Stobhill Nursing Home Care Home Service

Transcription

1 Stobhill Nursing Home Care Home Service 70 Stobhill Road Bishopbriggs G21 3TX Inspected by: (Care Commission Officer) Type of inspection: Ann McKinnon Announced Inspection completed on: 13 February /11

2 Service Number Service name CS Stobhill Nursing Home Service address 70 Stobhill Road Bishopbriggs G21 3TX Provider Number dummy Provider Name SP Tamaris (RAM) Limited, a member of the Four Seasons Health Care Group Inspected By dummy Inspection Type Ann McKinnon Care Commission Officer Announced dummy Inspection Completed Period since last inspection 13 February months dummy Local Office Address 4th Floor 1 Smithhills Street, Paisley PA1 1EB Tel: Fax: dummy 2/11

3 Introduction Stobhill Care Home provides 24 hour care and support (with nursing) for a maximum of 60 people. The service has been registered with the Care Commission since April This purpose built care home is on 2 levels, and is located in a residential area of Glasgow, a short drive from the city centre. The service aims to provide the highest possible standards of care, with residents treated as individuals, with respect and dignity, in a safe, comfortable and homely environment, providing stimulation and encouraging independence, where appropriate. Basis of Report This was an announced inspection by two Care Commission Officers. The service was inspected after receiving a Regulatory Support Assessment (RSA) to determine what level of support was necessary. The RSA is an assessment undertaken by the Care Commission which considers; - complaints activity, changes in the provision of the service, nature of notifications made to the Care Commission by the service, action taken upon requirements. The RSA indicated that there should be a medium level of regulatory support. This service was required to have a medium level of support that resulted in an inspection based on the national inspection themes, the core National Care Standards for the particular service type, any other standards or regulations indicated by the RSA and recommendations and requirements from previous inspections, complaint or other regulatory activity. The service completed an annual return and self evaluation prior to the inspection. During the visit, Care Commission Officers spoke with: The Manager, 7 Members of staff, 7 Residents Relatives of 7 residents A range of policies, procedures, records and documents were also looked at, including: Residents financial records and service agreement, Residents Care Plans, risk assessment and review documentation, Medication policies and records, Whistle-blowing policy, Restraint Policy, Recruitment Policy, application form and staff recruitment files, Staff off duty, Complaints records, Accident and incident records, Policy guidance on discharging a resident, Policy Guidance on death and dying, Policy Guidance on nutrition. Care Commission Officers observed staff members practice and interaction with residents. Care Commission Officers took into account and reported on whether the service was meeting the following National Care Standards Care Homes for Older People: Standard 4 Your Environment 3/11

4 Standard 5 Management and Staffing Standard 13 Eating Well Standard 19 Support and Care in Dying and Death Standard 20 Moving On During this Inspection year, the Care Commission is inspecting on themes of Improving Nutrition in Care Homes, Management of residents finances, Safer Recruitment and Fire Safety. Management of Residents Finances is reported on under the sections Contract Arrangements, Inspection and Complaints Information and Safekeeping of Money and Valuables. The theme of Improving Nutrition and Safer Recruitment is reported on under the appropriate Standard. Fire Safety was reported on in the last inspection. Action taken on requirements in last Inspection Report There were no requirements in the last inspection report. Comments on Self-Evaluation The self -evaluation for the National Care Standards under inspection was completed and returned. It was completed in an open and honest manner, identifying strengths and areas for development, and this assisted the inspection process. View of Service Users Residents comments were generally positive and included 'I'm well looked after'. View of Carers Comments were mainly positive included 'mother's care is superb', regular staff are 'excellent', 'staff are wonderful', 'I find staff are very good and very caring', ' staff are very caring and go beyond the call of duty', 'staff always keep me informed', 'cook will make almost anything mum wants' and 'food is excellent'. Concerns raised by family members focused mainly on the number of staff on duty and it was felt that there was an insufficient number of staff at times. Relatives of two residents were shown the staffing schedule on display and commented that the service did not appear to be meeting the staffing requirements, as detailed in the Staff Schedule. 4/11

5 Regulations / Principles Regulation : National Care Standards National Care Standard Number 1: Contract Arrangements, Inspection and Complaints Information A Service Agreement is in place and gives details the service provided, terms and conditions of accommodation and residence, payment arrangements and arrangements for ending the contract. A copy of Stobhill Care Home's policy and procedures are available on request. The Complaints Procedure is displayed on notice boards throughout the Care Home. This gives contact details of the Care Commission. Residents or their representatives should be provided with a copy of the Service Agreement. ( See Recommendation 1) The organisation should continue to develop the Service Agreement in a range of formats, appropriate to the needs of residents who may access care, to help ensure that residents or their representatives can understand the agreement. National Care Standard Number 2: Safekeeping of Money and Valuables The service manages the personal finances of some of the residents. Appointee authorisation was in place. Individual records are kept on the personal finances of residents. Residents funds were kept in an account which was separate from the business account. 5/11

6 Account information is kept on computer but can be printed for residents or their representative, if requested. Individual records for financial transactions show an opening balance, details of income and expenditure, as well as a closing balance. Residents were able to access funds from the Administrator, Manager or deputy Manager. Monthly reconciliation was carried out and the Manager advised that external audits were also carried out. The Manager advised that resident's valuables can be stored in the safe and an inventory would be maintained. The individual's ability to manage his/her own finances were reviewed on admission. Residents funds are kept in an account which does not attract interest. Efforts are currently progressing to open an interest bearing account for residents funds. National Care Standard Number 4: Care Homes for Older People - Your Environment Stobhill Care Home is purpose built, with single ensuite bedrooms (toilet and wash hand basin). Residents were encouraged to bring small personal belongings and photographs for their rooms. The premises were in good decorative order and a handyman is available to attend to repairs promptly. The service should progress plans to ensure that bedroom doors can be locked by residents if they wish to do so. ( See Recommendation 2). The use of pictorial signs, to assist residents in locating their bedroom and communal rooms should be given further consideration. National Care Standard Number 5: Care Homes for Older People - Management and Staffing Arrangements The service provided a range of policies and procedures, including administration of medication, restraint and prevention of abuse. 6/11

7 Staff members interviewed had a good understanding of the needs of the residents within their care and advised that they could access policy information. An appraisal system was in place and the service has a comprehensive induction programme, with a mentor allocated to new staff members. Staff members interviewed as part of the visit confirmed that training opportunities were available including moving & handling, infection control and health & safety. SVQ training is promoted within the service and staff members interviewed had either achieved the appropriate level of the qualification, working towards it or were awaiting start dates. As discussed with the Manager, during the inspection visit medication records were sampled. Details were written on the Medication Administration Records by a staff member, but were not signed or dated. It was not clear where this information was obtained. Policy Information must be updated to ensure that staff have appropriate guidelines for them to write medication details on the Medication Administration Record Sheets. The service must ensure that handwritten details and any changes to the Medication Administration Record Sheets are dated, signed and referenced to the appropriate prescribing authority. The service have also recently changed to a Monitored Dosage system. However, adequate secure storage was not in place. ( See Requirement 1) As discussed with the Manager, relatives interviewed during the inspection visit raised concerns about inadequate number of staff on duty. Records confirm that at times staffing levels and skills mix did not adhere to the current Staffing Schedule. The Manager advised that attempts were made to secure staff from other units, bank staff list and from agency staff. Details of this were not evident and at times the unit remained below the number of staff detailed in current Staffing Schedule. ( See Requirement 2). As discussed with the Manager, the service should ensure that staff members are familiar with the organisation's Whistle-blowing policy, as it was evident that staff members were unsure as to the details of policy guidance. ( See Recommendation 3) Staff support and supervision should be introduced to help ensure that staff members maintain and improve standards of care. ( See Recommendation 4). Regular staff meetings should be held to help ensure that all staff members are up to date with developments in practice and care. National Care Standard Number 13: Care Homes for Older People - Eating well Meals were observed to be well presented and table settings were attractive, with condiments available. Residents and their relatives commented that the quality and presentation of food was very good. 7/11

8 Information on residents food preferences, likes and dislikes were recorded on admission and can be updated with additional information during their stay. Care plans sampled confirmed that staff members had documented preferences and special dietary needs. At mealtimes, staff members were observed to listen to residents requests and residents can opt to eat in the dinning room or other areas, including their bedrooms. Assistance from staff was observed to be appropriate and sensitive. Food was prepared on the premises, with rotating menu which gave a minimum of two choices. Residents could have snacks, home baking, hot and cold drinks throughout the day and night. Special diets, including soft diet options, are available. In line with the organisation's staff training plan, the cook should be offered REHIS Intermediate food hygiene training. National Care Standard Number 19: Care Homes for Older People - Support and Care in Dying and Death Policy and guidance information was in place to assist staff in support and care for residents in dying and death. The care plan format can include information relating to the wishes of residents and relatives. The service have developed links with local places of worship to provide a pastoral service and spiritual support. Links have also been established with the Marie Curie Centre and professional guidance can be sought where needed. The service should continue to work with residents and their relatives to record wishes in relation to death and dying in the individual's care plan. In line with the service's training plan, training should be extended to all caring staff in relation to palliative care. National Care Standard Number 20: Care Homes for Older People - Moving On The Manager advised that prior to any discharge the resident, his or her family members or representatives and social worker, would be fully involved in any discussion. The current 8/11

9 place would be retained while the resident was considering other services and care plan records would be passed onto the new service. There are no areas for development identified at this inspection. National Care Standard Number 99: Other Issues Related to National Care Standards and Regulations Care Plan documentation has recently been introduced which appears to be comprehensive. Staff members interviewed had a good understanding of the needs of the residents within their care and were recording care details and risk assessment in the new care plan format. This will be looked at in more detail at the next inspection. The service should ensure that regular meetings are introduced for residents and relatives to assist with monitoring of quality within the service. 9/11

10 Enforcement There has been no enforcement action taken since the last inspection. Other Information Requirements 1) Policy Information must be updated to ensure that staff have appropriate guidelinesfor them to write medication details on the Medication Administration Record Sheets. The service must ensure that handwritten details and any changes to the Medication Administration Record Sheets are dated, signed and referenced to the appropriate prescribing authority. Medication must be stored in secured storage area. This is in order to comply with SSI 114 Regulation 4 (1)(a) a requirement to make proper provision for the health and welfare of service users, and SSI 114 Regulation 19 (3)(j) a requirement to keep records of medicines for use of the service users. The following national care standards have also been taken into account in making this requirement. National Care Standards Care Homes For Older People 5 (12) and 15 (6): Timescale for implementation: On publication of this report 2) Requirement 2 The Provider must ensure that at all times the number of staff on shift and the skills mix is as detailed in the Staffing Schedule. This is to comply with: SSI 114 Regulation 4 (1) Make proper provision for the health and welfare of service users and SSI 114 Regulation 13a Ensure that at all times suitable qualified and competent persons are working in the care service in such numbers as are appropriate for the health and welfare of service users. Timescale for implementation: On publication of this report. Recommendations 1) The Service should ensure that Residents or their representatives are provided with a copy of the service agreement. National Care Standards Care Homes for Older People Standard 3 Your Legal Rights. 2) The Service should ensure that appropriate locks are fitted to bedrooms doors so that residents have the option of locking their door if they wish to do so. National Care Standards Care Homes for Older People Standard 4 Your Environment 3) The Service should ensure that staff members are familiar with the organisation's Whistle-blowing policy. National Care Standards Care Homes For Older People Standard 5 (2) Management and Staffing 4) Supervision should be introduced to help ensure that staff members maintain and improve standards of care. National Care Standards Care Homes For Older People Standard 5 (4) Management and Staffing Ann McKinnon 10/11

11 Care Commission Officer 11/11