Care Home: Stuart House

Similar services:

• Claremont House
• Oak Ridge
• Sun Court Nursing Home
• Ashville House
• Bilney Hall
• Hill Barn
• Mabbs Hall Nursing Home
• Henrietta House

What the care home does well The inspection indicated that the home was running well, with a calm atmosphere and settled residents being cared for by confident, well-trained and motivated staff. There is a thorough assessment system in place, which is both detailed and comprehensive in its approach to identifying all the needs of new and existing residents. Detailed information about the operation of the service is provided to prospective and current residents. The residents appear to have some degree of involvement in their care planning and this enables staff to create an individual service in order to meet each persons needs and aspirations. The staff spoken with during the inspection appeared to have a clear understanding of their individual roles and responsibilities. The members of staff on duty were seen to support the main aims and values of the home. There are clearly defined job descriptions so that staff are aware of their roles. Staff receive regular supervision in order to carry out their roles effectively and professionally. The current manager has had a wealth of experience within the caring profession and has been at the home for a period of two years. She providesconfident leadership and support to the team and has clear expectations of staff. What has improved since the last inspection? The manager and staff work hard to continue to improve and further develop this service and have actioned all the requirements made at the last inspection, including introducing a new care planning system, further developing the quality assurance system and further improving the medication procedures within the home. These all improve outcomes for the people using the service. The environment has been further improved for the benefit of the residents with several bedrooms being completely re-decorated. To improve and aid mobility grab rails have been fitted to the front door access. The kitchenette now looks brighter as it has been repainted. To aid moving and handling a new standing hoist has been purchased which ensures that the people who use the service are transferred safely. What the care home could do better: All staff must receive the required mandatory training in order to carry out their role effectively and safely to ensure people are kept safe especially in relation to food hygiene as we saw some staff preparing food who had yet to receive this training and were not wearing any protective clothing whole preparing the residents tea. The proprietor and manager should consider replacing the existing locks on residents` bedroom doors, as the current locks are the `penny` locks which appear quite institutionalised and people are currently unable to hold keys for their own rooms if they so wish to and it is safe for them to do so. CARE HOMES FOR OLDER PEOPLE Stuart House 149 London Road St Albans Hertfordshire AL1 1TA Lead Inspector Julia Bradshaw Unannounced Inspection 8th January 2008 12:15 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 Stuart House DS0000019558.V357594.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. Stuart House DS0000019558.V357594.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stuart House Address 149 London Road St Albans Hertfordshire AL1 1TA 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) 01727 858200 01727 851143 Caremore Limited Pearl Agard-Smith Care Home 39 Category(ies) of Old age, not falling within any other category registration, with number (39) of places Stuart House DS0000019558.V357594.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th January 2007 Brief Description of the Service: Stuart House is a large residential house which has been converted and extended to provide residential care for up to thirty-nine people. The accommodation is offered in thirty-seven single occupancy rooms and one room which could accommodate a married couple or two people sharing, should they choose to do so. There are several lounges and small sitting areas, a conservatory and two dining rooms. The house is set in large well-maintained gardens and is on a main bus route into St Albans. The mainline train station is nearby. Fees at the home are from £405.00 - £690.00 per week Information regarding the service is available in the Statement of Purpose and Service User Guide. For these, a copy of the most recent CSCI inspection report or up to date fee information contacts the home manager. Stuart House DS0000019558.V357594.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*. This means that people who use the service experience good quality outcomes. This was a positive inspection with the majority of standards being met and only one requirement made in respect of the infection control. Consultation with both the residents during the inspection and through the service user questionnaires and other stakeholders involvement endorsed the findings of this inspection where standards were being provided at a good level and people living at Stuart House are offered a caring environment in which to live. Documentation examined included four peoples care plans, the service user’s guide, staff recruitment, supervision and training records and quality monitoring records. A tour of the premises was made, taking in all the bedrooms and all communal areas. What the service does well: The inspection indicated that the home was running well, with a calm atmosphere and settled residents being cared for by confident, well-trained and motivated staff. There is a thorough assessment system in place, which is both detailed and comprehensive in its approach to identifying all the needs of new and existing residents. Detailed information about the operation of the service is provided to prospective and current residents. The residents appear to have some degree of involvement in their care planning and this enables staff to create an individual service in order to meet each persons needs and aspirations. The staff spoken with during the inspection appeared to have a clear understanding of their individual roles and responsibilities. The members of staff on duty were seen to support the main aims and values of the home. There are clearly defined job descriptions so that staff are aware of their roles. Staff receive regular supervision in order to carry out their roles effectively and professionally. The current manager has had a wealth of experience within the caring profession and has been at the home for a period of two years. She provides Stuart House DS0000019558.V357594.R01.S.doc Version 5.2 Page 6 confident leadership and support to the team and has clear expectations of staff. 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. Stuart House DS0000019558.V357594.R01.S.doc Version 5.2 Page 7 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 Stuart House DS0000019558.V357594.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 – 5. (Standard 6 does not apply). Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents can be confident that a full assessment is carried out prior to admission to ensure their needs can be met at Stuart House. EVIDENCE: Examination of a newly admitted residents care plan showed that a full assessment had been carried out prior to admission. This formed the basis of a detailed care plan to meet people’s individual needs. The manager and staff have worked hard since the last inspection was carried out to improve the standard of both the assessment process and the individual care plans. There is a detailed statement of purpose and service user guide in place and this is updated either annually or when there are changes to the service so that people can access the most up to date information. Stuart House DS0000019558.V357594.R01.S.doc Version 5.2 Page 9 During the inspection there was a prospective resident and their family being shown around the home and it was positive to hear that people are offered the opportunity to “test drive” the service at Stuart house before moving into the home. This enables both the manager and the resident to gain an excellent over-view of the home before fully committing to moving in permanently. Stuart House DS0000019558.V357594.R01.S.doc Version 5.2 Page 10 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 –11. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at Stuart House can expect that their health and personal care needs will be set out in care plans for staff to follow which ensures that they receive the care they require and are treated with dignity and respect. People living here can also be assured that they will be safeguarded by the medication policies and procedures in place. EVIDENCE: The manager has worked hard to implement a new care planning system into the home and this process is now nearly completed. The care plans inspected provide a detailed insight and record into the needs of the people living at the home. Individual risks are identified and risk assessments are in place. These are reviewed annually. Several residents were spoken to during this visit and stated,” I wouldn’t want to be anywhere else” “the staff are all very nice and take great care of me”. Stuart House DS0000019558.V357594.R01.S.doc Version 5.2 Page 11 We also took the opportunity to talk to a new resident, in order to find out how their transition process had progressed. They stated that they were very impressed with how caring and kind everyone was and that her room was “beautiful”. Health needs and visits by the doctor are recorded within the care plan and followed up as required. A four-week dosette system for medication is in place through infacare services. The last pharmacy check carried out by infacare was in November 2007. A check on medication was carried out and we found that an auditing process is in place so that errors are picked up quickly and action taken. The deputy manager has worked hard to improve the medication system since the last inspection was carried out and the systems are now both effective and efficient. Staff are fully inducted into medication and assessed by the manager and deputy before being deemed competent in administering medication. Two staff always administers and checks medication. There are photos on all the individual medication sheets so to ensure that people do not the wrong persons medication. There were no gaps seen on the mar sheets. The deputy manager is responsible for receiving medication into the home and also for the management of the returns medication. A separate running record for the administration of paracetemol is maintained A new drugs trolley has been purchased since the last inspection. Stuart House DS0000019558.V357594.R01.S.doc Version 5.2 Page 12 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 –15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live at Stuart House can expect to be offered a range of social activities, which meets their needs, preferences and expectations. EVIDENCE: An activity co-ordinator is employed who arranges a programme offering a variety of activities including gentle exercise with music, crafts, table games, outings to the local theatre, shopping trips and visiting entertainers. Residents who spoke to us felt that there was a sufficient range of activities for those people who wanted to join in, although many were happy to spend time in their rooms or in the lounge areas. Several people received visitors on the day of the inspection and others said that they are able to welcome family and friends at any time and that they enjoyed outings with their families. Residents were generally very enthusiastic about the catering in the home; the cook offers a varied menu and uses fresh produce, including plenty of fruit for Stuart House DS0000019558.V357594.R01.S.doc Version 5.2 Page 13 those who want it. While there is no formal alternative to the main meal of the day, the cook knows each person’s particular likes and dislikes and caters accordingly. However there was a discussion held during the inspection with the manager and proprietor regarding the preparation and serving of meals and why people were not offered the opportunity to serve themselves from serving dishes rather than have their meals ‘dished up’ for them. The manager agreed to review this arrangement and discuss the option with individual residents. During the afternoon we were able to observe tea being prepared which offered a variety of sandwiches, made to individual tastes and requests. The manager must ensure that all staff who are involved in the preparation of meals/food must hold a basic food hygiene certificate as some of the staff seen preparing staff stated that they had to complete this qualification. The manager must also ensure that all staff who are involved in the preparations of food, within the kitchen, are provide with the appropriate clothing as those seen during our visit were not wearing a protective overall or apron. Stuart House DS0000019558.V357594.R01.S.doc Version 5.2 Page 14 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. People living at Stuart House and their family’s can be confident that their views, concerns and complaints will be listened to and acted on. EVIDENCE: Staff confirmed they have received training in safeguarding and are clear on how to respond to any allegations made known to them. The manager reported that further training in safe guarding adults had been booked for the whole staff group. A complaints procedure is in place and available to all who enter Stuart House. There have been no complaints received by the home since the last inspection was carried out. Resiudents said that they would be confident in taking any concerns to the manager and that they would be dealt with. Stuart House DS0000019558.V357594.R01.S.doc Version 5.2 Page 15 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 – 26. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People living at Stuart House benefit from an extremely comfortable and well maintained environment that meets their needs. EVIDENCE: The proprietor, manager and all staff at the home should be congratulated on providing a beautifully decorated home in which people can relax and truly enjoy all the comforts of home. All the communal areas of the home are well maintained and provide a range of in- house entertainment, including televisions, DVD’s and music centres. There is also a piano in one of lounges for people to enjoy. The dining room is both airy and light and has been arranged with small tables for four and five people. The home has a total of five lounges, which enables Stuart House DS0000019558.V357594.R01.S.doc Version 5.2 Page 16 people to have a choice of either joining a group of residents or to have some quiet personal time, in one of other lounge areas. The laundry room was inspected and it was pleasing to see that all the residents clothing was hanging up, having been washed and ironed. Great pride is taken in looking after residents clothing to the highest of standards. This was supported when meeting residents on an individual basis and discussing the arrangements for the washing of clothes. It was also encouraging to hear that nobody had any item of clothing lost or ruined by the laundry services at the home. We were invited in to view a few of the bedrooms and were very impressed by the standard of furnishings and fittings throughout the rooms. Residents are encouraged and supported in bringing items of their own furniture when they are admitted. Also it was encouraging to see that all the bedrooms were created on an individual basis and not incorporated into a ‘standard’ look. There were adequate bathing and toilet facilities and specialist equipment is being provided, where necessary. Grab rails have been recently fitted next to the front door to assist people with entering and leaving the home. A new standing hoist since the last inspection was carried out to assist in aiding transfers safely. During the inspection we discussed with the manager and proprietor the ‘penny’ type locks that are fitted to the bedroom doors. This type of lock does not provide an opportunity for people to have their own key to their bedroom and can present as quite institutionalised. Although this is not a requirement it would be useful to carry out further discussions with the residents in order to seek their views and preferences. The home was exceptionally clean on the day of the inspection and no mal odours were present. This is a tribute to the domestic and ancillary staff working at the home. The manager and proprietor are also vigilant in ensuring any issues relating to the maintenance of the home are addressed immediately. The grounds of the home are well maintained and provide a very pleasant environment in which to enjoy in the warmer months. All fire records were up to date on the day of the inspection, including a fire drill on the 2/10/07 which ensures people living in the home are kept safe. Stuart House DS0000019558.V357594.R01.S.doc Version 5.2 Page 17 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 –30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at Stuart House can expect to have their needs met by appropriate numbers of staff who have been appropriately recruited and are adequately trained to ensure that all are safeguarded. EVIDENCE: A thorough check of two staff files provided evidence that there is a robust procedure in place when recruiting staff and all appropriate documents are received prior to a position being offered. Staff spoken to were happy in their job and good teamwork was observed during the inspection. Stuart House have an on going training programme and records are kept to ensure staff are kept updated with their skills. There are currently over 60 of all staff who have gained their NVQ level 2. Two people have already obtained their NVQ level 3 and one member of staff is currently studying for their NVQ`level 3. Stuart House DS0000019558.V357594.R01.S.doc Version 5.2 Page 18 Adequate numbers of staff are available to meet the needs of the residents. Regular bank staff are brought in to cover any vacant shifts caused by sickness or annual leave where necessary. Adequate mandatory training is provided for staff, with the exception of food hygiene training, which had not been provided to all staff we saw involved in the preparation of food. The proprietor also stated that safeguarding adults training will be provided by the end of 2008.This will be checked at the next inspection. The home has a loyal and longstanding staff team, which clearly benefits the people living at Stuart House. There was evidence to confirm that all staff receives staff supervision and the proprietor completes staff annual appraisals. Stuart House DS0000019558.V357594.R01.S.doc Version 5.2 Page 19 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): 31,32,33,34,36,37 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at Stuart House can be confident that the home is well managed and is run in their best interests and that their health, safety and welfare will be promoted. EVIDENCE: The manager has a wealth of experience within the caring profession and has been in her current post for a period of two years. There have been several improvements to the existing systems within the home, including care plans, risk assessments and medication. Staff confirmed they felt supported and found the manager both approachable and professional. Stuart House DS0000019558.V357594.R01.S.doc Version 5.2 Page 20 There is an effective system in place for managing monies for those people who are unable or choose not too. Good recording systems are in place for the auditing of accidents and incident that effect the well being of the residents. The proprietor and manager have further improved and developed the quality assurance systems within the home. This now includes weekly medication, care plan, maintenance checks and resident and stakeholder questionnaires. The home sent out 37 questionnaires and 21 were returned completed. Health and safety systems are in place with regular checks being carried out on fire equipment, moving and handling equipment, any maintenance issues are recorded and dealt with appropriately this is to ensure that all who enter Stuart House have their health, safety and welfare promoted at all times. Stuart House DS0000019558.V357594.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 4 4 3 3 3 4 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 x 3 3 3 Stuart House DS0000019558.V357594.R01.S.doc Version 5.2 Page 22 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 OP30 Regulation 18 (1) (c) Requirement Staff employed at the care home must receive the training appropriate to the work they are to perform this includes food hygiene training to ensure residents are kept safe with appropriate food hygiene standards applied. Suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home must be made - this includes the provision of protective clothing to ensure effective food hygiene standards are maintained. Timescale for action 30/04/08 2. OP26 13 (3) 29/02/08 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 Stuart House DS0000019558.V357594.R01.S.doc Version 5.2 Page 23 Stuart House DS0000019558.V357594.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Inspection Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 Stuart House DS0000019558.V357594.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!