Care Home: Stone Gables

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What the care home does well What has improved since the last inspection? There have been ongoing improvements to the environment including a new stair lift, redecoration and replacement of furnishings and floor coverings. A snoezlem is to be delivered during January 2008. All of the requirements and recommendations made in the last inspection report have been addressed. These included specific training for staff, the recording of recruitment interviews with staff, recording of the administration of medication, care plan documentation and the setting of the dining room before meals. Good work has been done to make the presentation of information about the home, menus and questionnaires easier to understand for people with dementia. The manager has changed the layout of the lounge furniture to make cosier and more social areas. There has been a good deal of staff training both for care staff and domestic staff and the home exceeds targets for numbers of people with a National Vocational Qualification. What the care home could do better: CARE HOMES FOR OLDER PEOPLE Stone Gables Street Lane Gildersome Leeds West Yorkshire LS27 7HR Lead Inspector Paul Newman Key Unannounced Inspection 2nd January 2008 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Stone Gables DS0000001510.V357264.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. Stone Gables DS0000001510.V357264.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stone Gables Address Street Lane Gildersome Leeds West Yorkshire LS27 7HR 0113 2529452 F/P 0113 2529452 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) Castlegrounds Limited Mrs Serrina Cooper Care Home 40 Category(ies) of Dementia - over 65 years of age (15), Old age, registration, with number not falling within any other category (40) of places Stone Gables DS0000001510.V357264.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20/03/07 Brief Description of the Service: Stone Gables is a stone built converted and extended property, situated on the outskirts of the village of Gildersome it has a pleasant outlook. It is convenient for the bus service, which gives access to the surrounding area and Leeds city centre. Stone Gables provides residential care to 40 adults, accommodation is provided on 2 floors in 36 single bedrooms and 2 double bedrooms. There are well-maintained safe gardens to the rear of the home. There are sufficient bathing facilities around the home. Toilets are located near to service users accommodation and communal areas; separate toilet facilities are provided for staff. The ground floor has large lounge areas with a separate smaller area for service users who wish to smoke. Information about the home is provided in the form of a statement of purpose and service user guide. Both these documents are available at the home, are regularly updated and outline the terms and conditions for residents. The current fees charged are £408 to £442 per week. There are additional charges for hairdressing; newspapers; toiletries; and private chiropody. This information was provided by the home in January 2008 and is subject to annual review. Stone Gables DS0000001510.V357264.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This was an unannounced visit carried out by one inspector that started at 9:30 and finished at 15:30 on 2 January 2008. The purpose of the inspection was to make sure the home was operating and being managed for the benefit and well being of the people who live there and that the outcomes for the people meet National Minimum Standards. Before the inspection, information collected about the home over the last year was reviewed. This included looking at any reported incidents, accidents and complaints. Survey forms were sent to the home before the inspection for the manager to give out to people living at the home, visitors, healthcare professionals involved in peoples’ care and the staff working at the home. This gives people the opportunity to comment if they want to. Information provided in this way may be shared with the provider but the source will not be identified. Some of the written comments that were made in the surveys are included in the report to show what people think about the way the home is run. The manager had completed an Annual Quality Assurance Assessment (AQAA) before the visit to provide additional information. This is a self-assessment of the service provided and this gives a lot of information about how the manager thinks the home is meeting standards, how it has improved during the last year and what further improvements are intended in the year ahead. All of this information was used to plan the inspection visit. A number of documents that the home must keep up to date were looked at during the visit. All areas of the home used by the people who live there were checked. Time was spent talking with the people, watching what was going on, as well as talking with the manager and some of the staff on duty. The manager was given verbal feedback about the outcome of the inspection visit and provided with an analysis of the surveys that were returned. What the service does well: The home is well managed and the staff team are properly trained motivated and equipped for the job. They are happy in their work and committed to providing high standards of person centred care. The needs of residents are the focus of the staffs’ attention and people looked happy and well cared for. Staff make sure that residents are treated with dignity. Stone Gables DS0000001510.V357264.R01.S.doc Version 5.2 Page 6 Information about the home is readily available and is available in different formats. People are properly assessed before they come to live at the home. This helps to make sure a good care plan can be drawn up that identifies peoples’ needs. The home works closely with other healthcare professionals, makes referrals at an early stage and takes the advice that is given. These are some of the written comments made by healthcare professionals in surveys that were returned to the CSCI: • • • • ‘If the care staff feel that there is a problem with a resident, they always contact the District Nurse or GP for further advice or assessment’. ‘The staff work with the district nursing team and take any advice given to ensure that the health care needs are met for all residents’. ‘The home is happy for the district nursing team to provide training sessions – such as pressure area care, continence care and diabetic care’. ‘At the moment I am seeing improvements all the time at Stonegables ie. Good relationships have been formed with the district nursing team and communication is improving; the environment has improved; the home seems a clean and tidy environment’; the new manager is eager to work with the district nursing services to improve care’. ‘The home is actively engaged in supporting and educating staff with regard to improving dementia care’. ‘The home is actively improving standards of care – its person centred philosophy. Improving the home environment and social activities’. • • The home provides a range of enjoyable activities for people. The food provided is wholesome and meets with the approval of people living there. The building is homely, safe and comfortable. The collective evidence clearly shows this is a home that seeks the views of people, evaluates its own performance and recognises where improvements need to be made and will take the necessary action. These are some of the written comments made in surveys returned by relatives: • • • • • • ‘We always get information from the staff of how my Mum is getting on. They always make time to talk to us’. ‘I am very happy with the care my mother gets both physically and mentally’. ‘All the staff are very caring and friendly. They run the home to a very high standard and I have never had to complain about the care’. ‘The staff are so caring and I have nothing but praise for all the staff’. I am very happy with the care my mother is getting and feel very content knowing my mother is getting all the help she needs from the staff’. ‘I find the staff very good on my visits each day for up to an hour’. DS0000001510.V357264.R01.S.doc Version 5.2 Page 7 Stone Gables • ‘I have always taken notice of all the staff of how they approach and handle the ladies and gents of the home, and its always nice to see the manager making time to see the ladies and gents talking with them, getting involved……… she and all her staff do an excellent job’. What has improved since the last inspection? What they could do better: This inspection found that the home is meeting National Minimum Standards with good outcomes for the people living there. The following recommendations made will serve to improve some record keeping: • Although the conversations with staff show that they know the personal likes, dislikes and preferences of people, more detail should be included in the assessment for activities for daily living so that more personalised information about the person is included. There are documents in the care plans to record the activities that people are involved in but when checked these were found to be inconsistent in the recording and do not reflect the good work going on. • 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. Stone Gables DS0000001510.V357264.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Stone Gables DS0000001510.V357264.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3. Standard 6 does not apply to this home. People who use the service experience good quality outcomes in this area. We have made this judgement using available evidence including a visit to this service. People who use this service have good information about the home in order to make an informed decision about whether the service is right for them. People are properly assessed before admission so they can be sure the home can meet their needs. EVIDENCE: The information provided before the inspection visit that was summarised in the Annual Quality Assurance Assessment (AQAA), showed that all people considering coming to live at the home and their relatives are seen personally. A visit to the home is arranged when at least the relatives and, if possible, the prospective service user can see the room available the general facilities and meet other people living there. They are provided with a service user guide Stone Gables DS0000001510.V357264.R01.S.doc Version 5.2 Page 10 that outlines the terms and conditions. The manager has reviewed the guide since being appointed and has introduced photographs and a large print copy. This helps people with sight problems to read the guide more easily. The statement of purpose and service user guide are reviewed regularly and it was recommended that the section on the criteria for admission be ‘tweaked’ to reflect the capability that has developed with regard to the care of people with dementia. Three peoples’ files were checked to get a view about the detail of information that is gathered before a person is considered to come and live at the home. The files included the most recent admission. People are only admitted on the basis of a full assessment. The files showed that this includes gathering information from healthcare professionals, social workers, families and the person themselves. The manager goes to see the person to make their own assessment, so by the time a decision is made the home has enough information about, activities for daily living, medical history, care needs, nutrition, mobility and moving and handling. Although there was sufficient information to develop a plan of care, a recommendation was made to try to develop the detailed recording in the assessment for activities for daily living so that more personalised information about the person is included in the plan. Simple things like personal preferences for getting up times, bathing/showering preferences, how and what the person likes to dress in, will begin to fully evidence the ‘person centred’ approach the manager is keen to develop. Nevertheless, it was clear from the conversations with the manager and staff that they know the people they care for well. A new development has been the introduction of peoples’ life histories. This is a good development and helps staff with background information that gives them a better understanding of individuals’ lives and helps with day-to-day conversation and communication. Stone Gables DS0000001510.V357264.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. People who use the service experience good quality outcomes in this area. We have made this judgement using available evidence including a visit to this service. Peoples’ healthcare needs are met and care plans provide clear instruction for staff to follow so they are aware of peoples’ needs. People are protected by safe medication policies, procedures and practices. People are treated with respect and in a dignified way. EVIDENCE: Care plans are based on a pre admission assessment carried out by the manager together with information and assessments gathered from other people like healthcare professionals who have been involved in the persons care. The care plans that were checked showed that information had been accurately used from the pre-admission assessment so that needs were identified and then reviewed regularly. The plans included activities for daily Stone Gables DS0000001510.V357264.R01.S.doc Version 5.2 Page 12 living, risk assessments for moving and handling, nutrition, and it was good to see a risk assessment for peoples’ isolation. The involvement of the family and person about their life history, likes and dislikes, preferred ways of living and routines, is a way to make the care plans more person centred and helps staff deliver care in an individual way. The AQAA that was completed by the manager identified that the detail of this kind of recording is an area of development that the staff team will work on over the next year by increasing the amount of one to one time that keyworkers spend with individuals. There was evidence of this beginning to happen in the care files and in the course of time, this should improve the detail and advice to staff in the specific plans of care. Families are being encouraged to meet with staff on a regular basis to talk about the care that is being provided and there was evidence of this in the care files. There was good evidence of involvement with healthcare professionals, like the Community Nurse, Community Psychiatric Nurse and Doctors. Records were completed well and it was easy to track where staff began to identify health problems, made a referral and there was good documentation of the diagnosis and advice that should be followed. Survey that were returned by healthcare professionals included these written comments: • • • • ‘If the care staff feel that there is a problem with a resident, they always contact the District Nurse or GP for further advice or assessment’. ‘The staff work with the district nursing team and take any advice given to ensure that the health care needs are met for all residents’. ‘The home is happy for the district nursing team to provide training sessions – such as pressure area care, continence care and diabetic care’. ‘At the moment I am seeing improvements all the time at Stonegables ie. Good relationships have been formed with the district nursing team and communication is improving; the environment has improved; the home seems a clean and tidy environment’; the new manager is eager to work with the district nursing services to improve care’. ‘The home is actively engaged in supporting and educating staff with regard to improving dementia care’. ‘The home is actively improving standards of care – its person centred philosophy. Improving the home environment and social activities’. • • Medication procedures and practices were discussed and observed and were safe. The facilities for the storage of medication, the recording of the administration of drugs, including controlled drugs and the disposal of medication were checked and found to be sound. In the time spent watching what was going on the staff seemed organised and efficient in making sure people got the attention and care they needed. Staff Stone Gables DS0000001510.V357264.R01.S.doc Version 5.2 Page 13 were personable and professional and relationships appeared good with some friendly banter from time to time. There were examples of good practice in making sure that peoples’ dignity was maintained. Clothing was clean and all of the residents looked well cared. Staff were careful to make sure doors were closed at times when personal care was delivered and were seen knocking on doors before entering rooms. They were attentive to people and some overheard conversations showed staff to have a nice manner that people appreciated. Surveys that were returned by people living at the home included these written comments: • • ‘We always get information from the staff of how my Mum is getting on. They always make time to talk to us’. ‘I am very happy with the care my mother gets both physically and mentally’. ‘All the staff are very caring and friendly. They run the home to a very high standard and I have never had to complain about the care’. ‘Staff respond well to the emergency call’. ‘I can only speak on behalf of my Mother. Since she arrived, very angry and confused and she had not slept in a bed for 4 years, had no routine. She is now sleeping in her bed and is so relaxed and happy, it is a joy to come and see her. The staff are so caring and I have nothing but praise for all the staff’. I am very happy with the care my mother is getting and feel very content knowing my mother is getting all the help she needs from the staff’. ‘I find the staff very good on my visits each day for up to an hour’. ‘I have always taken notice of all the staff of how they approach and handle the ladies and gents of the home, and its always nice to see the manager making time to see the ladies and gents talking with them, getting involved……… she and all her staff do an excellent job’. • • • • • Stone Gables DS0000001510.V357264.R01.S.doc Version 5.2 Page 14 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 quality outcomes in this area. We have made this judgement using available evidence including a visit to this service. Peoples’ social expectations and personal preferences are met and they are able to exercise choice in their lifestyles so they can be as independent as they can be. People living at the home are provided with a varied and nutritious diet so they can eat healthily. EVIDENCE: The home offers a range of activities each week and around the building there are photograph displays of some of the more significant events like the trip to Bridlington during the summer. There had been a Christmas party and regular entertainers. There are two visiting activity organisers. ‘Kaleidoscope’ visits twice a week and provide exercise to music, bingo, hand massage, nail care and arts and crafts. Someone from Age Concern visits once every fortnight and provides a range of reminiscence type activities and quizzes. The home has its own activity organiser who provides, amongst other things, line dancing that proves to be popular with people living at the home. There are Stone Gables DS0000001510.V357264.R01.S.doc Version 5.2 Page 15 documents in the care plans to record the activities that people are involved in but when checked these were found to be inconsistent in the recording. There is some good work being done to develop information for things like menus in a pictorial form so that people with dementia or communication problems can identify things easier. Signage around the home and photographs on doors make it easier for people to find their way around the home. This all helps people maximise their choices and keep their independence. The surveys that were returned and conversations held during the inspection visit showed that people enjoy contact with their family and friends and the written information about the home identifies that there are no restrictions on visiting times. People said that they were made to feel welcome in the home. There are links with local schools and churches and in the lead up to Christmas local schools had put on a play and carols. Local clergy provide pastoral care and practical arrangements are made should anyone want to attend church or receive communion. The home has recently finished installing an audio loop system for the benefit of people who are hard of hearing. This is another indication of the positive approach to making sure that people enjoy as much independence and quality of life as possible. The home has been successful in a bid for a Government grant and is getting a snoezlem. This is a sensory relaxation device that the manager has been careful in choosing so that it is mobile and can be used in peoples’ own rooms if they wish. The surveys that were returned indicated that people are happy with the food provided. The menu board showed that there is a choice at each meal. The AQAA stated that there are regular reviews of the menus and these are discussed at residents’ meetings that are held regularly. The manager took onboard the comments made in the last inspection report and the dining room is now practically set just before the meal. The people spoken with on the inspection visit confirmed that the food was good and they had enjoyed the lunchtime meal. Staff were seen giving good sensitive support and encouragement to those people who needed assistance. Stone Gables DS0000001510.V357264.R01.S.doc Version 5.2 Page 16 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 judgment using available evidence including a visit to this service. The people who live at the home and their relatives know how to complain and feel confident that they will be listened to and that appropriate action will be taken when necessary. There are adult protection procedures that staff are aware of and understand. People can be assured that they can feel safe at the home. EVIDENCE: The manager said that the home encourages people to air views and concerns at an early stage so that staff can act upon this and resolve things quickly. In their surveys staff stated that knew how to respond to a complaint. There has been one complaint made since the last inspection. This was properly recorded, investigated but not substantiated. The CSCI was aware of the complaint and happy with the way this was dealt with by the home. Everyone spoken to during the visit said that staff were approachable, listened and wanted to make sure people were happy. Written comments made in surveys returned by people living at the home and their relatives indicated that they know the complaints procedure, are Stone Gables DS0000001510.V357264.R01.S.doc Version 5.2 Page 17 confident in raising issues and feel the manager and staff are very approachable and address problems if they arise. Policies and procedures are in place for the protection of vulnerable adults and staff have been given training on this. The training includes indicators of abuse and whistleblowing. There was evidence of recent training and further training planned for staff. Stone Gables DS0000001510.V357264.R01.S.doc Version 5.2 Page 18 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 available evidence including a visit to this service. People live in a safe, comfortable and well-maintained environment that is pleasant, clean and hygienic. EVIDENCE: There has been a good deal of redecoration and refurbishment since the last inspection visit with more planned. A stair lift has been fitted that now makes sure that all areas of the home can be accessed without having to manage steps. The entrance hall has been redecorated and provides a wealth of information about the home for people and visitors. During January a snoezlem will be delivered and more redecoration will be completed. Over recent months the manager has tried to move furniture around in the communal lounge areas moving away from seating around the edges. This has Stone Gables DS0000001510.V357264.R01.S.doc Version 5.2 Page 19 created more social ‘cosier’ sitting areas that meet with the approval of people living there. A library of books, DVD’s and CD’s is being developed. Signage is used in corridors to help people orientate themselves around the building and photographs and pictures relating to each person’s past interests or work were attached to bedroom doors to make it easier for people to recognise their own room. People spoken with said that they are free to use their rooms during the day. The bedrooms seen were personalised with people’s own belongings including photographs ornaments and pictures. The tour of the building found things to be safe and hazard free and all areas were clean, tidy and free from unpleasant odours. The laundry was busy but organised and a new tumble drier has been added to the existing equipment since the last inspection. The ongoing redecoration and refurbishment programme and the fact that the home has the services of a ‘handy person’ who carries out regular checks of equipment and services makes sure that good and safe standards are maintained. The owner is required by law to make monthly reports about the conduct of the home and has chosen to employ the services of someone from an inspection background to do this on his behalf. These reports were available for inspection and further demonstrate that things are checked very regularly. Stone Gables DS0000001510.V357264.R01.S.doc Version 5.2 Page 20 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 excellent quality outcomes in this area. We have made this judgement using available evidence including a visit to this service. People living in the home are cared for by experienced staff who are organised, properly recruited, well trained and qualified for the job. EVIDENCE: Since her appointment, the manager has reviewed the way duty rotas are organised and made changes to increase staffing levels at key and busy times of the day. Staff spoken with during the visit and comments made in the surveys that were returned acknowledged that this was better for them and for people using the service. The manager said that accident levels had reduced significantly since revising duty rotas. Staff on duty were personable and professional in the way they related with each other and with people living at the home and there was a good atmosphere. The manager was able to provide training records that showed staff have attended a good deal of relevant training since the last inspection. This includes safe working practice, medication, safeguarding and more specialist training in dementia including managing aggressive behaviour. The staff spoken with said that they enjoyed the training and saw the benefits in their work. The home exceeds targets that were set for the numbers of care staff Stone Gables DS0000001510.V357264.R01.S.doc Version 5.2 Page 21 gaining National Vocational Qualifications (NVQ). In addition to the care staff, domestic staff are also working towards NVQ’s in housekeeping. Some written comments made by staff in surveys that were returned stated: • • • ‘Since June the new manager has enrolled staff on a lot of training, helping us to all work together to work as a team and have a better understanding of dementia’. ‘I have carried out many courses and achieved many qualifications while working at Stonegables’. ‘’We do plenty of training to meet everything we need to know’. The recruitment files for two staff appointed since the last inspection were checked to see that the proper references and checks had been made before the people were appointed. The files were organised and complete with all the required information. Stone Gables DS0000001510.V357264.R01.S.doc Version 5.2 Page 22 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, 32, 33, 35 and 38. People who use the service experience good quality outcomes in this area. We have made this judgement using available evidence including a visit to this service. The home is well managed. The opinions and interests of the people are central to the way the home is run and there is a clear approach to resident care that is person centred and is the focus of staff practice. Regular auditing and checking of facilities, equipment and services make sure the home is a safe place to live. EVIDENCE: The manager has been in post for seven months and has completed a recognised management qualification and the formal process of registration Stone Gables DS0000001510.V357264.R01.S.doc Version 5.2 Page 23 with the CSCI. She has qualifications in the care of people with dementia and the owner has arranged for some additional management training during January 2008. The manager is young, enthusiastic and has a clear vision of person centred care. Written comments made by healthcare professionals, relatives and staff in surveys that were returned indicate her positive approach and positive outcomes for people living at the home. These are some comments made: • • • ‘All the new changes that have been made are good for staff and service users’. ‘I think the service has improved since the new manager has been appointed. Service users get more say and more choice’. ‘Since the new manager has taken over, things certainly seem to have improved in every way. Her happy relaxed manner, seems to rub off on everyone’. There was good documentary evidence of a commitment to quality assurance. The manager is organised and was able to provide files that show the system is National Minimum Standard focused, with performance indicators, regular checking and auditing and documentary evidence of improvements that have been made. The owner visits the home monthly but employs someone from an inspection background to visit monthly and make a written report about the conduct of the home that includes talking with staff, people living at the home, visitors and inspection of the building and documentation and safety checks. The home carries out its own satisfaction surveys and an evaluation report of the last survey will be ready at the end of January 2008. The manager has developed pictorial questionnaires for those with communication difficulties. This is good practice. The home holds some amounts of personal money for safekeeping for some people. The systems of accounting for this were discussed and the records seen. One persons record was checked and reconciliation made with the cash held and found to be correct. The information provided in the AQAA showed that regular checks are made of equipment and services to make sure that everything is safe and in good working order. Staff have access to all essential policies and procedures and are trained in safe working practices. The maintenance person is responsible for a range of regular checks of systems and equipment. A recent monthly report recommended that water temperatures are checked monthly and this has been implemented. Fire safety records were checked and were organised and up to date. Accidents are recorded and audited regularly to check if there are ways to reduce the risks to people. Stone Gables DS0000001510.V357264.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 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 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X X 3 Stone Gables DS0000001510.V357264.R01.S.doc Version 5.2 Page 25 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP3 Good Practice Recommendations Although the conversations with staff show that they know the personal likes, dislikes and preferences of people, more detail should be included in the assessment for activities for daily living so that more personalised information about the person is included. There are documents in the care plans to record the activities that people are involved in, but the recording should be more consistent to reflect the good work going on. 2 OP12 Stone Gables DS0000001510.V357264.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 Stone Gables DS0000001510.V357264.R01.S.doc Version 5.2 Page 27 - 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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