the inspection was made on 11 November 2008. During the visit we spoke with residents, staff and visitors. We walked round the building to see all the communal areas and were able to visit some of the bedrooms. We checked some of the records kept at the home and spent time talking with the deputy manager of the home and the regional director of the company that runs the home. Care Homes for Older People Page 6 of 27 We also looked at any information that we had received about Station House since our last inspection there. Before the inspection the manager was asked to complete a questionnaire to give us up to date information about the service. What the care home does well: What has improved since the last inspection? What they could do better: No requirements or recommendations have been made as a result of this inspection. Care Homes for Older People Page 8 of 27 We saw evidence that the management are always looking at ways to improve the service they provide. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People interested in going to live at Station House are assessed by a senior nurse from the home to make sure that their needs can be met there. Evidence: Station House provides a total of 69 places on two separate units. There is also a day centre attached to the home. Coppenhall unit accommodates up to 39 people who have dementia, and Victoria unit accommodates up to 30 people who are physically frail. Forty-eight places are contracted to the Primary Care Trust and are funded by the NHS. As a result of this, many of the people who live at Station House, or have a short stay there, need a high level of care and support. Some of the people who come to stay at Victoria unit are at the end stage of their illness and require palliative care to keep them comfortable in their final days. The deputy manager told us that senior staff from the home go out to visit people who Care Homes for Older People Page 11 of 27 Evidence: have been referred to the home and we saw copies of the assessments that had been carried out. This is to make sure that Station House will be the right place for them and that their needs can be met there. Written information about the home and the service it provides is available for residents and their relatives so they have the information they need to decide whether the home will be right for them. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Station House receive the nursing care and personal care they need so they remain comfortable and safe. Evidence: Each person living at Station House has a care plan that details their needs and what the staff need to do to meet those needs. The care plans are electronic on a computerised system that has been introduced since we last inspected the home. We looked at a sample of care plans to see the details of the care people receive at the home. We found that some had been completed to a very good standard, but others were less detailed, depending one which member of staff had written the plan. For example, one of the care plans we looked at was for a very frail person but it did not contain much detail to show how that persons needs should be met. The care plans we saw included details of visits from GPs and other medical professionals including a dietician and speech therapist. Staff of the home work closely with MacMillan nurses and a local hospice to provide end of life care. The unit manager Care Homes for Older People Page 13 of 27 Evidence: for Victoria unit has a diploma in palliative care which means that she is skilled and knowledgeable about this type of care. We saw from the files that mental health professionals give support and advice about the care of people living on Coppenhall unit. We also saw plenty of equipment around the home for keeping people safe. We looked at the arrangements for ordering, storing, administering and disposal of medicines. We found that the medicine storage rooms were tidy, orderly and drugs were stored appropriately. Administration records were good. Controlled drugs were stored and recorded to comply with legislation. This means that the medicines are being well managed so that people at the home receive their medicines safely as prescribed by their doctors. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a good range of social opportunities provided for people living at Station House and they are able to exercise choice in the way they spend their time, so they maintain control over their daily lives. Evidence: At the entrance to each unit there is a noticeboard with pictures of staff, their names and job titles to help residents and their visitors identify each member of staff. The programme of social activities is also displayed so residents know what events are happening. There is an activities organiser employed at the home to make sure there is social stimulation for residents. This year there was a big party for the 15th anniversary of the home opening and there have been several trips out over the summer. A Friends of Station House group meets monthly. There are two nondenominational religious services each month in the home that people who live there can choose to take part in. Coppenhall unit provides a spacious environment for people to walk around, and there are various places where they can sit down. There are pictures on the walls, and toilets and bathrooms are clearly identified so they are easy to find. We found a peaceful and Care Homes for Older People Page 15 of 27 Evidence: relaxed atmosphere in Coppenhall unit. Peoples bedrooms are personalised so they are more homely and adapted to suit individual needs. Victoria unit also has a choice of sitting areas and lounges. A life story book being developed for each resident. This contains a personal history and pictures to help staff know more about each residents life before they moved into the home. Families are involved in putting together the life story book and some families have appreciated having this book to keep after the person has died. There were visitors at the home throughout the morning and some had brought a dog with them for residents to see. There is a visitors room where families of people who are terminally ill can stay. There was a menu on a dining table in Victoria which showed the choices of meals for each day. There is a kitchen in each unit where drinks and snacks can be made and the deputy manager told us food is always available for residents. Bread, cake, biscuits and so on are taken to the units and staff also have access to the main kitchen out of hours. This means that food can always be made available if residents want to eat outside of the main meal times. There is a choice of two hot meals and two puddings at lunch time and all can be pureed for people who have swallowing difficulties. Residents can choose to have a full cooked breakfast, and this can also be pureed. The manager told us that the chef visits new residents to find out their preferences to make sure these are catered for in the daily meal choices. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints and concerns are dealt with very well so people living at the home know their concerns will be taken seriously and staff receive effective training about safeguarding people from abuse so they know what to do to protect people at the home from harm. Evidence: The homes complaints procedure is clearly displayed and there are complaints forms available for people to use if they have any concerns. There is also a comments book for residents and visitors on each of the units. There were records of five complaints received during 2008, and for each there was a record of a very full and detailed investigation. Recommendations had been made as a result of these investigations. These were discussed at unit meetings and with individual staff in supervision meetings. Our discussions with the deputy manager and the regional director showed an open and honest approach to dealing with complaints and a commitment to learning from complaints. Two complaints had been received from relatives of people who had short stays at the home. Following this a system has been put in place whereby people who come to stay at the home for respite have a discharge form to take home with them and a satisfaction questionnaire to return if they wish to. The unit manager also phones them 48 hours after they go home to ask whether there were any problems. Full details of Care Homes for Older People Page 17 of 27 Evidence: any serious complaints are sent are to the CSCI. The home has a copy of the most recent guidance on safeguarding adults and there are also detailed company policies and procedures about protecting vulnerable people from abuse. We saw a very good training package for staff, which involves an interactive electronic programme. Staff must achieve 100 to pass. Records we saw showed that staff also have an annual update of this training. There has been good reporting of any safeguarding issues to both social services and CSCI and the records show that these matters have been dealt with promptly and correctly to make sure that people living at the home are protected. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well maintained so that it provides spacious, comfortable and safe surroundings for people to live in. Evidence: The home provides a comfortable, safe and well-maintained environment for people to live in. It is a single storey building with plenty of space and a choice of places for people to sit. There is a smoking area outside and secure gardens that residents can use. Everywhere looked to be in a good state of repair and the regional director of the company that runs the home told us that there is a five year plan of significant expenditure for development of the environment. Over the next year, Victoria unit will be redecorated and have new carpets. A number of bedrooms will be refurbished, and new specialist chairs, lounge chairs, dining room furniture and profiling beds will be provided. All parts of the building were clean and there were two domestic staff working in each unit. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are thorough recruitment procedures and a good training programme so residents can be confident that the staff caring for them are well qualified and trained. Evidence: During our visit to the home there were enough staff on duty to meet the needs of residents. Staff who completed one of our questionnaires told us that there are always enough staff on duty except when staff go off sick at short notice. The deputy manager said that she will provide cover if there are not enough nurses for a shift. Senior care staff have been appointed on each of the units and they complete a three month competency training course. There is a low staff turnover and small use of agency staff so residents at the home receive good continuity of care from staff that they know. More than 80 of the care staff have NVQ level 2 in care and four others have started working towards NVQ level 2. Three care staff have NVQ level 3 and three others are working towards it. This provides a very well qualified staff team who have the knowledge and skills to meet the residents needs. We looked at the recruitment records of three new members of staff (a nurse, a care assistant and a domestic). All had completed application forms giving details of previous employment. Satisfactory references, Criminal Record Bureau (CRB) Care Homes for Older People Page 20 of 27 Evidence: disclosures and medical declarations had been received before they started working at the home, to ensure that they would be suitable to work with vulnerable people. The records we saw showed full induction training for all of these people. A comment that we received from a nurse was I was very impressed by the induction programme. There is a training room in the home and there are six in-house trainers. Records showed that training about safe moving and handling, safeguarding and fire safety is updated every year for staff. All of the staff who completed our questionnaires expressed their satisfaction with the training opportunities provided for them. Nurses attend training provided by the primary care trust about subjects including catheterisation, venepuncure and wound care, which means that they have up to date knowledge on how to provide care in these areas. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is very well managed to ensure that the health, safety and well-being of the people who live at Station House are promoted and protected. Evidence: The home has strong and stable management team. The manager has been in post since 2000 and the deputy manager has worked at Station House since 2001. Both are registered nurses and have completed the registered manager award. There are also two unit managers and a night manager. We received very positive comments about the home and the way it is managed from staff. All expressed their satisfaction with their induction, ongoing training, and the support they receive from the manager. The questionnaire the manager was asked to complete before our visit to provide us with up to date information by the home was detailed and showed that the management team of the home are always considering how the service they provide can be improved. Care Homes for Older People Page 22 of 27 Evidence: The regional director of the company that runs the home visits at least once a month. She completes the monthly visit required and provides one to one support for the home manager. There are monthly unit meetings and monthly heads of department meetings. Each member of staff has a bi-monthly individual support meeting with their manager to make sure they receive the support and guidance they need. There is a quarterly meeting for relatives and we saw the minutes from the meeting held in September 2008, when the use of bedrails was discussed. An annual customer satisfaction survey is carried out by the company that runs the home. The results are made available for residents, staff and visitors to see. There is also a suggestions box and a comments book on each of the units for residents and their relatives to use. Monthly care plan audits are done by the manager and the deputy manager. The regional director also looks at a sample of care plans. The audits identify where staff are not performing to the required standard and this is then dealt with. There are also regular checks done of medicines to make sure these are being managed well and safely so that residents receive their medicines as prescribed. There is a system for residents to be able to keep some personal spending money in a safe at the home. Detailed individual records are kept. At present all residents have a relative or other person who looks after their finances and the home is not involved in any of their financial arrangements. Accidents that happen in the home are recorded electronically by the nurse on duty at the time the accident occurs. We saw an example of where a night nurse had provided a very detailed report of an accident suffered by a resident. The accident reports are signed off by a manager and if they are incomplete they are sent back to the nurse for more detail. A monthly accident report is sent to the regional director and the clinical governance department of the organisation that runs the home. The maintenance person who works at the home carries out weekly checks of bedrails, wheelchairs, window restrictors, hot water temperatures and fire alarms to make sure these are all safe and working correctly. We saw the records that he keeps of all these checks. There are regular fire drills and the names of staff attending are recorded to show that they know what to do if a fire breaks out. Emergency evacuation mats have recently been provided at the home. The information we were sent before our visit gave dates to show that all plant and equipment had been serviced within the last year to make sure that it is safe. Care Homes for Older People Page 23 of 27 Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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