Care Home: Strafford House

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What the care home does well Comprehensive assessments took place, and detailed information was recorded from these assessments. Through comprehensive documentation and the recording of information the service and each member of staff will be aware of the person`s needs prior to admission. The care plans were up to date and recorded the person`s needs and there was a daily entry. The people who use the service, who were spoken with expressed they were satisfied with their care. The people who use the service`s quality of life will be enhanced because of the availability of activities and outings and the participation within their selection and preparation of meals. People who use the service were able to express their concerns and these were acted upon.On touring the building it was observed that the rooms had been personalised by pictures, posters and included items, which would be in a younger persons room i.e. stereos etc. The home was clean and well decorated and odour free, except for one room. The atmosphere within the service was warm, friendly and relaxed. The robust staff recruitment process regarding the checking of staff will contribute toward the protection of people who use the service. What has improved since the last inspection? The service had complied with the requirements, and taken on board the recommendations. What the care home could do better: The environment, monitored at this inspection, had been maintained to the required standard to provide a well-maintained environment for people who use the service, except for the one room. An explanation for the room being in a poor state was given and an agreement to return the room to a good standard was offered by the team leader. CARE HOME ADULTS 18-65 Strafford House Off Doncaster Road Hooton Roberts Rotherham South Yorkshire S65 4PF Lead Inspector Ivan Barker Key Unannounced Inspection 6th March 2008 10:00 Strafford House DS0000065108.V360573.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 Strafford House DS0000065108.V360573.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. Strafford House DS0000065108.V360573.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Strafford House Address Off Doncaster Road Hooton Roberts Rotherham South Yorkshire S65 4PF 01709 855796 01709 855547 hootonroberts1@tiscali.com Voyagecare.com Voyage Ltd 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 John Michael Egbury Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Strafford House DS0000065108.V360573.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st August 2006 Brief Description of the Service: Strafford House is a care home for up to six adults with learning disabilities. It is located in a small village near to the town of Rotherham, in a converted building behind the Earl of Strafford public house. The home overlooks farmland and has its own private garden. Each of the 6 rooms is spacious and has an en-suite bathroom. They are located on the first and second floors of the house. There is a communal lounge, a large kitchen dining room and a games room. A small laundry room is available for service users if appropriate. Fees at the date of the visit range from £1100 to £1900 each week and depend on the amount of staffing required. Information about the home is available from the home in the form of a service user guide. Strafford House DS0000065108.V360573.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 that the people who use this service experience good quality outcomes. Only a limited number of the National Minimum Standards were examined at this inspection (with emphasis on the ‘key standards’), and the previous requirements. The person present at the inspection was: Vanessa Nortcliffe, Team leader. Within this site visit, which occurred over a four hour period, the inspector toured the building, examined requirements relating to the previous inspection, case tracked 2 people who use the service (Case tracked means looking at the care and service provided to specific people living at the home; checking records relating to their health and welfare, care plans and other records; by talking to the people who use the service; viewing their personal accommodation as well as communal living areas), and spoke with other people who use the service, and 3 staff and examined assessments, care plans, risk assessments, menus, complaint files, staff files and quality monitoring documents. The history of the service was examined prior to the site visit. This included the Annual Quality Assurance Assessment document, telephone contacts, letters, notifications etc. What the service does well: Comprehensive assessments took place, and detailed information was recorded from these assessments. Through comprehensive documentation and the recording of information the service and each member of staff will be aware of the person’s needs prior to admission. The care plans were up to date and recorded the person’s needs and there was a daily entry. The people who use the service, who were spoken with expressed they were satisfied with their care. The people who use the service’s quality of life will be enhanced because of the availability of activities and outings and the participation within their selection and preparation of meals. People who use the service were able to express their concerns and these were acted upon. Strafford House DS0000065108.V360573.R01.S.doc Version 5.2 Page 6 On touring the building it was observed that the rooms had been personalised by pictures, posters and included items, which would be in a younger persons room i.e. stereos etc. The home was clean and well decorated and odour free, except for one room. The atmosphere within the service was warm, friendly and relaxed. The robust staff recruitment process regarding the checking of staff will contribute toward the protection of people who use the service. What has improved since the last inspection? 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. Strafford House DS0000065108.V360573.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 Strafford House DS0000065108.V360573.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): Standard 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. Through comprehensive documentation and the recording of information, the service and each member of staff will be aware of the people who use the service’s needs prior to admission. EVIDENCE: The team leader advised that the prospective person’s assessment from the care managers was sent to the manager and the ‘senior planner’ for the company. On receipt of the assessment the manager and senior planner would undertake the assessment for the service. Following the assessment the person would be offered a place at the service, if their needs could be met and the contracting agreed with the costing of the placement. These costs would be in line with the assessed needs of the individual in relation to the pricing scale operated by the company. The assessments were comprehensive and detailed all the social and health needs of the person so that it informed the service and staff of the needs so that accurate care plans could be produced. Strafford House DS0000065108.V360573.R01.S.doc Version 5.2 Page 9 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): Standards 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. People who use the service will benefit from up to date comprehensive care plans. EVIDENCE: On examination of the care plans it was found that the care plans were extensive and details all aspects of the care needs of the individual. These included the required social, mental and physical interventions. The plans were ‘core’ care plans, which had additional assessments to ensure that they were individualised plans to identify the needs of that particular individual. The care plans were up to date, and had been evaluated on a regular basis. The evaluation was written within an empty space within the care plan. It was discussed that a separate form may be useful in which to write the evaluations. The team leader advised that new documentation had been produced but was Strafford House DS0000065108.V360573.R01.S.doc Version 5.2 Page 10 yet to be implemented. On examination of the new documentation it was established that evaluation forms had been included. Each plan had a daily entry of care. The people who use the service were spoken with and it was established that they were satisfied with their care. The comments were that ‘They look after us well’. ‘We have a good time here’. ‘We like it here’. Strafford House DS0000065108.V360573.R01.S.doc Version 5.2 Page 11 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): Standards 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. The people who use the service’s quality of life will be enhanced because of the availability of activities and outings and the participation within their selection and preparation of meals. EVIDENCE: There was evidence recorded of activities for people who use the service, within their own daily entry within their care plan. This showed that people who use the service undertook various activities. These ranged from swimming, working with horses, dog walking, working with falcons, and included trips out to the church, cinema and to the shopping outlets. The people who use the service commented that they went out to places as they wished and reiterated some of the list of places stated above. Strafford House DS0000065108.V360573.R01.S.doc Version 5.2 Page 12 Regarding the meals, the team leader advised that there were six people who use the service and this allowed each person one choice of meal for everyone within a week and then a roast meal on Sundays. Following the choices being made a menu for the week was drawn up and displayed within the dining room. The choices took account of people’s likes and dislikes. Also the person who had chosen that meal for the day was involved with the staff, in preparing and cooking the meal and washing up and clearing away following the meal. The people who use the service commented that they were satisfied with the food. Strafford House DS0000065108.V360573.R01.S.doc Version 5.2 Page 13 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): Standards 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. The people who use the service receive their medication in a safe manner and independence with medications was promoted. EVIDENCE: The people who use the service had the opportunity to access the primary care facilities, which included GP and dental services etc. The medications were stored within cupboards within the main office. The office could be locked when the room was left unattended. The medication administration records were pre printed and all the administration boxes were signed. On discussing the staff training on the administration of medications, the team leader identified that it was mainly the senior staff, either team leaders or acting team leaders who administered the medications. All had undertaken medication training. Strafford House DS0000065108.V360573.R01.S.doc Version 5.2 Page 14 There was only one person who was self-administrating medication and he was using his own inhalers. There was evidence that several attempts had been made by several people who use the service to self medicated but for various reasons they had to receive assistance from the staff. However the team leader advised that they continually reviewed the people who use the service with their medications so as to promote independence. Strafford House DS0000065108.V360573.R01.S.doc Version 5.2 Page 15 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): Standards 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. People who use the service were able to express their concerns and these were acted upon. EVIDENCE: The complaints procedure was printed within the service user guide. A copy of the guide was available to the service users and visitors. On discussing complaints with the team leader, she identified that the service had received one complaint in Jan 07 regarding a person who use the service accessing another person’s room. This matter had now been resolved. There had been no complaints received by the Commission for Social Care Inspection, regarding the service prior or during the visit. However it was observed that any ‘views’ expressed by the people who use the service, were recorded within the daily entry of the care plan, with later entries recorded to show if it had been acted upon. Also there were meetings for people who use the service, where they could express their views. The service had policies and procedures regarding Safeguarding Adults. The training records of the staff were examined and it was established that staff had attended training on Safeguarding Adults. Strafford House DS0000065108.V360573.R01.S.doc Version 5.2 Page 16 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): Standards 24 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 environment, monitored at this inspection, had been maintained to the required standard to provide a well-maintained environment for people who use the service, except for one room. EVIDENCE: On touring the building it was observed that the rooms had been personalised by pictures, posters and included items, which would be in a younger persons room i.e. stereos etc. The home was clean, generally well maintained and well decorated and odour free. The atmosphere within the service was warm, friendly and relaxed. Strafford House DS0000065108.V360573.R01.S.doc Version 5.2 Page 17 It was observed that one of the rooms had considerable damage to the walls, the furniture and had a torn carpet. On discussing the state of the room with the team leader, she advised that the person who resided in the room had just decided one day ‘to take out his frustrations on the room’. It was discussed that the room was well below the standard expected within a care service. The team leader advised that the staff were currently working with the person and the service intended to redecorate and refurbish the room as soon as possible. A timescale of the 30th April 08 was offered for the completion of the work. This timescale was accepted. The main entrance and exits had keypad security, however the fire doors to be building had no security. It was discussed that there are systems that secure the door but release on the fire alarm being activated or sounders that operate when the door was opened. This was particularly important because of the fact that the staffing numbers are reduced at night and some people who use the service had absconded at various times. It was recognised that the people who use the service had not left by the fire doors, but the team leader agreed that the doors could be used as a means of exit. The manager has since the inspection contacted us and informed us that sounders have been fitted to the doors. The service is located behind a public house and accessed through the car park. It was discussed that the service had a number of phone calls from people who were visiting, but who were unable to locate the service. It was suggested that the service look at providing some signage to the service, either at the bottom of the car park or on the building. This may prove helpful to visitors and the emergency services should they be required. Strafford House DS0000065108.V360573.R01.S.doc Version 5.2 Page 18 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): Standards 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. The robust staff recruitment process regarding the checking of staff will contribute toward the protection of the people who use the service. EVIDENCE: On examination of the staff on duty and the rota it was established that the staffing was as follows: A.M. P.M. N. 1 team leader plus 2 or 3 care staff 1 team leader plus 2 or 3 care staff 1 waking care staff and 1 sleep in care staff The manager was supernumerary to these figures. There was also a senior member of staff on call, during the night. Strafford House DS0000065108.V360573.R01.S.doc Version 5.2 Page 19 Caring for 5 people who use the service. The team leader advised that the figure of 2 or 3 care staff on duty was dependant on the activities, which were planned for that particular day. For example if a person who used the service needed a member of staff to accompany them for swimming then 3 staff would be on duty. On examination of the staff training records, the staff had received training in fire, moving and handling and other clinical training. On examination of 3 staff files, it was established that the files contained all the information required within Schedule 2. The staff comments were: ‘Its good working here’ ‘We get plenty of training’ ‘We work well as a team’ The team leader identified that there was a stable workforce with a minimal turnover of staff. Strafford House DS0000065108.V360573.R01.S.doc Version 5.2 Page 20 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): Standards 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. An experienced registered manager is in post. This will contributed to the effective organisation and operation of the service. Extensive quality assurance systems were in place that should assist the manager and owners to measure the service against expected outcomes EVIDENCE: On arrival at the service, on this unannounced inspection, it was established that the manager was on annual leave. Therefore the inspection was undertaken with the assistance of the team leader. Strafford House DS0000065108.V360573.R01.S.doc Version 5.2 Page 21 The manager had 20 years experience in care and 9 years experience in management, and had attained the Registered Managers Award. Regarding Quality Assurance, the manager and his manager undertook the quality monitoring of the service. The systems include the monitoring of the environment and Health and Safety audits. Regulation 26 documentations, which are a record of the registered person’s monthly visits, was complied on a monthly basis, evidence of this was seen at the visit. Regulation 37 notices, which are documents that are sent to the Commission regarding untoward occurrences, including falls, accidents etc; have been received by CSCI (Commission for Social Care Inspection). Strafford House DS0000065108.V360573.R01.S.doc Version 5.2 Page 22 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 X 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 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 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 X 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Strafford House DS0000065108.V360573.R01.S.doc Version 5.2 Page 23 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 YA24 Regulation 23 Requirement The decoration, furniture and refurbishment of the room should be to the required standard. Timescale for action 30/04/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Strafford House DS0000065108.V360573.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Strafford House DS0000065108.V360573.R01.S.doc Version 5.2 Page 25 - 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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