Care Home: Stoneleigh

Similar services:

• Flint House
• The Ley Community
• Yeldall Manor
• 21 High Street
• Vale House
• Chestnut Walk
• The Old Vicarage
• Cherwood House Care Centre

What the care home does well From the evidence gained during the inspection process it was clear that Stoneleigh is a valued service for people with mental health needs. It provides a good personalised service for those who live in the home. The manager and staff enjoy good relations with the local community including mental health and other care professionals. The home encourages people to be independent and supports them to access other services and facilities in the community. The home and its staff provide a safe, supportive and stable environment, which enables people to develop daily living skills and independence. What has improved since the last inspection? What the care home could do better: Formal training in safeguarding adults from abuse must be provided for staff. This is to ensure that vulnerable people are safeguarded from all forms of abuse. Old and deteriorated furniture and fittings in individual bedrooms must be replaced. Consideration should be given to upgrading the homes system of storing medicines by introducing a purpose built medicines cupboard of suitable size and construction with a quality lock. CARE HOME ADULTS 18-65 Stoneleigh Stoneleigh 11 Arthurs Hill Shanklin Isle of Wight PO37 6EU Lead Inspector Neil Kingman Unannounced Inspection 8 May 2008 10:15 Stoneleigh DS0000063853.V363741.R01.S.doc Version 5.2 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 Stoneleigh DS0000063853.V363741.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 Adults 18-65. 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. Stoneleigh DS0000063853.V363741.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stoneleigh Address Stoneleigh 11 Arthurs Hill Shanklin Isle of Wight PO37 6EU 01983 862931 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) Mr Kevin Michael Bell Clare Shilton Care Home 9 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (7), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (2) Stoneleigh DS0000063853.V363741.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is currently accommodating 1 person under the age of 65 years with a past or present dependence on alcohol. This named person may remain at the home. 28th June 2007 Date of last inspection Brief Description of the Service: Stoneleigh is a residential care home registered to provide care support and accommodation for up to 9 adults who have, or have had, mental health problems. It can accommodate 2 people over the age of 65 years. The home is a detached property located on the corner of Arthur’s Hill and St Boniface Road, close to Shanklin town centre with its shops and amenities. The main road outside the home is well served with buses. The single room accommodation is arranged over two floors with stairs to the first floor. There is a garden and patio area with seating for use by the residents. The home provides 24 hour staffing and weekly fees range between £383 and £395. Stoneleigh DS0000063853.V363741.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 report details the results of an evaluation of the quality of the service provided by Stoneleigh and brings together accumulated evidence of activity in the home since it was last inspected on 28 June 2007. Part of the inspection process is to consult with people who use the service. To this end we sent out survey comment cards to all those who live in the home, a visiting health professional and five social services care managers. To date we have received no replies. Included in this inspection was an unannounced site visit to the home by an inspector on 8 May 2008. The registered manager Clare Shilton and the provider, Kevin Bell were available throughout the day. At the visit we had an opportunity to speak with the staff on duty and most of the residents either alone or as a group. We also toured the building and looked at a selection of records. Prior to the site visit the manager sent to the Commission a detailed selection of information about the service including an Annual Quality Assurance Assessment (referred to as ‘the assessment’ during the report), which has been used with other information to inform the various judgements made about the service. What the service does well: What has improved since the last inspection? Since the last inspection the home has made the following improvements: • Met all requirements identified at the last inspection. Stoneleigh DS0000063853.V363741.R01.S.doc Version 5.2 Page 6 • • • • • • Updated the service user guide and ensured that each resident has a copy. Developed peoples’ personal plans to record how they are supported to take responsible risks as part of an independent lifestyle. Developed individual activity plans, which incorporate peoples’ preferred use of time. Developed a comprehensive hospital admission information booklet for each resident. Decorated one bedroom and a bathroom. Fitted new flooring in the kitchen and a new carpet in the dining room. Replaced the cooker, some curtains and fitted privacy locks on bathroom doors. Progressed with staff training, especially National Vocational Qualifications (NVQs). 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. Stoneleigh DS0000063853.V363741.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Stoneleigh DS0000063853.V363741.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 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. People who may use the service and their representatives have the information needed to choose a home that will meet their needs. 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, what they hope for and want to achieve, and the support they need. EVIDENCE: The home has a Service User’s Guide containing details of the staff, the management of the home and the complaints procedure. The guide also contains a copy of the Statement of Purpose and each person’s contract. We noted that the guide had been updated to include the current contact details of the Commission and each person had signed that they had received a copy. At the last key inspection this outcome group was judged as good and the standard relating to assessing the needs of people before they entered the home was met. There have been no new admissions to the home since the Stoneleigh DS0000063853.V363741.R01.S.doc Version 5.2 Page 9 last inspection. We looked at a sample of three service user files and noted an assessment of needs to be in place on each one. Provider’s Annual Quality Assurance Assessment The assessment identified what the service does in this area: • • • We provide a relaxed homely atmosphere for service users and provide good standard of care for each client. We ensure that we can meet the individual’s needs in all aspects of their lives. A full assessment is carried out to ensure we can meet these needs. We have updated service user guides and a signature proves each resident has received one. Stoneleigh DS0000063853.V363741.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 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. Peoples’ needs and goals are met. The home has a plan of care and support that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, and have support with their finances. This is because the staff promote their rights and choices. EVIDENCE: Each person living in the home has a personal plan of care and support. During the site visit we looked at a sample of three plans. The home has developed a person centred approach to planning the delivery of care and support to the residents. Plans contain a profile of the individual and set out their wishes, opinions and feelings in respect of a range of areas of daily living, e.g., personal care and Stoneleigh DS0000063853.V363741.R01.S.doc Version 5.2 Page 11 hygiene, communication and comprehension, social and leisure activities, relationships etc. They provide specialist information applicable to individuals with clear guidelines on how peoples’ needs are to be met. Daily running records are maintained with information to demonstrate that peoples’ needs are being met. The home uses a key worker system, which, amongst other things, enables individual staff members to ensure they support people to attend medical appointments, shopping trips and leisure activities. In discussions with residents it was clear that some had knowledge of their plans but showed no particular interest in them. Information in personal plans and discussions with staff on duty provided evidence that they respect residents’ rights to make their own decisions. Residents meetings have brought up suggestions about activities, trips out and food etc. Several residents are able to take responsibility for their own finances. However, the manager was very clear that alternative arrangements are found for those who find this difficult. We noted that one person comes under the Court of Protection, and another has a relative acting as Power of Attorney. At the last inspection a requirement was made for care plans to record how service users are supported to take responsible risks as part of an independent lifestyle. At this inspection we noted the requirement had been met. Individual risk assessments are in place with guidelines on how risks are to be minimised. The assessments are specific to individuals and their circumstances, e.g., they show how the home has assessed the support needed for daily activities and the approach being taken. Provider’s Annual Quality Assurance Assessment The assessment identified what the service does in this area: • • • • • Stoneleigh is an open house and service users are free to come and go in accordance with their needs. Independence is encouraged and service users are supported with their independency needs. Some residents attend day services. Clients are given information on opportunities and risks. All service users have an updated care plan that is reviewed in accordance with developing needs and choices. The care plans incorporate finance management and risk assessments. Care plans record how service users are supported to responsible risks as part of an independent lifestyle. Stoneleigh DS0000063853.V363741.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 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. 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal and family relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. Stoneleigh DS0000063853.V363741.R01.S.doc Version 5.2 Page 13 EVIDENCE: The manager said that the assessed needs of most of the residents are such that seeking jobs for them is not appropriate. Voluntary work has been found for one person that has proved to be therapeutic, enabling the individual to get involved in plants and history, arts and crafts. It was clear from our observations and from information in personal plans that residents enjoy going out from the home. On the day of the site visit several residents spent time outside of the home, returning for meals. Staff treat residents as individuals and support them variously to visit local pubs, cafes, shops, day services and places of interest, including day trips especially during the summer months. We looked at an activities record, which showed that a range of activities offered to people had been taken up by some and not by others according to their individual preferences. The home has the use of two vehicles, which are used by staff to transport people to the venues described above. Individuals are supported to pursue their hobbies and interests such as indoor plants for one person and a personal computer for another. Two people attend church on Sundays and while the home would support anyone with their religious observance the manager said there was limited interest. Most but not all residents maintain contact with their families. While visits to the home are welcome and encouraged some residents maintain contact by visiting family away from the home. The home arranged a family barbeque last summer, which was attended by relatives and was regarded as a success. All those who live in the home have at least one day at home each week when they are supported to undertake their domestic activities such as cleaning their bedrooms and doing laundry. Some help with washing and drying up, laying tables and hoovering. People are encouraged to undertake domestic tasks but can opt out if they choose to do so. The manager explained that it was a personal choice for people to help with meals and most lacked the motivation. During our visit we noted residents would make their own drinks during the day when they wanted them. Menus are arranged over a four-week rota and showed food to be varied and appealing. A record is kept of what people are actually served at each meal. We had an opportunity during the site visit to sit with the residents over lunch. It was quite a social gathering and the atmosphere was warm and goodhumoured. Everyone ate together in the dining room and staff were available for support as required. Stoneleigh DS0000063853.V363741.R01.S.doc Version 5.2 Page 14 Staff take turn to prepare the meals and they confirmed that this arrangement works well and adds to the domestic feel of it being peoples’ home. Provider’s Annual Quality Assurance Assessment The assessment identified what the service does in this area: • • • • • We integrate well with the local community with a good relationship, rapport at the local shop and taxi company. Staff maintain good relationships with service users, encourage activities and support service users to maintain family links. We ensure mealtimes are what the service users are comfortable with. We supply a varied nutritious balance diet, which is well presented and eaten in a family atmosphere. Individual activity plans incorporate service users’ preferred use of time and are sensitive to their needs. Stoneleigh DS0000063853.V363741.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 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. People receive personal care and support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. EVIDENCE: At the time of the inspection there were nine people resident at Stoneleigh, none of whom require support with their mobility. Peoples’ plans clearly record individuals’ personal and healthcare needs and incorporate each person’s wishes, opinions and feelings. Staff use a person centred approach to deliver care and support and meet people’s changing needs, which tend to be around their psychological and emotional needs. At the last inspection a requirement was made for care plans to detail health care needs such as neurological conditions and any action Stoneleigh DS0000063853.V363741.R01.S.doc Version 5.2 Page 16 plans. At this inspection we noted the requirement had been met as exampled in the plan of one individual with a neurological condition. There are now clear and person centred details of the assessment and a record of the symptoms and risks associated with the condition. In discussions with staff members it was clear that they have a good understanding of peoples’ individual needs through training and working with the same people over several years. They confirmed that they had seen significant improvements and were confident that the home provided a very good service for those who lived there. Residents are largely self-caring and really only need occasional encouragement or prompts with their personal hygiene. There is a mix of male and female staff to enable same gender support where needed. Records show that health needs are monitored, such as weight, diet and mental health. There is evidence of residents having appointments for physical health needs with general practitioners, a variety of specialist community nurses, chiropodists and opticians. The home uses the Shanklin Medical Centre at which there are several GPs and the dental practice, which is just across the road from the home. Each person has a Health Action Plan, which clearly records individuals’ personal and healthcare, including physical, emotional and psychological needs in written and pictorial format, detailing how they prefer their support to be delivered. Since the last inspection a comprehensive hospital admission information booklet has been developed for each resident. This is to give hospital staff a detailed picture of an individual’s needs, essential if they are not in a position to help themselves. We looked at the home’s arrangements for residents’ medication with the manager. Records showed that medication is administered by staff who have received the B/Tech training in medicines administration and deemed competent by the manager. The home uses a monitored dosage (blister pack) system for medicines that can be stored in this way. This hygienic method is designed to simplify the procedure for giving out medication. At the time of the site visit records relating to the safekeeping and administration of medicines were found to be in good order. However, we noted that medicines were being stored in an old wardrobe, which while locked could be improved with the introduction of a purpose built medicines cupboard of suitable size and construction with a quality lock. The manager said that residents’ assessed needs are such that those in receipt of medicines would not be safe to self-administer, therefore the home takes that responsibility. At the last inspection a requirement was made for a procedure to be in place for testing blood sugar levels where there is piercing of the skin. The home Stoneleigh DS0000063853.V363741.R01.S.doc Version 5.2 Page 17 needed to seek the advice of the district nursing service regarding the testing of blood sugar levels and the need for staff training in this area. At this inspection we noted the requirement had been met. There was a safe procedure in place for people to test their own blood sugar levels with support from staff who had received training. Provider’s Annual Quality Assurance Assessment The assessment identified what the service does in this area: • • • • We support service users with health care requirements and attend medical appointments with clients who need support but respect service users wishes and independence to attend alone. Personal hygiene is supported through encouragements and prompts. We have developed a comprehensive hospital admission information booklet for each resident. Service user who tests blood sugar levels where there is piercing of the skin, self tests and the procedure for how she does it is in her care plan. Stoneleigh DS0000063853.V363741.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 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. If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. EVIDENCE: The home has a formal complaints policy and procedure, which is summarised in the Service User’s Guide a copy of which is held by each resident. Residents spoken with did not know the detail of the procedure but knew who to go to if they had any concerns. The manager said they had received no complaints about the service from residents and was very clear that they would certainly voice concerns if they had any. A complaints log is in place to record the details of any complaints should they arise. The residents meetings were seen as a good forum for raising and discussing issues. Records are kept of the meetings and action is taken where applicable. Stoneleigh DS0000063853.V363741.R01.S.doc Version 5.2 Page 19 Information provided as part of the homes assessment indicated that policies, procedures and codes of practice are in place in the area of safeguarding adults and the prevention of abuse. The home follows the Isle of Wight Adult Protection Policy Guidance, the latest copy of which was available in the home for inspection. In discussions with the manager and the staff we understood that no formal training is provided for staff in safeguarding adults from abuse. However, this was recognised by the manager who stated she has already looked for the training resources to book the training for staff. It is essential with such an important subject that staff training is formalised. However, in terms of outcomes for the people who use the service there had been no safeguarding referrals in the home and staff were very clear about their responsibilities to report any issues of concern without delay. They also were aware of the home’s “whistle-blowing” procedure. It must also be said that adult protection is a subject covered in the National Vocational Qualification (NVQ) training programme, which three of the four care support workers have completed. Provider’s Annual Quality Assurance Assessment The assessment identified what the service does in this area: • • • • • • Stoneleigh is proactive in dealing with complaints. All service users have a guide that contains the complaints procedure. We have not received any complaints in the last twelve months. We have a complaints logbook. Service users are safeguarded against all forms of abuse. We have a policy and procedure in place for protection. Aggression in service users is dealt with appropriately. There are guidelines in care plans where applicable. Stoneleigh DS0000063853.V363741.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26 and 30 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 physical design and layout of the home enables residents to live in a safe, well-maintained and comfortable environment, which encourages independence. All areas of the home are kept clean, hygienic and free from unpleasant odours. EVIDENCE: Stoneleigh has been a home for adults with mental health needs in Shanklin for many years and underwent a change of registration when the current owners purchased the home in October 2005. While not purpose built the home has been developed over the years to be suitable for its stated purpose of providing a safe, manageable and comfortable environment for the people who live there. The home is located in Arthurs Hill, about a half mile from the shops and amenities of Shanklin. It is clear from conversations with residents and staff that the present owners have made significant improvements to the environment both inside and out. Stoneleigh DS0000063853.V363741.R01.S.doc Version 5.2 Page 21 We noted during our tour of the building that requirements identified at the last inspection had been addressed: • • • • Residents have adequate curtains that provide privacy. The broken mirror and vanity unit in one bedroom had been repaired. Residents have a lock with a key to their bedroom door where they wish to have one. Staff can override privacy locks in an emergency. Privacy locks on toilet and bathroom doors can be overridden by staff in an emergency. All areas of the building are accessible to the people who use the service, including the rear garden, where residents were sitting at various times on the day of our visit. The home is generally comfortable with communal areas reasonably well decorated and furnished. We toured the building with the provider. Bedrooms have been decorated as part of an ongoing programme and most were seen to be reasonably well furnished. However, the vanity unit in one room needed to be replaced, as it was in on old and deteriorated state. Furniture in another room needed to be replaced, as wardrobes were old and worn. People who live in the home have rooms on the ground and first floors. Stairs access the rooms on the first floor where all occupants are fully mobile Bathing, shower and toilet facilities on both levels are adequate for the needs of people who use the service. People spoken with were generally satisfied with their rooms and the standard of the environment in general. One person whose hobby is indoor plants was happy to show us their room, which was clean, tidy and well stocked with healthy looking plants. All areas of the home were found to be clean and free from unpleasant odours. However, in discussions with the management it was apparent that at least two people needed extra support to help them manage issues relating to hygiene and challenging behaviours. As mentioned later in the report the whole staff team carry out care support, catering and domestic duties. There is a laundry equipped with machines that can deal with soiled articles, although the manager stated that continence is not an issue with the current resident group. The home’s assessment confirms it has policies and procedures for preventing infection, managing infection control and soiled waste disposal. Stoneleigh DS0000063853.V363741.R01.S.doc Version 5.2 Page 22 Provider’s Annual Quality Assurance Assessment The assessment identified what the service does in this area: • • • • • The home is airy, cheerful and has a homely atmosphere. It is kept clean, hygienic and free from offensive odours. Policies and procedures are in place for infection control. The home meets all required health and safety. 1 bedroom has been decorated. Completion of downstairs bathroom. New flooring in kitchen and new cooker. New carpet in the dining room. Replacement of some curtains and net curtains. Privacy locks on bathroom doors can be overridden. Stoneleigh DS0000063853.V363741.R01.S.doc Version 5.2 Page 23 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 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. Staff in the home are deployed in sufficient numbers, are trained and given the necessary skills and experience to meet the needs of the people who live there and support the smooth running of the service. EVIDENCE: The manager said that the home has a very stable staff group and that no new staff had been recruited since the last inspection when recruitment records were audited. At that time records were found to be in good order. The manager was very clear that nobody commences work at the home before the right checks have been carried out. This is to ensure as far as possible that people considered unsuitable to work with vulnerable people are not employed The home has a training plan, which identifies training achievements and dates that refresher training is scheduled. Records demonstrate that the full range of mandatory training is provided together with additional service specific training such as mental health and aggression in the workplace. Stoneleigh DS0000063853.V363741.R01.S.doc Version 5.2 Page 24 The manager described and produced evidence of the induction programme new care support workers would undertake when joining the home. The current programme follows the Common Induction Standards recommended by ‘Skills for Care’. The manager confirmed and records showed that three of the four care support workers have achieved the NVQ at level 2. Two have achieved the qualification at level 3 and one at level 4. This gives a ratio of 75 of the staff group trained. Care support workers spoken with said that the home provides ongoing training, which equips them well for the work they do. Provider’s Annual Quality Assurance Assessment The assessment identified what the service does in this area: • • • • • • Stoneleigh has a good qualified team with a good balance of male/female staff. Employment of staff with complement skills. All service users are actively involved in staff recruitment. We have employed NVQ, previous training and experienced staff. All recruitment procedures are within requirements and relevant paper work is obtained prior to employment. All staff have handbooks. We have retained staff for longer periods. Stoneleigh DS0000063853.V363741.R01.S.doc Version 5.2 Page 25 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 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 management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a competent manager. Policies, procedures and practices ensure so far as is reasonably practicable the health, safety and welfare of people who live and work in the home. EVIDENCE: The registered manager Clare Shilton has been in post for over two years and has achieved the NVQ at level 4 in care and currently undertaking the training for the Registered Managers Award (RMA). When this qualification has been achieved the standard will be fully met. She states that she keeps up to date with regular mandatory and service specific training, and adopts a ‘hands-on’ Stoneleigh DS0000063853.V363741.R01.S.doc Version 5.2 Page 26 approach to the running of the home, working alongside care support workers as part of the team. All staff spoken with regarded the home as being well run, with regular staff meetings and formal supervision. They confirmed that the morale of staff was good and the manager was approachable and supportive. Stoneleigh has an annual development plan for 2008, which includes a proposed extension to the home. There was evidence during the site visit that surveys are carried out with both staff and residents. These take the form of questionnaires, the results of which are used to inform the annual development plan. In addition, suggestions brought up in residents meetings are also used to improve the service. The home’s pre-inspection information sent to the Commission by the manager confirmed that policies and procedures are in place to ensure safe working practices in the home. A sample of records was viewed during the site visit including public liability insurance, fire alarm tests, electrical appliance and wiring tests, and gas boiler servicing. Staff training records showed, and staff confirmed that statutory training is scheduled and updated in manual handling, first aid, fire training, infection control and food hygiene. Provider’s Annual Quality Assurance Assessment The assessment identified what the service does in this area: • • • Training for staff through NVQ’s and first aid training. The manager ensures risk assessments are carried out and safe practices carried out throughout the home. 3 staff have completed NVQ’s and 1 NVQ nearly completed. Stoneleigh DS0000063853.V363741.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 2 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 X 3 X X 3 X Stoneleigh DS0000063853.V363741.R01.S.doc Version 5.2 Page 28 No Are there any outstanding requirements from the last inspection? 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 YA23 Regulation 13 Requirement Formal training in safeguarding adults from abuse must be provided for staff. This is to ensure that vulnerable people are safeguarded from all forms of abuse. Old and deteriorated furniture and fittings outlined under standard 26 in the report and identified to the manager must be replaced. Timescale for action 30/06/08 2. YA26 16 30/06/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA20 Good Practice Recommendations Consideration should be given to upgrading the homes system of storing medicines by introducing a purpose built medicines cupboard of suitable size and construction with a quality lock. Stoneleigh DS0000063853.V363741.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Stoneleigh DS0000063853.V363741.R01.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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