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Inspection on 25/03/08 for St Helier`s Residential Hotel

Also see our care home review for St Helier`s Residential Hotel for more information

This is the latest available inspection report for this service, carried out on 25th March 2008.

CSCI found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home prepares care plans, which assists staff in providing consistent and appropriate care. The food is varied, nutritious and well presented. Staff are caring, friendly and well supported. The home provides a well furnished and decorated, homely, safe, clean environment.

What has improved since the last inspection?

Medication procedures and storage have been reviewed and improved. A sprinkler has been installed as part of an improved fire safety system.

What the care home could do better:

Improve storage facilities for daily records. Prepare risk assessments for all residents regarding their ability to store and/or administer their own medication.

CARE HOMES FOR OLDER PEOPLE St Helier`s Residential Hotel 25/26 Clifton Gardens Folkestone Kent CT20 2ED Lead Inspector Mrs Sue Gaskell Unannounced Inspection 25th March 2008 10:00 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 St Helier`s Residential Hotel DS0000023583.V359458.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. St Helier`s Residential Hotel DS0000023583.V359458.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Helier`s Residential Hotel Address 25/26 Clifton Gardens Folkestone Kent CT20 2ED 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) 01303 254980 hotel@st-heliers.net Fraser Residential Ltd Mrs Vanessa Alexandra Simpson Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (0) of places St Helier`s Residential Hotel DS0000023583.V359458.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Old age, not falling within any other category - (OP). The maximum number of service users to be accommodated is 30. Date of last inspection Brief Description of the Service: St.Heliers is made up of two large Victorian style terrace properties, which have been linked internally. It is situated in a quiet residential area of Folkestone, close to The Leas, the sea front, and the town centre. Accommodation is provided for up to 30 residents in large rooms for single use; most of the rooms have en-suite toilet facilities. A number of rooms are of sufficient size for two people to share if that is their wish (e.g. partners). Bedrooms and bathrooms are situated on the ground, first and second floors, and the dining area; kitchen and office facilities are situated in the basement. A passenger lift provides easy access to all floors. The Home has access to shared gardens at the rear of the property, featuring beautiful trees and shrubs. Staffing is provided in sufficient numbers to meet service users needs. Over 50 of staff hold an NVQ certificate. The Providers, Fraser Residential Limited, have been running the Home for several years, and are committed to ensuring that residents receive high standards of care. The company has a team of three dedicated managers. All previous inspection reports are available from the home. The fee for this home starts from £392 rising to £550.00. St Helier`s Residential Hotel DS0000023583.V359458.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 25th March between 10.00am and 2.30pm. There were 25 residents living in the home at the time of the inspection. We spoke with 5 residents in private and with two residents’ relatives. We spoke with the registered manager, and two care staff. We toured the building and looked at bedrooms and all communal areas. The inspection process also consisted of information collected before and during the visit to the home. The home also submitted the annual quality assurance assessment required by the CSCI. Other information seen included general assessments, risk assessments and care plans, medication records and the duty rota. There were no outstanding requirements from the previous inspection and no requirements made following this inspection. The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. What the service does well: The home prepares care plans, which assists staff in providing consistent and appropriate care. The food is varied, nutritious and well presented. Staff are caring, friendly and well supported. The home provides a well furnished and decorated, homely, safe, clean environment. St Helier`s Residential Hotel DS0000023583.V359458.R01.S.doc Version 5.2 Page 6 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. St Helier`s Residential Hotel DS0000023583.V359458.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 St Helier`s Residential Hotel DS0000023583.V359458.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, 3 & 6 People who use the service experience excellent outcomes in this area. The statement of purpose and service user guide says what service will be offered. Prospective residents can be confident that their needs can be met This judgement has been made using available evidence including a visit to this service. St Helier`s Residential Hotel DS0000023583.V359458.R01.S.doc Version 5.2 Page 9 EVIDENCE: The home’s Statement of Purpose and Service User Guide have been regularly reviewed and amended and provide residents, prospective residents and their relatives with all necessary information about the home. The manager said that this information can be translated into another language or Braille if necessary. Six care plan files were examined, including one referring to a resident who was admitted a week ago and another who was admitted three weeks ago. One resident confirmed that the manager had visited him at his previous home prior to admission. All files inspected include clear and comprehensive pre-admission assessments carried out by the home with supporting information from care managers. The manager writes to prospective residents to confirm that their needs can be met. St Helier`s Residential Hotel DS0000023583.V359458.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, 8, 9 & 10 People who use the service experience excellent outcomes in this area. Residents’ care plans are reviewed and their health care needs are met. Residents are protected by the home’s policies and procedures for dealing with their medication. Residents are treated with respect. This judgement has been made using available evidence including a visit to this service. St Helier`s Residential Hotel DS0000023583.V359458.R01.S.doc Version 5.2 Page 11 EVIDENCE: All of the residents’ care plan files inspected include reference to all of the various aspects of their daily living including mobility, nutrition, skin condition, likes and dislikes and behavioural needs. The care plans were seen to be reviewed regularly and recently, and include risk assessments. The risk assessments have been reviewed and include guidelines on how best to minimise risks and assist residents. The daily records are clear and both the day and night records contain enough detail to monitor residents’ health and well being. There is further evidence in the care plan of the monitoring of residents’ health care needs and general well being, eg residents are weighed regularly, their diet is monitored and they are referred for specialist care or advice whenever necessary. Residents have access to local health care services. The local G.P.’s, District Nurses and Community Nurses call regularly and these visits are clearly recorded. Residents are able to choose their own GP and all have access to dentists, opticians and other community services. The home’s medication policy is clear and accessible to staff. Staff confirmed that they do not administer medication unless they have received training, been judged as being competent, and feel confident. There are appropriate records for the receipt, administration and disposal of medication. Medication administration records were in order and important details and administration times are highlighted to make them clearer. Separate records are kept for particular types of medication which require special attention. The storage of controlled drugs, oxygen and refrigerated medication has been improved. Medication is safely and securely stored in a lockable medication trolley in a lockable room. The room also contains a lockable fridge and a special cabinet for specific medication. Risk assessments have been prepared for residents who care for and administer their own medication. Support with personal issues is provided in a sensitive manner that respects residents’ choice and dignity. All staff interviewed spoke of the need to treat residents with respect and to consider dignity when delivering personal care. The residents and their relatives also confirmed this. The five residents and two relatives I spoke to said that the home is a nice place to live in and that the care is good. They said that all of the staff are very kind and helpful and that they know that they only have to ask if they require something. Residents also said that they enjoy being able to have a laugh and joke with staff. St Helier`s Residential Hotel DS0000023583.V359458.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, 13, 14, & 15 People who use the service experience excellent outcomes in this area. Residents’ lifestyle preferences and expectations are generally met. Residents have regular contact with their families and friends. Residents receive a nourishing and balanced diet. This judgement has been made using available evidence including a visit to this service. St Helier`s Residential Hotel DS0000023583.V359458.R01.S.doc Version 5.2 Page 13 EVIDENCE: The care plans contain a list of residents’ needs, likes and dislikes and preferences. There was evidence in the residents’ daily records to show that families, and other visitors are encouraged and welcomed. I also spoke with two visitors who visit on a very regular basis. They both said that they are always made to feel welcome and offered refreshments and meals. Residents’ visitors pay a small charge for their meals but this money goes into the residents’ amenity fund. The residents I spoke with said that they generally get up and go to bed at the time they choose although this is not always possible if they require assistance. One member of staff said that they try to bear in mind which residents like to get up early and which like to stay in bed later when they need to help those residents who require a greater degree of assistance. Residents may take meals in the dining room, in one of the quiet areas or in their own rooms. The food served on the day of the inspection appeared appetising and wholesome and the residents said that it tasted good. Residents confirmed that there is always a choice of two dishes for the midday meal and a wider choice for breakfast and the evening meal. One resident said that he always has a cooked breakfast. The manager said that meals provided are mainly based on residents’ choices, but also take into account the need for a reasonably balanced diet. The store cupboard contained a wide range of food including fresh fruit and vegetables. Nutritional assessments are carried out and residents are weighed monthly. Residents said that they have activities in the home such as visiting entertainers, bingo, armchair exercises, food tasting sessions, quizzes and games. The residents said that they also enjoy using the sun lounge and bar. Staff said that they try to encourage residents to join in activities but they have to be flexible if residents’ needs or wishes change. The home keeps a record of the activities offered, The residents generally are in control of their finances, and family or appointees help people who need additional support. The home only holds small amounts of cash on service users behalf, if this is requested. The home keeps records of any involvement in residents’ finances, with appropriate receipts and records kept. Staff signatures are required for monies taken out St Helier`s Residential Hotel DS0000023583.V359458.R01.S.doc Version 5.2 Page 14 either to purchase something on residents’ behalf or when residents spend money on social activities such as going on outings. Staff said that there are no residents at present with different ethnic or cultural needs but former residents have been assisted in following their religious beliefs, The manager said that residents would be supported with personal relationships whatever their gender or choice of lifestyle. St Helier`s Residential Hotel DS0000023583.V359458.R01.S.doc Version 5.2 Page 15 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 People who use the service experience excellent outcomes in this area. Residents and/or their representatives can be confident complaints will be listened to and dealt with appropriately and that they will be protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service user guide includes the home’s complaints procedure. Although it was not possible to confirm this with all of the residents, all of the residents and residents’ relatives I spoke to confirmed that they would feel comfortable St Helier`s Residential Hotel DS0000023583.V359458.R01.S.doc Version 5.2 Page 16 in mentioning any complaints to the management or staff and confident that any concerns would be resolved. Staff confirmed that they are provided with initial training on safe guarding adults and are issued with a copy of the company’s “whistle blowing” procedures during their induction period. The staff interviewed all showed an awareness of the complaints procedure and of all of the issues concerning safe guarding adults. The manager said that this issue is always covered in depth during induction training and one member of staff said that she has recently a training session regarding the safe guarding of adults. The home has a copy of the Kent and Medway Safeguarding Adults Procedures. St Helier`s Residential Hotel DS0000023583.V359458.R01.S.doc Version 5.2 Page 17 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 People who use the service experience excellent outcomes in this area. Residents live in a well furnished and decorated, comfortable, safe, clean environment. This judgement has been made using available evidence including a visit to this service. St Helier`s Residential Hotel DS0000023583.V359458.R01.S.doc Version 5.2 Page 18 EVIDENCE: The building is on four levels and there is an alarm call and intercom connecting staff with all areas. There is a lift to all floors and the home is suitable for people with impaired mobility. All residents are in single room accommodation, most of which have en-suite facilities. Security cameras are fitted to the entrance areas only. All of the bedrooms and communal living areas are furnished and decorated to a good standard, and contained the type of furniture and equipment necessary to provide a homely environment. Residents have had some choice in the colour scheme of their rooms. There is a range of individual aids and adaptations to assist resident’s mobility and independence, including raised toilet seats, walking aids, hoists, ramps and grab rails. Bedroom doors have locks which are of a type which enable staff to gain access in the event of an emergency. All windows have been fitted with restrictors or other means of reducing risk and all radiators are covered. As well as having smoke detectors, the home had a sprinkler system fitted last year. Although there is no garden as such, residents have direct access to wellmaintained private gardens used by local residents and there is a large, well furnished sun lounge, complete with licensed bar. All areas of the home are clean and there are no unpleasant odours. There is separate laundry room with a commercial washer and a drier. Staff showed a good awareness of health and safety issues. There are disposable hand drying towels and pump soap dispensers in communal WC’s and shower rooms to reduce the risks of cross infection. Disposable wipes are used for personal care. There are appropriate foot operated bins for particular waste products and staff confirmed that personal items are disposed of appropriately. St Helier`s Residential Hotel DS0000023583.V359458.R01.S.doc Version 5.2 Page 19 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 People who use the service experience excellent outcomes in this area. Staffing numbers are adequate to meet the daily needs of the residents. Residents are protected and supported by the home’s recruitment and induction training procedures. Residents benefit from a well trained and supported staff team. This judgement has been made using available evidence including a visit to this service. St Helier`s Residential Hotel DS0000023583.V359458.R01.S.doc Version 5.2 Page 20 EVIDENCE: Staffing generally comprises the registered manager and/or her assistant managers, and three care staff. There is also a cook, and adequate kitchen, domestic and laundry staff. Staffing levels at the time of the inspection appeared generally adequate to meet residents’ needs in terms of their daily care. I look at five staff files. They all included evidence of sound recruitment practices. Staff said that all staff must be CRB checked and have verbal and written references taken up prior to their employment. Staff confirmed that there is a comprehensive induction training for core issues and then further on-going training. NVQ training is encouraged and over 50 of the staff have NVQ’s. Six staff are shortly to commence NVQ3 training and assessment. Recent training has included first aid, food hygiene, fire safety, moving and handling, and medication. Further training planned includes diabetes awareness and equality and diversity awareness. The registered manager is a trained trainer and NVQ assessor and there is a training session available to staff on Wednesday afternoons. Staff receive regular supervision either from the manager or her assistants and there was evidence of this in staff files. Staff referred to the high level of teamwork, and on-going support from the manager for work and personal issues affecting their work. St Helier`s Residential Hotel DS0000023583.V359458.R01.S.doc Version 5.2 Page 21 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, 33, 35, 36 & 38 People who use the service experience excellent outcomes in this area. The current management arrangements ensure that the home is being run in a way that benefits residents and staff. The record keeping, and health and safety systems are sufficient to safeguard residents’ welfare, rights and best interests. This judgement has been made using available evidence including a visit to this service. St Helier`s Residential Hotel DS0000023583.V359458.R01.S.doc Version 5.2 Page 22 EVIDENCE: The manager, who has been registered since the last inspection, has extensive experience and recognised care and management qualifications. The management of the home and completion of records are generally of a good standard with daily records regularly checked by the registered manager. There are further checks by the owners as part of the monthly regulation 26 reports. Staff said that the home is run for the residents and that residents are regularly asked for their views and feelings about activities, meals and how things are done. This is either through residents’ meetings or through questionnaires for residents, and/or their families, and staff. The questionnaires include questions on satisfaction with personal support, the quality and quantity of the meals, staff attitudes, complaints and the comfort and cleanliness of the environment. Residents and their relatives confirmed that any suggestions or feedback are acted upon. Other quality assurance methods include the monthly reports and an annual business plan. Staff said that the manager and owners are supportive and that staff morale is good. The manager was very ready to praise the staff team. There were no obvious hazards around the home and there was evidence to show that health and safety issues are taken seriously eg staff ensuring that personal items were appropriately disposed of and warning signs in place for wet floors. The maintenance file contains current certificates to show that regular checks on gas and electricity, are carried out. Risk assessments on the environment, and for activities involving residents, have also been prepared. The fire alarm and emergency lighting is tested regularly and equipment is serviced at the appropriate intervals. St Helier`s Residential Hotel DS0000023583.V359458.R01.S.doc Version 5.2 Page 23 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 X 4 X X 4 HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 4 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 4 4 X X X X X X 4 STAFFING Standard No Score 27 4 28 4 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 4 4 X 4 St Helier`s Residential Hotel DS0000023583.V359458.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action 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 St Helier`s Residential Hotel DS0000023583.V359458.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. 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