Care Home: Stenson Court

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What the care home does well We observed good interaction between the staff and people living at the home. People`s individual needs and personalities were understood. Staff took every opportunity to maintain people`s independence and enable them to exercise choice. The manager encourages staff to train and extend their knowledge and skills. Stenson Court is a clean, homely and comfortable home. What has improved since the last inspection? Additional specialist equipment has been provided to assist with the moving and handling needs of people. What the care home could do better: Provide training and increase staff awareness of the Mental Capacity Act 2007 to fully protect people.` CARE HOMES FOR OLDER PEOPLE Stenson Court 10 Greenfield Lane Balby Doncaster South Yorkshire DN4 0PT Lead Inspector Ian Hall Key Unannounced Inspection 14th November 2007 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 DS0000032034.V354681.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. DS0000032034.V354681.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stenson Court Address 10 Greenfield Lane Balby Doncaster South Yorkshire DN4 0PT 01302 853122 F/P01302 853122 none 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) Doncaster Metropolitan Borough Council Post Vacant Care Home 30 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (10) of places DS0000032034.V354681.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The support for a variety of day care centres must not impact on the staffing needs of Stenson Court; there must be no removal of staff from the homes rota to meet a shortfall in the day centre staffing. Wheelchair dependent service users must be allocated private accommodation that has 12 square metres of useable floor space. One specific service user under the age of 65 (DE), named on variation dated 1st September 2006, may reside at the home. 17th October 2006 Date of last inspection Brief Description of the Service: Stenson Court is a residential care home owned and operated by Doncaster Metropolitan Borough Council (DMBC) for people above the age of 65. The home can accommodate up to 20 people with dementia and up to 10 elderly people. All private accommodation is in single bedrooms. Accommodation for people with dementia is in a ground floor purpose built unit. Accommodation for elderly people is in the main building. There are 5 bedrooms on the ground floor with 5 more on the first floor that is served by a lift. There are conservatories with views of the gardens and a busy road to the front of the home. There are six lounges that vary in size; two have their own sink units with tea and coffee making facilities. There is a patio that has a pergola, a room with patio doors opens onto this area. The weekly fees were £330.00 per week for elderly people and £490.00 per week for people with dementia. This information was provided on the 14th November 2007. The home charges extra for chiropody, toiletries, clothing, telephone calls, holidays and hairdressing. A copy of the home’s Statement of Purpose was available in the entrance hall. DS0000032034.V354681.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted over 5 hours. During the inspection we spoke to 5 people who live at the home and 5 staff members. The home’s annual quality assurance assessment (AQAA), survey feedback from relatives, health care professionals and people living at the home provided additional comment and information for the inspection. These included: • I like it at this home, I feel safe. • I think Stenson Court and the staff there are first class. • The food is varied well cooked and presented. • I have never had a serious complaint about the home or staff. The staff always make you welcome, and the officers are open with their answers when questioned. • There have been delays in personal care I was told this was due to staff shortages, sometimes non emergency medical issues are left for a day or two before referring to the GP, things have improved since recent changes. • Mum is encouraged to take part in activities and does, staff are always on hand. • I’m well satisfied with the care mum is receiving. • My family are always well received and listened to. • Beautiful throughout and smells sweetly. The staff are most happy and helpful at all times. We are pleased and my mum is more than happy. People spoken with were happy to assist with the inspection. Comments were positive when describing the care and motivation of the staff, these included: “the nurses are very good to me”, and “its lovely here the girls are smashing”. At the end of the inspection verbal feedback was given to the homes acting manager. What the service does well: What has improved since the last inspection? DS0000032034.V354681.R01.S.doc Version 5.2 Page 6 Additional specialist equipment has been provided to assist with the moving and handling needs of people. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. DS0000032034.V354681.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000032034.V354681.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6. People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service and sampling care records. Detailed information is provided to enable people to choose whether the home is the one for them. Detailed assessments showed that people’s needs could be met prior to offering them a place. Opportunities were available for people to visit and sample the service provided. EVIDENCE: Records examined demonstrated that steps for pre admission assessment had been followed. These included records/reports of each visit and included people’s comments and response to time spent there. Care needs had been identified and plans developed prior to people’s arrival. Written evidence from community agencies had been included within the assessment process. Intermediate care is not provided at the home. DS0000032034.V354681.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service and sampling people’s case files. Care staff ensured that people’s health care needs were met. Staff attitude and approach to care was based on respect for the person and this helped to safeguard and promote people’s rights and dignity. Staff were working to the home’s policies for the administration of medication, this promoted the wellbeing of people who lived at the home. EVIDENCE: People’s care needs had been assessed; there were detailed care plans to inform staff how to meet these needs. These had been reviewed regularly. Most people we spoke to knew about their care plan, relatives were informed and involved whenever possible. There were records of visits by the GP, community nurse, occupational therapist, dentist, opticians and chiropodist. People said staff helped them to go to the doctors when they needed to. One person has been admitted to hospital recently. The home provides the aids and equipment necessary to meet people’s moving and handling needs. DS0000032034.V354681.R01.S.doc Version 5.2 Page 10 All people are registered with a family doctor; the home has good relationships with the doctors and the district nurses. People were able to manage their own medication if they wished several had been assessed as capable of doing this safely. No one was currently doing this – those spoken with said that they were happy for staff to manage their medication on their behalf. Ordering storage, administration and disposal of medicines was checked. We observed medicines being given to people. They were helped and assisted to take them appropriately. We observed staff knocking upon bedroom doors and waiting to be invited before entering this promoted the privacy and dignity of each person. Our observations were of mutual respect with warm relationships between staff and people living at the home. DS0000032034.V354681.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. People who use 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 sampling care files, talking with people and staff. Social and leisure activities are organised by staff, people spoke favourably about their involvement in the activities. There was a good catering service, which met people’s nutritional needs and food preferences. People who live at the home were encouraged to eat a healthy and varied diet. EVIDENCE: A range of activities was provided to meet people’s abilities and choice. There were records of people making telephone calls and visiting local shops. Stenson Court is well equipped with TV and radio with games, books and magazines. Drinks and snacks are available throughout the day. There was a choice of menu for each meal, staff were observed to encourage and assist with meals. The meal was unhurried with extra portions available as required. The dietician had assisted with compiling the menu we saw that a varied and nutritious menu was planned for the week. DS0000032034.V354681.R01.S.doc Version 5.2 Page 12 Most people said that they liked the food, one commented that “it’s fine but not like I would cook for myself at home”. The cook was aware of any special diets and was knowledgeable about individual’s likes and dislikes. There was information about people’s dietary needs in the care plans. DS0000032034.V354681.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People who use the 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 staff and management operated a complaints policy to protect people. The policy and procedures for adult protection complied with DMBC safeguarding policy. Staff had been trained to implement these procedures to protect people from all forms of abuse. EVIDENCE: There have been no complaints or protection issues reported to CSCI since the last inspection. We spoke with a new member of staff and found that their induction training included information regarding both the complaints policy and the adult protection policy of Doncaster Metropolitan Borough Council (DMBC); the member of staff was aware of their responsibilities in these areas. We spent time with people currently accommodated in each area of Stenson Court. They spoke well of the home and the staff who care for them. Concerns they had raised with staff about meals and laundry services had been dealt with promptly and to their satisfaction. DS0000032034.V354681.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. People who use the 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 was clean, well-maintained, odour free and homely. Bedrooms were clean, comfortable, well decorated and furnished to meet people’s needs. Good hygiene standards were maintained and this helped with the control of infection and making the home more pleasant. EVIDENCE: We toured of the building accompanied by a member of staff. The premises had a good standard of décor and furnishings. There were no unpleasant odours all rooms entered were clean, tidy and well maintained. DS0000032034.V354681.R01.S.doc Version 5.2 Page 15 People’s bedrooms were comfortable and reflected their choice and own interests. Toilets and bathrooms were equipped with mobility aids and adaptations and located throughout the building to encourage people to maintain their independence. There was lounge located on each wing of the building. They varied in size and were used by different people as they chose. A member of staff was present in each area to supervise and assist people with their needs and maintain safety. DS0000032034.V354681.R01.S.doc Version 5.2 Page 16 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 this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including looking at training and supervision records, speaking to available staff and people who use the service. The numbers and skill mix of staff were sufficient to meet peoples’ needs. Staff had received training to meet general and specific needs. Appropriate support and guidance was provided to new staff, enabling them to safely care for people who lived at the home. Staff files included the required information. The home operated a recruitment policy that promoted people’s protection EVIDENCE: We met with five members of staff including the acting manager during the course of this inspection. We also observed them working with people and noted that there was an atmosphere of mutual respect the conversations were relaxed and friendly. A number of staff have worked with the people for a long time. One new member of staff we interviewed was able to provide evidence both written and verbal of her induction training and developing knowledge of the care needs of people at Stenson Court. She confirmed that she had been DS0000032034.V354681.R01.S.doc Version 5.2 Page 17 required to provide two satisfactory written references and a Criminal Records Bureau check before commencing employment with these vulnerable people. Records of staff supervision and identified training needs were examined. The majority of staff had achieved National Vocational Qualifications, the remaining staff were working to achieve the award. Skills for prevention of infection and fire and health and safety were updated each year. This ensures that staff are trained to meet people’s care needs safely. DS0000032034.V354681.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including interviewing the manager and observing staff as they work. Staff said that they were well supported by the manager. Systems were in place to protect people’s financial interests. The home is well organised and managed ensuring that people’s health, safety and welfare needs were promoted and protected. EVIDENCE: We saw that there was always a senior member of staff on duty at the home with advice and support readily available. Responsibilities for the day-to- day operation of Stenson Court are shared between senior members of the team. Risk assessments had been completed and were being reviewed regularly. DS0000032034.V354681.R01.S.doc Version 5.2 Page 19 People felt that their views and opinions were taken into account by the staff. The providers (DMBC) had carried out regular, unannounced monthly visits to the home to monitor the care and services provided. Service records for the moving and handling equipment, fire safety records and other maintenance records were up to date; personal finances were properly recorded and personal allowances provided. The manager and deputy had received training in the Mental Capacity Act. This training has not been provided for all staff to ensure they are aware of the changes needed to fully protect vulnerable people at the home. DS0000032034.V354681.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 3 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 x x 3 DS0000032034.V354681.R01.S.doc Version 5.2 Page 21 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 OP38 Regulation 13(6) Requirement Staff must receive training in the Mental Capacity Act 2007. Timescale for action 01/04/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations DS0000032034.V354681.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR 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 DS0000032034.V354681.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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