Care Home: Stratton House [Burnham-on-Sea]

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What the care home does well All bedrooms at Stratton House are for single occupancy and people are able to personalise their rooms to reflect their tastes and needs. There is ample communal space and all areas seen during the inspection were clean and fresh.Anyone wishing to move the home has their needs assessed and is able to spend time at the home to make sure it is the right place for them. There is a clear staffing structure meaning there are clear lines of responsibility. There are adequate numbers of staff to meet the needs of the people who live at the home. Recruitment procedures are robust and minimise the risks of abuse. In answer to the question "what does the service do well?" staff wrote comments that included "treats everyone as an individual," "I think it offers a homely atmosphere and a good level of care" and "makes sure all residents needs are met and respects their rights." What has improved since the last inspection? Since the last inspection the provider, manager and staff have worked extremely hard to raise the standard of the environment and the care offered. An improvement plan has been put in place, which has included up-grading facilities in the home to provide a more enabling environment for people who have a dementia. There is now signage in place to assist people to orientate themselves around the building, areas have been decorated and some carpets have been replaced. The building is now much more homely and there are books, magazines and rummage boxes around the place for people to look at. The lunch-time experience in the home has improved and people are now being assisted to make choices about the food that they eat. Staff were seen to assist people with meals in a dignified and sensitive manner. The atmosphere in the dining room was relaxed and people ate a good meal. Weights are now being more closely monitored and advice from outside professionals has been sought for those who are not maintaining a stable weight. Opportunities for staff training have improved and staff are now receiving training that is appropriate to their jobs and gives them the skills and knowledge to appropriately support people living at the home. The manager has applied to the Commission for Social care Inspection to be registered. The manager has good management skills but limited experience in working with people who have a dementia. They have been pro-active in gaining knowledge by extensive reading and by attending training courses. People have had their needs reviewed by professionals outside the home and two people have moved to more appropriate accommodation. All care plans have been completely updated and now give information about peoples` lifestyles, likes and preferences as well as their physical needs. All staff have signed each care plan to say that they have read and understood it. All care plans seen had been reviewed and up dated within the last month. One member of staff takes responsibility for auditing the care plans on a regular basis. This has led to better monitoring of peoples healthcare needs. One relative wrote "Stratton House has improved, decor and furnishings much better, care plans, newsletter, activities and most importantly staff morale seems much better." CARE HOMES FOR OLDER PEOPLE Stratton House [Burnham-on-Sea] 15 Rectory Road Burnham-on-Sea Somerset TA8 2BZ Lead Inspector Jane Poole Unannounced Inspection 18th September 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 Stratton House [Burnham-on-Sea] DS0000070059.V372045.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. Stratton House [Burnham-on-Sea] DS0000070059.V372045.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stratton House [Burnham-on-Sea] Address 15 Rectory Road Burnham-on-Sea Somerset TA8 2BZ 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) 01278 787735 01278 787735 stratton.house@btconnect.com Angels (Stratton House) Ltd Manager post vacant Care Home 24 Category(ies) of Dementia (24), Old age, not falling within any registration, with number other category (24) of places Stratton House [Burnham-on-Sea] DS0000070059.V372045.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home providing personal care only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (Code OP) Dementia (Code DE) The maxmimum number of service users who can be accommodated is 24. 22nd April 2008 2. Date of last inspection Brief Description of the Service: Stratton House is a large and extended detached property, which is situated in a pleasant residential area not far from the town of Burnham-on-Sea and the sea front. The home is owned by Angels (Stratton House) Ltd. The responsible individual in Mr M Pattani. The home does not currently have a registered manager. The home is registered with the Commission to provide personal care only to a maximum of 24 people who require care by means of old age or dementia. The home is not registered to provide nursing care. The Commission was provided with the following information about the home’s fee range and charges. Fees are between £390 & £450 per week. Extra charges are met by service users for hairdressing, personal toiletries, chiropody, newspapers, private opticians/dentist. Full details can be found in the home’s brochure. Stratton House [Burnham-on-Sea] DS0000070059.V372045.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. The focus of this inspection visit was to inspect relevant key standards under the Commission’s ‘Inspecting for Better Lives 2’ framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are: - excellent, good, adequate and poor. Since the last key inspection in April 2008 two random inspections have been carried out at different times of the day. One took place in the evening and the other at lunch-time. This inspection was carried out over a one-day period. During this time the inspector was able to meet with people living and working at the home, observe care practices, tour the building and view records. The inspector was also able to attend a senior staff meeting. Prior to the inspection the home completed an Annual Quality Assurance Assessment (AQAA.) This gave information about the service offered and the improvements that are planned in the coming year. Prior to the inspection 2 people living at the home and 3 members of staff completed questionnaires. Some of their comments have been incorporated into this report. Correspondence was also received from two relatives of people living at the home. Both were complimentary about the changes that had occurred in the home. The following is a brief summary of the inspection findings and should be read in conjunction with the whole of the report. What the service does well: All bedrooms at Stratton House are for single occupancy and people are able to personalise their rooms to reflect their tastes and needs. There is ample communal space and all areas seen during the inspection were clean and fresh. Stratton House [Burnham-on-Sea] DS0000070059.V372045.R01.S.doc Version 5.2 Page 6 Anyone wishing to move the home has their needs assessed and is able to spend time at the home to make sure it is the right place for them. There is a clear staffing structure meaning there are clear lines of responsibility. There are adequate numbers of staff to meet the needs of the people who live at the home. Recruitment procedures are robust and minimise the risks of abuse. In answer to the question “what does the service do well?” staff wrote comments that included “treats everyone as an individual,” “I think it offers a homely atmosphere and a good level of care” and “makes sure all residents needs are met and respects their rights.” What has improved since the last inspection? Since the last inspection the provider, manager and staff have worked extremely hard to raise the standard of the environment and the care offered. An improvement plan has been put in place, which has included up-grading facilities in the home to provide a more enabling environment for people who have a dementia. There is now signage in place to assist people to orientate themselves around the building, areas have been decorated and some carpets have been replaced. The building is now much more homely and there are books, magazines and rummage boxes around the place for people to look at. The lunch-time experience in the home has improved and people are now being assisted to make choices about the food that they eat. Staff were seen to assist people with meals in a dignified and sensitive manner. The atmosphere in the dining room was relaxed and people ate a good meal. Weights are now being more closely monitored and advice from outside professionals has been sought for those who are not maintaining a stable weight. Opportunities for staff training have improved and staff are now receiving training that is appropriate to their jobs and gives them the skills and knowledge to appropriately support people living at the home. The manager has applied to the Commission for Social care Inspection to be registered. The manager has good management skills but limited experience in working with people who have a dementia. They have been pro-active in gaining knowledge by extensive reading and by attending training courses. People have had their needs reviewed by professionals outside the home and two people have moved to more appropriate accommodation. Stratton House [Burnham-on-Sea] DS0000070059.V372045.R01.S.doc Version 5.2 Page 7 All care plans have been completely updated and now give information about peoples’ lifestyles, likes and preferences as well as their physical needs. All staff have signed each care plan to say that they have read and understood it. All care plans seen had been reviewed and up dated within the last month. One member of staff takes responsibility for auditing the care plans on a regular basis. This has led to better monitoring of peoples healthcare needs. One relative wrote “Stratton House has improved, decor and furnishings much better, care plans, newsletter, activities and most importantly staff morale seems much better.” 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. Stratton House [Burnham-on-Sea] DS0000070059.V372045.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 Stratton House [Burnham-on-Sea] DS0000070059.V372045.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): 3 & 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home carries out pre admission assessments to ensure that they are able to meet the needs of anyone wishing to move to the home. EVIDENCE: Only one new person has moved to Stratton House since the last key inspection. There was evidence that the person had been able to visit the home with their family before deciding to move in. The manager had carried out a pre-admission assessment and obtained a copy of a full assessment of need carried out by professionals outside the home. Stratton House [Burnham-on-Sea] DS0000070059.V372045.R01.S.doc Version 5.2 Page 10 The newest person said that the staff had been very kind and helped them to settle in. Stratton House [Burnham-on-Sea] DS0000070059.V372045.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 & 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans have been completely up dated to give comprehensive information about peoples needs, likes and preferences. Healthcare needs are monitored and appropriate professionals are contacted for advice and support. EVIDENCE: Since the last key inspection the home has expanded the care plans in place to ensure that they provide more comprehensive information about individual needs and preferences. 3 care plans were viewed in detail and 3 others were sampled. All contained personal profiles of the person, giving details about their life and interests. All care plans also gave details about peoples preferred routines and preferences to make sure that people receive care in their chosen way even if they are no longer able to fully express their views. Stratton House [Burnham-on-Sea] DS0000070059.V372045.R01.S.doc Version 5.2 Page 12 One member of staff wrote on their questionnaire “care plans have been completely up date and keyworkers appointed to make everything more organised.” All care plans seen had been reviewed within the past month and up dated where appropriate. Care plans are signed by all staff to ensure that they have been read and understood by all. The Annual Quality Assurance Assessment (AQAA) states that people living at the home, or their representatives, are being invited to be more involved in the care planning process. Since the last key inspection the needs of people have been reviewed by professionals outside the home and this has resulted in two people moving to more appropriate accommodation. A programme of staff training has been put in place since the last key inspection to give staff greater knowledge of the needs of people who have a dementia. All staff have now also received training in the safe administration of medication. Everyone is now weighed on a regular basis and records of weights show that for the majority of people these have remained stable. Where concerns have been raised advice has been sought from a dietician and other relevant professionals. Nutritional assessments have been completed for everyone at the home. Records of healthcare appointments are recorded and these show that people are accessing services and professionals according to their individual needs. It was observed that staff interacted with people in a friendly and respectful manner. People are able to spend time in the communal areas or in the privacy of their rooms. It was noted that staff knocked on bedroom doors, before entering, ensuring peoples privacy was respected. One relative praised the way that staff respected privacy and encouraged people to maintain their appearance. The home uses a Monitored Dosage System for medication. All medication is appropriately stored including controlled drugs and medication that requires refrigeration. Medication Administration Records were viewed. Medication is checked and signed for when it comes to the home and signed for when administered or refused. This gives a clear audit trail. Controlled drugs were checked and stocks held correlated with records maintained. It was noted that two people, who were prescribed medication on an “as required” basis, had been receiving medication on a regular basis. This was discussed at the senior staff meeting, held during the inspection, and one member of staff was allocated the responsibility of writing out comprehensive protocols for the circumstances where this medication should be given. Stratton House [Burnham-on-Sea] DS0000070059.V372045.R01.S.doc Version 5.2 Page 13 Stratton House [Burnham-on-Sea] DS0000070059.V372045.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Great improvements have been made to the lunch time experience meaning that people are now encouraged to make choices about the food they eat and portion size. There are some organised activities in the home but staff need to ensure that everyone receives adequate social stimulation and are supported to make choices. EVIDENCE: Since the last key inspection an activities worker has been employed and an activity programme, which includes a range of outside entertainers, has been put in place. The activity worker stated that they are using the personal profiles in care plans to make sure that activities are based around peoples known interests. Stratton House [Burnham-on-Sea] DS0000070059.V372045.R01.S.doc Version 5.2 Page 15 There are now photographs on display featuring activities that have taken place. Books, magazines and rummage boxes have made available in the lounge and it was noted that some people were enjoying looking through these. It was observed that during the morning there was limited staff interaction between people using the lounge and staff. This meant that some people, who were unable to occupy their time, received limited social stimulation. There are some routines in place but the senior staff gave evidence that they are using up to date research and good practice guidelines to ensure that any routines are appropriate to the people living at the home and not for the convenience of the staff. This will enable people to have greater choice about how they spend their time and when they receive assistance with care. People are able to have visitors at anytime and the home recently held an afternoon strawberry tea for people living at the home and their guests. The whole of the mid-day meal was observed at this and a previous random inspection. Vast improvements were noted. New tables and chairs have been purchased. Everyone at the same table was served at the same time. People were shown two drinks to choose from and everyone was able to make a choice. Large serving dishes were placed in the centre of tables and staff assisted people to make choices about vegetables and portion sizes. The home is no longer using side plates for main meals and portions appeared ample. No one living at the home was wearing a plastic apron and those who needed protection for their clothes had a much more discreet apron on. The atmosphere during lunch was calm and relaxed and people ate a good lunch of roast meat and vegetables. One person did not eat well and they were offered various alternatives by staff. One person chose to eat their main meal in the lounge and a tray was taken to them. Another person chose to eat lunch in their bedroom. A member of the care staff team supported one person who required physical assistance to eat. The person was assisted in a very dignified way, they were not rushed and there was constant interaction between the two people. Stratton House [Burnham-on-Sea] DS0000070059.V372045.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Appropriate systems are in place to minimise the risk of abuse to people living at the home. EVIDENCE: The home has policies and procedures in respect of making a complaint, recognising and reporting abuse and whistle blowing. Staff have received training in recognising abuse and on assisting people with decision making in line with the Mental Capacity Act. Both people living at the home who completed questionnaires said that they knew how to make a complaint. All staff answered YES to the question ‘Do you know what to do if a service user / relative/ advocate or friend has concerns about the home?’ The AQAA states that the manager has an open door policy and welcomes comments from people living and working at the home and from visitors. Staff spoken to said they found this to be the case. Stratton House [Burnham-on-Sea] DS0000070059.V372045.R01.S.doc Version 5.2 Page 17 No complaints have been received since the last key inspection. People have unrestricted access to their personal rooms and all communal areas. Since the last key inspection the main garden has been enclosed to provide a safe outside space for people to use. One relative wrote that they had been about to meet with the manager to discuss their concerns. Another said “ I visit regularly and if I raise any concerns they are dealt with.” Stratton House [Burnham-on-Sea] DS0000070059.V372045.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 24 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Improvements have been made to make the home more enabling for the people who live there and assist people to move around independently. Standards of cleanliness are good. EVIDENCE: The home have put in place, and begun work, on an improvement plan to make the environment more appropriate to the needs of the people who live at Stratton House. Signage has now been put in place to assist people to orientate themselves around the building and the heavily patterned carpet has been removed from the stairs and entrance hall and replaced with a plainer one. Stratton House [Burnham-on-Sea] DS0000070059.V372045.R01.S.doc Version 5.2 Page 19 Some areas have been redecorated to provide a lighter and fresher environment. There is an orientation board in the hallway and photographs of activities that people have taken part in. The home is looking at the possibility of colour coding doors and corridors in line with up to date research on enabling environments for people with a dementia. The main garden has been made secure so that people have access to a safe outside space. Some new furniture has been purchased and furniture in the lounge has been repositioned to create a much more homely feel. A sample of bedrooms was viewed, all had been personalised to reflect the tastes and personalities of their occupants. New bed-linen has been purchased for all rooms. Work had begun on up-grading the laundry and there are plans to further develop this. There are also plans to up-grade bathrooms to ensure that the facilities are appropriate for all. One decision made by senior staff at their meeting was to make bathrooms more homely and inviting. On the day of the inspection all areas seen were clean and fresh. Suitable hand washing facilities are available throughout the home. Stratton House [Burnham-on-Sea] DS0000070059.V372045.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are now receiving training that is specific to their role and enables them to assist and support people living at the home. Recruitment practices are robust and minimise the risk of abuse to people. EVIDENCE: The home employs 22 care staff, 9 (41 ) have a National Vocational Qualification (NVQ) in care at level 2 or above. 12 staff are currently working towards this award. 9 ancillary staff are also employed. There are 4 staff on duty each morning and 3 in the afternoon and evening. Overnight there are 2 members of staff. The managers’ hours and all ancillary hours are in addition to this. Staff spoken with during the inspection felt that there were adequate staff on duty to meet the needs of the people currently living at the home. Since the last inspection the home has improved the staff training opportunities and staff now receive training that is relevant to their roles and to the needs of the people who live at the home. Staff spoken with during the Stratton House [Burnham-on-Sea] DS0000070059.V372045.R01.S.doc Version 5.2 Page 21 inspection felt that training opportunities were now good and they were receiving training that was specific to their roles and the needs of people who have a dementia. There is comprehensive induction programme in place and the company have just purchased a training package to ensure that all staff receive ongoing, up to date training. The recruitment files of the three most recently appointed members of staff were viewed. These gave evidence of a robust recruitment procedure, which included checking prospective staff against the Protection Of Vulnerable Adults (POVA) register, undertaking a Criminal Records Bureau (CRB) check and obtaining written references. The newest member of staff was spoken with. They said that they had received adequate information and training for their job and that they had been made to feel welcome by other members of staff. Staff observed throughout the day demonstrated a good knowledge of people living at the home and assisted people in a discreet and respectful manner. Stratton House [Burnham-on-Sea] DS0000070059.V372045.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed taking account of peoples’ views and opinions. There are systems in place to monitor and improve the quality of care provided at the home. EVIDENCE: The home has a manager in place who has applied to the Commission for Social Care Inspection to be registered. The manager has achieved the Registered Managers Award (NVQ level 4) and has many years experience of management and working with older people, although limited experience of Stratton House [Burnham-on-Sea] DS0000070059.V372045.R01.S.doc Version 5.2 Page 23 working with people who have a dementia. The manager has been pro-active in increasing their knowledge of dementia. They have undertaken extensive reading on the subject and attended training courses. They are currently undertaking a comprehensive course ‘Leadership Matters in Person Centred Dementia Care’ Since the last key inspection a deputy has been appointed who has experience in working with people who have a dementia. There are clear lines of accountability within the home. There is always a senior carer on duty who co-ordinates the shift and supports less experienced members of staff. The manager is keen to share their new knowledge with other staff members to ensure that practices in the home are based on up to date good practice guidelines. During the inspection a senior staff meeting was held and this demonstrated that both the manager and senior staff have a commitment to ongoing improvements and working in a person centred way. In addition to monthly senior staff meetings there are also regular meetings for all staff. Minutes of these meetings showed that a variety of subjects are discussed and people are able to express their views and opinions. Staff spoken with during the inspection stated that the manager listened to their views and was supportive. One member of staff wrote on their questionnaire “The manager is doing a brilliant job, always supportive and open to discussion.” There are various quality assurance systems in place, which include sending out questionnaires to interested parties and collating results to see how improvements can be made. The registered provider visits the home on a regular basis to monitor the quality of care and writes a monthly report. There are regular health and safety checks which include ensuring that the fire detection and call bell system are working, checking the temperature of hot water to minimise the risk of scalds to people living at the home and making sure that all equipment is regularly serviced. Some staff in the home have not received up to date training in fire safety. A training session was arranged although attendance was poor and the home is addressing this through their disciplinary procedures. All accidents are recorded and the manager audits these records on a 3 monthly basis to monitor individuals’ health care needs and to ensure that staffing levels are sufficient. Stratton House [Burnham-on-Sea] DS0000070059.V372045.R01.S.doc Version 5.2 Page 24 The home does not act as a financial appointee or power of attorney for anyone living at the home. Up to date certificates of insurance and registration are in place. Stratton House [Burnham-on-Sea] DS0000070059.V372045.R01.S.doc Version 5.2 Page 25 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 x x 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 2 3 x 3 x 2 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 2 3 3 x 3 x x 3 Stratton House [Burnham-on-Sea] DS0000070059.V372045.R01.S.doc Version 5.2 Page 26 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 OP26 Regulation 13(3) Requirement The laundry area must be refurbished to ensure that it is appropriate for the home and promotes good infection control practices. Timescale for action 31/03/09 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 2 Refer to Standard OP9 OP12 Good Practice Recommendations It is recommended that individual protocols are in place for the use of ‘as required’ medication. Recommendation made at last inspection. The home should ensure that routines are flexible and provide people with adequate social stimulation. DS0000070059.V372045.R01.S.doc Version 5.2 Page 27 Stratton House [Burnham-on-Sea] 3 4 OP14 OP21 The home should ensure that people are given opportunities to make choices about their day-to-day lives. Bathrooms should be made more homely and inviting. Stratton House [Burnham-on-Sea] DS0000070059.V372045.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Stratton House [Burnham-on-Sea] DS0000070059.V372045.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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