Care Home: Stoneygate Oaklands

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What the care home does well Stonetgate Oakland`s has been recently refurbished and provides a comfortable and homely environment which is decorated and furnished to a high standard. The atmosphere at the home on the day of this inspection was relaxed and homely. The service is managed by an experienced and skilled person and the management approach at the home was open and inclusive. People spoken with praised the staff at the home and felt they were kind and competent. Staff were trained to follow national safeguarding adults procedures and guidelines. The majority of people living at the home were encouraged and enabled to live as independently as possible and had opportunities to participate in recreational and social meaningful activity. Staff worked to-wards meeting individual needs and were flexible in order to meet individual needs and preferences. People moving into the home are well supported and given the information they need to help them settle in. What has improved since the last inspection? The communal areas had recently been refurbished to a high standard offering a choice of pleasant lounge and dining areas which were also furnished and decorated to a high standard. All areas of the home were fresh and clean and people spoken with said this was always the case. What the care home could do better: All care staff should receive the training they require to meet the specialist needs of people living at the home. Risk assessments should be specific to individual needs and people should be screened for risk of malnutrition. People living at the home should be given the opportunity to be involved in their care plan and consulted about the day to day running of the home. All areas of the home should be maintained to provide a safe environment. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Stoneygate Oaklands 328 London Road Leicester LE2 2PJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Debbie Williams     Date: 2 5 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Stoneygate Oaklands 328 London Road Leicester LE2 2PJ 01162703454 F/P01162703454 oaklands@prime-life.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Prime Life Ltd Name of registered manager (if applicable) Ms Bev Hopkins Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 past or present alcohol dependence dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: No one falling in the categories A or A(E) should be admitted to Stoneygate Oaklands when there are 12 persons in total falling in the categories or combined categories already accommodated in the home No one falling in the categories DE or DE(E) should be admitted to Stoneygate Oaklands when there are 22 persons in total falling in the categories or combined categories already accommodated in the home No one falling in the categories MD or MD(E) should be admitted to Stoneygate Oaklands when there are 22 persons in total falling in the categories or combined categories already accommodated in the home No one falling in the categories of PD or PD(E) should be admitted to Stoneygate Care Homes for Older People Page 4 of 27 care home 44 Over 65 12 22 22 44 15 12 22 22 0 15 Oaklands when there are 15 persons in total falling in the categories or combined categories already accommodated in the home The maximum number of persons accommodated within Stoneygate Oaklands is 44 The minimum age for admission to Stoneygate Oaklands under categories MD, PD DE and A is 50 years. To accommodate the named person in category LD named in variation application number V6461 and dated 3rd March 2004 To be able to admit the named person of category A named in variation application number V32341 dated 25th May 2006 Date of last inspection Brief description of the care home Stoneygate Oaklands is a residential care home for people over the age of fifty, who may have mental health problems, alcohol related problems, physical disabilities, or dementia. Located in a large extended house in the Stoneygate area of Leicester City, it is in easy reach of all local amenities. The majority of bedrooms are for single use, there are also two flats to support people in living more independently, and two shared rooms. All communal areas are on the ground floor. There is a pleasant garden for clients use and off road parking at the front of the home. Information about the fees, services included in the fees and the last inspection report are available at the home. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This key inspection included a visit to the service. We visited the service on the 25th of March 2009. The main method of inspection used was case tracking which meant selecting three people and tracking the quality of their care by checking records, discussion with them and with staff. We also looked at the providers own assessment of the services they provide, which they sent to us, this is called the annual quality assurance assessment or AQAA. We checked all the standards which the Commission for Social Care Inspection have Care Homes for Older People Page 6 of 27 decided are key standards during this inspection. In some sections we have also checked additional standards, these will be detailed in the main report. We spoke with people living at the home and their relatives. We also spoke with staff and observed care practice. We looked at records required for the efficient and safe running of the home and spoke with the registered manager about policy and procedure at the service. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 27 Care Homes for Older People Page 9 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Stoneygate Oaklands have their needs assessed before moving into the home and are provided with the information they need to make an informed choice before moving in.The majority of care staff have the skills and experience to meet the needs of people living at the home. Evidence: A brochure and statement of purpose is provided to all prospective residents and or their families and this provides information about the service provided and the aims and objectives of the service.The statement of purpose is designed to be read in conjunction with the homes policy and procedure booklet and this sets out the health and safety policies that are in place. This information can be provided in different languages or in larger print if requested. Before moving into the home a needs assessment is carried out by the registered Care Homes for Older People Page 11 of 27 Evidence: manager or a senior member of the team in order to ensure the service can meet the persons needs, where applicable, social services care needs assessments are included within the assessment process. Whenever possible, people are encouraged to visit the home before moving in. Trial periods are offered to all residents before deciding whether to move in permanently. Care and assessment records were seen for four people who we case tracked as part of this inspection. A needs assessment was carried out prior to admission and initial assessments included assessment of risk. Risk assessments did not address all potential risk such as risk of malnutrition and should be specific to individual needs. One person we case tracked had recently moved into the home. Staff used a document called meet and greet and this provided a checklist to ensure people were introduced to the home properly. This included providing information and literature about the service, viewing the home and a trial day, assessment, terms and conditions of residency, introduction to key worker and introduction to people living at the home. This ensures that people moving in to the home are provided with the information they need. Approximately half of the staff employed had received training in mental health and drug and alcohols dependency. All care staff must receive training in this area in order to meet the specialist needs of people living at the home. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Stoneygate Oaklands had their health and personal care needs met. Evidence: We looked at care plans for four people that we case tracked. Care plans were in place for identified needs, for one person information available was limited and therefore the social inclusion care plan was limited and not individualized. Other care plans such as a care plan for eating and drinking did state individualized preferences. Risk assessments were incorporated in to care plans but more detail was required regarding specific risks to the individual and nutritional risk. Staff were observed as being gentle and kind to people living in the home. People were treated with respect in the way they were spoken with. People spoken with said that staff were respectful. One person said staff treat you with respect without exception, they are first class. Residents care plan consent forms were not filled in for all of the people we case Care Homes for Older People Page 13 of 27 Evidence: tracked. These forms are used for consultation with people living in the home or their representative regarding the care planning process. A recommendation was made that people regarding this. Evidence was seen of staff consulting with health-care professionals such as GPs or consultant psychiatrists. Community nurses are consulted when people are identified as at risk of developing pressure sores. Medication is managed by staff who have received training in this area. People spoken with said their medication was managed effectively and administered to them at the correct time. People were able to manage their medication independently following risk assessment and staff regularly checked compliance with prescribed medicines. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Routines of daily living are made flexible to meet peoples needs. There are opportunities for people to take part in activities and have a relaxed lifestyle. Evidence: The majority of people living at the home were able to go out independently and did so on a regular basis. One person we case tracked was participating in maintenance work around the home and had also restored some old picture frames. The providers said they were hoping to set up a workshop for this person. People were seen moving freely around the communal areas and the majority of people were engaged in meaningful activity. People spoken with were satisfied with the provision of social and recreational activity. There was a choice of lounges which had recently been refurbished to a high standard and these provided an attractive and pleasant environment for people to spend some time. People spoken with said they were free to choose how to spend their day and their Care Homes for Older People Page 15 of 27 Evidence: were no restrictions. Visitors and staff spoken with also confirmed this. One person we case tracked had limited opportunity to participate in social or recreational activities and this was due to their physical and mental condition, staff should seek further advice from a relevant specialist regarding the provision of meaningful activity for this person. The lunch time meal was observed during this inspection. The meal provided appeared nutritious and appetizing. Menu records were seen and a choice of meal was usually on offer. People spoken with said they enjoyed the meals provided and that they were of a good standard. Snacks and drinks were always available and fresh fruit was delivered to the home every week. One staff member made smoothies every afternoon which people spoken with said they enjoyed. The dining room was congenial and the atmosphere calm and relaxed. Staff were seen assisting residents in a sensitive manner. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home can feel confident their complaints will be listened to, responded to and taken seriously. Recruitment procedures protect people living at the home from harm. Evidence: The complaints procedure is included within the information guide that is given to people before moving in to the home. The majority of staff had completed a protection of vulnerable adults work book, staff are instructed during their induction training regarding the prevention of abuse and actions to take in the event of suspected abuse. Staff spoken with were able to demonstrate a good awareness of safeguarding adults policies and procedures. The registered manager said they would be undertaking the local authorities safeguarding adults training. The service is registered to accommodate people with mental health and drug and alcohol dependency needs. Not all care staff had received training in this area or regarding the safe management of challenging behaviour. A requirement was made regarding this. Care Homes for Older People Page 17 of 27 Evidence: Recruitment practices at the home were robust and ensured that the relevant checks and references were obtained before staff commenced employment, this minimizes risk for people living in the home. Policies and procedures were in place regarding the management of peoples personal money and this minimized the risk of financial abuse. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A comfortable and homely environment is provided for people living at the home. Evidence: A partial tour of the premises was undertaken. Fire and risk assessments were in place and information provided stated that all routine maintenance and safety checks had been carried out. Peoples bedrooms were personalized with their own possessions and people could lock their bedroom doors. Staff had received training in infection control and this minimized the risk of cross infection for people living in the home. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home have their needs met by the numbers and skill mix of staff. Recruitment procedures minimize risk for people living at the home. Evidence: Staffing levels were sufficient to meet the needs of people living in the home. One staff member spoken with confirmed they had received induction training and had also received training in food hygiene and moving and handling. This person was also due to undergo training in the safe management of challenging behaviour and first aid. Recruitment procedures at the home were robust, all relevant checks and references were obtained for new staff before they commenced working at the home, this minimizes risk from harm for people living at the home. All new staff complete a period of induction training and records were seen of this. Training records were seen, staff were provided with the necessary mandatory training such as induction, moving and handling and fire. Not all staff had received training about caring for people with mental health, drug and alcohol dependency and the safe management of challenging behaviour, a requirement was made about this. A programme of National Vocational Qualification in care training was in progress. Care Homes for Older People Page 20 of 27 Evidence: People living in the home spoken with felt that staff were competent to meet their needs. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is run in the best interests of people living at the home. The health, safety and welfare of people living at the home is promoted. Evidence: The registered manager has been in post for many years and has the relevant skills, experience and qualifications. People living in the home and staff spoken with felt the manager was approachable and would listen to their concerns and suggestions. One staff member spoken with said they had never met a more approachable manager. The registered manager demonstrated a strong commitment to the service and a thorough understanding of peoples needs and was very much involved in the day to day care practices at the home. Systems were in place to assess quality assurance but consideration should be given to more consultation with people living at the home regarding the quality of service Care Homes for Older People Page 22 of 27 Evidence: provided. Policies and procedures were in place regarding peoples personal money and this minimized the risk of financial abuse. Staff had received all mandatory health and safety training. Information provided confirmed that all routine maintenance and safety checks had been carried out. Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 4 18 All care staff must receive the training they require to meet the specific needs of people living in the home. Staff have the skills to meet the specialist needs of people living in the home. 26/06/2009 2 8 13 Nutritional screening must be undertaken on admission and be re assesses and monitored on a regular basis. Risk of malnutrition must be identified and appropriate action taken. 30/04/2009 3 18 13 All staff should receive 19/06/2009 training in the care of people with mental health needs and the safe management of challenging behaviour. For people living at the home to be protected from harm. Care Homes for Older People Page 25 of 27 4 19 23 The bedroom door identified during this inspection must be repaired. All areas of the home must be appropriately maintained. 30/04/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 7 12 People using the service should be involved in the care planning and review process. Advice should be sought from a relevant professional regarding the provision of meaningful activities for one person living at the home. Consideration should be given to holding regular residents meetings regarding the say to day running of the home. 3 12 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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