Care Home: Stoneleigh

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What the care home does well The home has available detailed information for people and their representatives in the Statement of Purpose and Service User Guide. People have assessments have an assessment before moving into the home to the home and these assessments were detailed and reflected the individual persons needs and preferences in how care is delivered. The home makes sure that every person has a care plan that tells staff how the care should be given. This information is summarised so staff to remind them of the help needed can use it quickly.The residents Health Care needs were met. The home showed that they were quick to identify the changing needs in health and make sure that appropriate health professionals were informed. People who visit the home said that the staff were very pleasant and happy atmosphere. They also said that the staff were very caring and committed, that they always kept relatives informed of any changes and they react to peoples changing needs quickly. People said that they had noticed a marked improvement of their relatives health and well being since moving into the home. People are encouraged with assistance to go out to the local shops if able and to maintain good contacts with relatives and friends. There was no restriction of people walking around the building or going to their rooms if they wished. People said that the food was good well prepared and hot. The home offers a choice of food at each mealtime and residents were monitored for changes in appetite as part of overall health monitoring. The homeowner has meeting s with relatives and people who live in the home routinely to talk about concerns, and improvements the home can make and this openness tends to prevent concerns being complaints. The home was clean and fresh, well furnished and decorated. The staff continue to undertake NVQ training and there are good levels of trained staff in the home. All sampled maintenance and inspection records for services such as gas and electric were in place and in date. What has improved since the last inspection? A formal Quality Assurance programme has been implemented. This is evidence that the home listens to the opinions and ideas of people living in the home and takes action to include these in the development of the service. What the care home could do better: More information needs to be recorded in the care plans as to what action staff should take to reach the recorded goal.Activities need to be further developed to include the choices of people so that they become more meaningful. CARE HOMES FOR OLDER PEOPLE Stoneleigh Retirement Home 19 Victoria Road Stechford Birmingham West Midlands B33 8AL Lead Inspector Ashley Fawthrop Unannounced Inspection 30th June 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 Stoneleigh Retirement Home DS0000062525.V369009.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. Stoneleigh Retirement Home DS0000062525.V369009.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stoneleigh Retirement Home Address 19 Victoria Road Stechford Birmingham West Midlands B33 8AL 0121 628 6099 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) stoneleighh@btconnect.com Mrs Pamela Sale Mrs Ann Patricia Smith Mrs Pamela Sale Care Home 15 Category(ies) of Dementia - over 65 years of age (15), Old age, registration, with number not falling within any other category (15) of places Stoneleigh Retirement Home DS0000062525.V369009.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. That in addition to the care manager that there are a minimum of two care staff on duty throughout the waking day. That at night the minimum staffing levels of one person on waking night duty and one person on sleeping in duty are maintained. Shower facilities within the home are to be improved to floor draining level access over a period commencing from six months of registration and completed within twelve months of registration. Additional aids and adaptations within bathrooms, toilets and shower rooms are to be fitted as guided by an occupational therapist within six months of registration. Velux windows are to fitted with window blinds within three months of registration. A guard or cover for the radiator in the en-suite shower room is to be fitted within three months of registration. 12th July 2006 4. 5. 6. Date of last inspection Brief Description of the Service: Stoneleigh is an adapted domestic property located within the residential area of East Birmingham. The home is situated close to a local railway station and is well sited for public transport links and local road networks. There is sufficient off road parking at the front of the premises to accommodate 2 vehicles. Stoneleigh can provide residential accommodation for 15 older persons. The home has eleven single bedrooms and two shared rooms. Twelve bedrooms are located on the two upper floors and a single room is situated on the ground floor. There is a shaft lift, which enables access to the first floor. The premises include a flat on the upper floor, which is currently utilised by staff for sleep-in purposes. Communal space is offered in two lounges, a dining room and a conservatory. There is a secluded staged rear garden including a paved area where residents can sit during clement weather. The home has a bathroom on each of the upper floors and a spacious assisted shower room is located on the ground floor. Stoneleigh Retirement Home DS0000062525.V369009.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 two stars this means that people using the service experience good quality outcomes. The site visit was unannounced and was carried out by one inspector in one day. The inspector would like to thank everyone who took the time to talk to them and express their views. Before the visit, accumulated information about the home was reviewed. This included looking at the number of reported accidents and reports from other agencies, i.e., the Environmental Health Officer, and correspondence following the last inspection. This information was used to plan this inspection visit. The inspector case tracked three people’s care plans. Case tracking is the method used to assess whether people who use services receive good quality care that meets their individual needs. Where appropriate, issues relating to the cultural and diverse needs of residents and staff were considered. Using this method, the inspectors assessed all twenty-one key standards from the Care Homes for Older People National Minimum Standards, plus other standards relevant to the visit. The inspectors spoke with identified people who live at the home and relevant members of the staff team who provide support to them. Documentation relating to these people was looked at. What the service does well: The home has available detailed information for people and their representatives in the Statement of Purpose and Service User Guide. People have assessments have an assessment before moving into the home to the home and these assessments were detailed and reflected the individual persons needs and preferences in how care is delivered. The home makes sure that every person has a care plan that tells staff how the care should be given. This information is summarised so staff to remind them of the help needed can use it quickly. Stoneleigh Retirement Home DS0000062525.V369009.R01.S.doc Version 5.2 Page 6 The residents Health Care needs were met. The home showed that they were quick to identify the changing needs in health and make sure that appropriate health professionals were informed. People who visit the home said that the staff were very pleasant and happy atmosphere. They also said that the staff were very caring and committed, that they always kept relatives informed of any changes and they react to peoples changing needs quickly. People said that they had noticed a marked improvement of their relatives health and well being since moving into the home. People are encouraged with assistance to go out to the local shops if able and to maintain good contacts with relatives and friends. There was no restriction of people walking around the building or going to their rooms if they wished. People said that the food was good well prepared and hot. The home offers a choice of food at each mealtime and residents were monitored for changes in appetite as part of overall health monitoring. The homeowner has meeting s with relatives and people who live in the home routinely to talk about concerns, and improvements the home can make and this openness tends to prevent concerns being complaints. The home was clean and fresh, well furnished and decorated. The staff continue to undertake NVQ training and there are good levels of trained staff in the home. All sampled maintenance and inspection records for services such as gas and electric were in place and in date. What has improved since the last inspection? What they could do better: More information needs to be recorded in the care plans as to what action staff should take to reach the recorded goal. Stoneleigh Retirement Home DS0000062525.V369009.R01.S.doc Version 5.2 Page 7 Activities need to be further developed to include the choices of people so that they become more meaningful. 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 Retirement Home DS0000062525.V369009.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 Stoneleigh Retirement Home DS0000062525.V369009.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, 3 and 6 People using the service experience good quality outcomes. This judgement has been made using available evidence including a visit to this service. Documentation provide to people before they move in gives them sufficient information to decide whether the home can meet their needs or not. Pre admission assessment has enough information for staff to start the care plans as soon as the person moves into the home. EVIDENCE: The statement of purpose and service user guide has enough information to allow people to make the decision of whether or not the home can meet their needs. Copies are made available for all people looking to move into the home, this also include the contract of terms of residency. Stoneleigh Retirement Home DS0000062525.V369009.R01.S.doc Version 5.2 Page 10 The pre-admission assessments has been further expanded and contains good information about the individuals past history and their present needs, this proves good information to staff who can begin to plan the persons care before they move in. Pre-admission assessments are carried out by one of the owners either in the persons home or in hospital where appropriate. There was evidence that people are invited to visit the home, socialise with staff and other people living in the home, sample the food and overnight or weekend stays can also be arranged. Following admission a trial period of 28 days is provided prior to a placement being confirmed. Stoneleigh Retirement Home DS0000062525.V369009.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 using the service experience good quality outcomes in this area. The judgement has been made using available evidence including a visit to this service. Care plans, and people’s daily records set out an individual plan of care, that makes sure that the health, and social care needs of individuals are being met. Staff interact well with people living in the home and their privacy and dignity are maintained. EVIDENCE: Two care plans were examined. They were seen to be comprehensive and contained clear, easy to understand information. Evidence was seen that the plans had been reviewed regularly and a range of risk assessments had been carried out. The manager does need to make sure that staff always sign and date the assessments. Stoneleigh Retirement Home DS0000062525.V369009.R01.S.doc Version 5.2 Page 12 There continues to be clear record of visits from GP, District Nurses and other health professionals such as optician and chiropodist. People are weighed monthly and where indicated regular monitoring of those at risk of developing pressure ulcers. Care plans need to be further developed to give staff information on how goals in the care plan can be met. Recording in care plans included “encourage to eat little and often” “encourage to interact with other people”. Information should be included instructing staff on what staff should do to reach these goals Files contain life histories, hobbies and social and recreational preferences. Daily records described activities and incidents throughout the day and gave a good picture the individuals day. There were medication, homely remedies and self-administration policies and procedures available. On observing staff administering medications this was seen to be safe. Staff made sure that the medication had been taken before they signed the medication sheets. Those people who needed assistance were given this and were not rushed. Medications are stored appropriately and there were no errors in the recording or administration. On observing staff interact with people staff were seen to respect people’s privacy, they treat people with respect and protected their dignity. Staff were noted to be using the preferred term of address and personal care was delivered in the privacy of a bathroom or the bedroom. There was good interaction observed between the residents and staff. When people become very ill the owners continue to give people are given the choice of remaining at the home or being admitted to hospital. The decision is made in consultation with the family and health care professionals. The services of District Nurses and McMillan Nurses can be utilised if required. Stoneleigh Retirement Home DS0000062525.V369009.R01.S.doc Version 5.2 Page 13 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 using the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. ] There is a variety of food served in the home, which enables a balanced and nutritious diet. Residents are enabled to maintain contact with family and friends and local community as they wish. EVIDENCE: External entertainers continue to be invited to the home including regular movement to music. On the day of the inspection an outside entertainer was in the home in the afternoon. The home continues to take people out to the theatre and trips out in the mini bus. Other activities include sing a longs, crafts and exercises. One person’s care plan said that their religion was important to them and there was evidence that their needs were met by having regular visits from the clergy Stoneleigh Retirement Home DS0000062525.V369009.R01.S.doc Version 5.2 Page 14 The manager said that they were in the process of sourcing new and different activities for the residents. People continue to be encouraged to make the most of their mobility, and go out with family and friends and there continues to be wheelchairs available for anyone who cannot walk far. Meetings involving people who live in the home continue with minutes being distributed accordingly. This is evidence that people are given the opportunity to be involved in the way the service develops. Members of the legal profession are able to make appointments and the home offers an advocacy service from an external source. The home has a rolling menu; lunch is the main meal of the day. The menu indicated that a balanced diet continues to be provided and that alternatives are always available. People have the opportunity to request anything they wish for breakfast and a light meal is supplied each evening. The food is varied, hot or cold, and is available throughout the day as well as at the set meal times. Individuals preferences are catered for, and at suppertime as well as sandwiches and soup there is a hot option available should anyone want it. Drinks are freely available throughout the day. We observed the lunchtime the atmosphere was relaxed those people who needed assistance were given this. Staff did not rush people or hover over them. There were sufficient numbers of staff to give assistance where needed and staff interacted with people giving meal times a social feel. Stoneleigh Retirement Home DS0000062525.V369009.R01.S.doc Version 5.2 Page 15 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 using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints procedure that is accessible to people and visitors so that they are aware of how to make a complaint ensuring the promotion of protection matters. People’s opinions are listened to and acted upon and the arrangements for the protection of people are satisfactory. EVIDENCE: The complaints procedure is comprehensive and available to people living in the home and their relatives. There is a document for the logging and monitoring of complaints. There have been no complaints received since the last inspection. The written policy regarding adult protection provides adequate information and instruction to staff in how to respond to concerns raised or witnessed. There is also a policy advising about whistle blowing. Staff have had training in adult protection and dealing with challenging behaviour. Stoneleigh Retirement Home DS0000062525.V369009.R01.S.doc Version 5.2 Page 16 Stoneleigh Retirement Home DS0000062525.V369009.R01.S.doc Version 5.2 Page 17 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, 21, 23, 24 and 26 People using the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is warm, generally comfortable and safe environment. The rooms meet the individual needs of people. The premises are tidy and hygienic throughout. EVIDENCE: The home is decorated and maintained to a good standard. The communal areas are light and spacious they are pleasantly decorated and furnished. On touring the building it was noted the people were able to decorate and furnish their own rooms and have their own personal possessions around them. Stoneleigh Retirement Home DS0000062525.V369009.R01.S.doc Version 5.2 Page 18 This gives the rooms a feeling of individuality and ownership. There is special equipment available including assisted baths, hoists and wheelchairs. There is a small garden with decking and pot plants. There are plans to purchase some garden furniture. The home was generally clean and pleasant, and people said that they were happy living at the home. Stoneleigh Retirement Home DS0000062525.V369009.R01.S.doc Version 5.2 Page 19 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 using the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Recruitment practices and appropriate training help protect people and ensure their needs are met. EVIDENCE: Two carers and a manager are on duty during daytime hours and there is one carer at night with a senior person providing a sleep-in service. The manager informed the inspector that when dependency levels of residents required it there were 2 waking staff on duty at night. Staff were interacting with people throughout the day and there was always one member of staff in the lounge with people. The home also has a full time cook who displayed in depth knowledge of people’s preferences. A housekeeper is employed and a good level of cleanliness appears to be maintained. Record Bureau checks and checks against the Protection of Vulnerable Adults list. The home was on occasions employing staff for their supervised the home Stoneleigh Retirement Home DS0000062525.V369009.R01.S.doc Version 5.2 Page 20 showed continues to provide NVQ training to staff and levels of trained staff are good. The home undertakes a recruitment process and details of this were kept on the staff files for example the inspector found application forms, references. Mandatory training has been supplied and other courses have been arranged. Staff have had training in Adult Protection and abuse and on managing challenging behaviour. Stoneleigh Retirement Home DS0000062525.V369009.R01.S.doc Version 5.2 Page 21 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 using the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home was well run and managed with the best interests of people who live in the home and staff. Health and safety being promoted and people are protected. EVIDENCE: Both owners have the skills and experience to run the home with the best interest of the people who live there. Stoneleigh Retirement Home DS0000062525.V369009.R01.S.doc Version 5.2 Page 22 People spoken during the course of the inspection said that they knew both the owner and the manager well and said that the home was run very well and that they were always available to speak to. Since the last inspection the home has established a quality assurance system, this is in the form of a questionnaire that covers very specific area of the care. People who live in the home and their relatives views are welcomed and acted upon. Regular staff meetings are held with minutes circulated accordingly. Regular formal staff supervisory meetings have been taking place and are documented. There is a file of policies and procedures available and accessible for all staff. People’s files continue to be stored in a locked cupboard in the dining room; staff have access to them at all times. The home had appropriate records of maintenance testing and inspection of the building to ensure the safety of Gas and Electrical installations, Lifting equipment and Fire equipment. Stoneleigh Retirement Home DS0000062525.V369009.R01.S.doc Version 5.2 Page 23 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 3 X 3 3 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 Stoneleigh Retirement Home DS0000062525.V369009.R01.S.doc Version 5.2 Page 24 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 OP8 Regulation 12(1)(a) Requirement Information relating to how staff reach recorded goal needs to be improved Timescale for action 31/08/08 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 OP13 Good Practice Recommendations Activities need to be developed further to make them more individual and meaningful. Stoneleigh Retirement Home DS0000062525.V369009.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Retirement Home DS0000062525.V369009.R01.S.doc Version 5.2 Page 26 - 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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