Care Home: Stuart House

What the care home does well There are appropriate assessments and risk assessments in place for each resident. Medication is stored securely and safely, including controlled drugs and spare medication. The home has sufficient staff on duty to meet the needs of the residents accommodated and staff work well as a team. Any complaints made to the home are dealt with professionally either by staff or the registered providers (depending on the circumstances of the complaint). Communal areas and bedroom accommodation are well decorated and well furnished, and provide comfortable and homely accommodation for the people living at the home. The dining room has been relocated so that it is next to the kitchen. This leaves three lounge areas, giving residents plenty of choice about where they would like to spend their day. The arrangements in place for fire safety are good and are adhered to by staff. What the care home could do better: The door to the area of the home used just by staff is occasionally left open to allow for maintenance work; this must remain locked at all times so that it cannot be entered by residents. Some medication administration records include a photograph of each resident but others do not. A photograph assists with identification and increases safety. All complaints should be recorded in the complaint log. Not all staff are currently included on the staff rota and the role of each person is not recorded; this would make it clear who is on duty at any one time. There should be a training and development plan in place that records the training achievements and needs of the full staff group; this evidences that staff have the skills and knowledge to work with residents living at the home and also assists with identifying the need for refresher training. Inspecting for better lives Random inspection report Care homes for older people Name: Address: Stuart House 10 - 14 Eastbourne Road Hornsea East Yorkshire HU18 1QS two star good service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Diane Wilkinson Date: 2 7 0 2 2 0 0 9 Information about the care home Name of care home: Address: Stuart House 10 - 14 Eastbourne Road Hornsea East Yorkshire HU18 1QS 01964534011 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Margaret James,Ian Bernard James care home 19 Number of places (if applicable): Under 65 Over 65 19 19 dementia old age, not falling within any other category Conditions of registration: 0 0 On completion of Phase 1 alterations to the premises and subject to confirmation by the CSCI that evidence of compliance with all necessary regulations and standards has been received, the service may provide accommodation for a maximum of 14 (fourteen) persons in the permitted registration categories. On completion of Phase 2 alterations to the premises and subject to confirmation by the CSCI that evidence of compliance with all necessary regulations and standards has been received, the service may provide care and accommodation for a maximum of 17 (seventeen) persons in the permitted registration categories. On completion of Phase 3 alterations to the premises and subject to confirmation by the CSCI that evidence of compliance with all necessary regulations and standards has been received, the service may provide care and accommodation for a maximum of 19 (nineteen) persons in the permitted registration categories. Date of last inspection Care Homes for Older People Page 2 of 9 Brief description of the care home Stuart House is a privately owned care home that is situated in the seaside town of Hornsea, in the East Riding of Yorkshire. It is registered to provide care and accommodation for nineteen older people, including those with dementia related conditions. Communal accommodation is provided in two lounges, a dining room and a conservatory. All private accommodation is provided in single bedrooms. The home is close to the centre of the town and the sea front, and shops and other local amenities are within easy reach. At the rear of the property, there is a landscaped garden that includes a patio area, flowerbeds and a raised pond. This provides a very safe area for service users to sit out in the fresh air or to take a walk. Care Homes for Older People Page 3 of 9 What we found: We checked the care records for a resident who had recently been admitted to the home. These included an individual care plan that contained information specific to the person concerned such as their behaviour, their individual need for assistance with personal care and their particular communication needs. There were assessments in place for physical health and continence/pressure care and a personal risk assessment; this recorded any history of falls, assistance needed with dressing and bathing, communication needs and assistance needed with eating meals. It also recorded that the person concerned always needed the assistance of one carer when mobilising. All of these assessments/risk assessments had been reviewed in January 2009. In addition to this information, we observed that visits from health care professionals, visits from or contact with family and friends and any activities undertaken are recorded. The senior carer on duty and the registered providers were having a meeting to discuss the introduction of new care planning documentation at the time of this site visit. We saw the new documentation that was due to be introduced on the 2nd March 2009 and felt that this would improve care planning at the home, as information would be more detailed and would be clearly recorded. We examined the medication records for the person being case tracked and two other residents and found that there were no gaps in recording. In one instance we noted that the GP had prescribed medication to be taken four times daily and medication administration records had been altered by staff to twice daily. The senior carer on duty told us that the GP had told staff to administer this medication as required by the resident but this had not been recorded on the medication administration record. We advised staff to ask the GP to prescribe this medication as as required to avoid any confusion and to ensure accuracy on medication administration records. We noted that some medication records included a photograph of the person concerned and others did not. We recommend that all medication records should include a photograph of the resident as this enhances safety by giving staff another means of checking that medication is being given to the correct person. This is of particular help to new staff. We checked the storage arrangments for all medication. A cupboard has been made specifically for the storage of medication; this is in the area of the home only used by staff and this improves safety and security. The cupboard contains the medication trolley, the controlled drugs cabinet and a cabinet for the storage of spare medication. A medications fridge has been purchased by the home but this was not in use at the time of this site visit. We did not examine the list of sample signatures on this occasion. There is a complaints policy in place and this is displayed in the home. We examined the complaints log and this records minor complaints received from residents, staff and relatives; all had been dealt with appropriately. The registered provider told us that they now have a complaints and compliments box located in the front entrance hall. The Commission have been involved in two formal complaints that were made to the home, one via the Commission for Social Care Inspection (CSCI) and the other directly to the home. At the time the registered provider informed us about the investigation Care Homes for Older People Page 4 of 9 that took place and the outcome, and we were satisfied that a thorough investigation had taken place; we advised that these details should be recorded in the complaints log. There is no training and development plan in place for the full staff group so it was not possible to check if staff have had training on safeguarding adults from abuse and dementia care. There are individual records in staff files and some training certificates are retained. The senior carer on duty told us that they had recently been given responsibility for staff training and that all staff have recently had moving and handling training. Training on infection control is booked for March and this monthly training programme will continue until staff have completed all core training. It is planned that this will be repeated on an annual basis. We checked the bedroom of the service user being case tracked and a bedroom where new flooring had been laid that day to replace the existing carpet; this was non slip flooring. Both bedrooms were well decorated and furnished and provided comfortable accommodation for the residents concerned. One bedroom had a mobility hoist stored in there and the provider told us that this hoist was used just for the resident in that room. There was sufficient space around the bed to enable staff to assist the resident to transfer from chair to bed. We were concerned that the door to the area of the home only used by staff was open to allow the handyman and the provider to remove unwanted items from the home. This may only have been for a short period but one resident wandered into this area whilst we were at the home. This area of the home is not completely safe and the door into it should be closed at all times. We saw the communal areas of the home and these were well furnished and well decorated, and they were clean and tidy on the day of the site visit. The dining room has been relocated so that it is next to the kitchen. There are now three lounges and this gives residents plenty of choice about where they would like to spend their day. We examined the staff rota - this indicates that there are enough care staff on duty to care for the number of residents accommodated at the home. The hours worked by the cook are recorded on the rota but hours worked by domestic staff and the handyman are not. The rota does not record the role of each member of staff and the senior carer on duty agreed that this would be actioned. The registered manager and care manager have recently left the home and two senior carers are temporarily managing the home. The registered providers told us that this arrangement has been successful and that the staff group are now working very well as a team; this was observed on the day of this site visit. We did not check the quality assurance systems on the day of this site visit due to the period of change that staff are going through; we advised that we would look at this in some detail at the next key inspection of the home. We examined fire safety records at the home. The senior carer told us that the Fire Officer had recently visited the home and as a result, some minor recommendations were received. These were to be actioned by February 09 and April 09. The senior carer told us that all of the work had been completed. We examined records for in Care Homes for Older People Page 5 of 9 house tests of the fire alarm system and noted that these take place consistently. What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 6 of 9 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 9 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 9 A photograph of each resident should be attached to medication administration records to assist with identification and enhance safety. All complaints should be recorded in the complaints log so that there is evidence of the investigation that has taken place, and the outcome of that investigation. All staff should be recorded on a staff rota and the role of each member of staff should be recorded. This would provide a accurate account of the staff on duty at any one time. 2 16 3 27 Care Homes for Older People Page 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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