Inspection on 31/07/08 for Abbeyfield St George`s House

This inspection was carried out on 31st July 2008.

CSCI found this care home to be providing an Adequate 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.

Other inspections for this house

Abbeyfield St George`s House 01/08/07

Abbeyfield St George`s House 05/09/06

Abbeyfield St George`s House 23/02/06

Abbeyfield St George`s House 19/08/05

Abbeyfield St George`s House 25/03/05

Abbeyfield St George`s House 19/01/05

Abbeyfield St George`s House 28/11/03

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 26/11/2008.

CARE HOMES FOR OLDER PEOPLE Abbeyfield St George`s House Park Terrace Westcliff On Sea Essex SS0 7PH Lead Inspector Carolyn Delaney Unannounced Inspection 31st July 2008 11:00 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 Abbeyfield St George`s House DS0000015412.V368660.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. Abbeyfield St George`s House DS0000015412.V368660.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Abbeyfield St George`s House Address Park Terrace Westcliff On Sea Essex SS0 7PH 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) 01702 331512 01702 342893 The Abbeyfield Southend Society Limited Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places Abbeyfield St George`s House DS0000015412.V368660.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st August 2007 Brief Description of the Service: Abbeyfield St George’s care home provides care for twenty-five older people who do not fall within any other registration category. The home is decorated, furnished and maintained to a high standard. All personal accommodation is offered on a single occupancy basis. Twentyfour bedrooms have en-suite facilities. Each room has access to telephone and television points. The gardens are well maintained and attractive. There is parking available to the side of the building that can accommodate six cars. The home is situated in close proximity to Southend-on-Sea town centre, local community amenities and facilities. There is close access to local buses and the mainline train station to London. All prospective residents are provided with a Statement of Purpose and Service User Guide that supplies them with up to date information on the home. Fees range from £389.97 to £477.26 and there are additional charges for hairdressing, chiropodist, newspapers, telephone, toiletries and transport. Abbeyfield St George`s House DS0000015412.V368660.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 1 star. This means the people who use this service experience adequate quality outcomes. This was a routine unannounced inspection, which included a visit made to the home between the hours of 11.30 and 19.30 on 31st July 2008. As part of the inspection process we reviewed information we have received about the service over the last twelve months including notifications sent to us by the manager of any event in the home, which affect residents such as injuries, deaths and any outbreak of infectious diseases. We used the information provided in the home’s Annual Quality Assurance Assessment. This is a self-assessment document where the manager / registered provider tells us about the services they provide and planned improvements planned for the next twelve months. People who live and work in the home were spoken with to obtain their views and these views were incorporated into the report. During the site visit, records including residents’ care plans and assessments, and staff training files were examined. A brief tour of the premises was carried out and communal areas including lounge, dining room and bathrooms were viewed. In addition some residents’ bedrooms were viewed. Information obtained was triangulated and reviewed against the Commission’s Key Lines for Regulatory Activity. This helps us to use the information to make judgements about outcomes for people who use social care services in a consistent and fair way. What the service does well: People who are considering moving into Abbeyfield St. Georges have a detailed assessment of their health and care needs carried out by the home’s manager and are offered the opportunity to visit the home to see if they like it. Staff record detailed information about each resident’s needs in a care plan, which reflects the individual’s preferences and wishes for how they are cared for. People living in the home are supported to remain as independent for as long as they can. Residents are treated well and their privacy and dignity is promoted. The home is well maintained and comfortable. Residents may bring in some items of furniture and other items to personalise their bedrooms. Staff are Abbeyfield St George`s House DS0000015412.V368660.R01.S.doc Version 5.2 Page 6 recruited thoroughly to help ensure that they are suitable to care for residents in the home. A new manager has been employed (promoted from within the home) since the last inspection. This person is committed to acting on the issues raised and improving the home for the people who live there. 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. Abbeyfield St George`s House DS0000015412.V368660.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 Abbeyfield St George`s House DS0000015412.V368660.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): 3&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who choose to move into Abbeyfield St. Georges can be assured that their assessed needs will be met. EVIDENCE: The manager told us in the Annual Quality Assurance Assessment that staff carry out a thorough person-centred assessment, which is undertaken at the applicant’s existing residence and applicants are encouraged to visit the home prior to final admission. On the day of the inspection the pre- admission assessment records for three people, including one person who was yet to move into the home, were examined. The manager had carried out these assessments. Information was written in a clear way, which described each person’s needs in respect of daily activities of living such as eating and drinking, maintaining personal hygiene, mobility, risks to safety, continence, communication and emotional / mental wellbeing. Abbeyfield St George`s House DS0000015412.V368660.R01.S.doc Version 5.2 Page 9 Where it was possible the person or their relative had been involved in the assessment and this was evidenced through the information recorded in the assessment document. Each person’s preferences had been recorded. For example it was recorded for one person that they would wish to retain control of their money rather than keep it locked in the home’s safe. It was positive to note that the impact of the move into the home (which can be stressful when a person can no longer remain in their home safely) was recorded for one person and there was evidence as to what staff did so as to make the admission process as easy as possible for both resident and their relatives. One person who had recently moved into the home was spoken with during the inspection. They said that they had not had the opportunity to visit the home but that their daughter had made all of the arrangements and had visited the home and felt that it would be suitable. The resident told the inspector that while they would prefer to live in their own home, this not being possible that they were ‘happy and content living here’. One visitor said that they had visited the home and spoke with the manager and staff before choosing the home for their relative (as the relative was unable to visit the home due to ill health). Staff said that when a person moves into the home that the person is allowed to settle into their room before being introduced to other residents. Residents who were spoken with this confirmed this. Abbeyfield St. Georges does not provide rehabilitative or intermediate care. Abbeyfield St George`s House DS0000015412.V368660.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in Abbeyfield St. Georges have their assessed health and personal care needs met in a way, which suits their individual preferences and meets their expectations. EVIDENCE: The manager told us in the Annual Quality Assurance Assessment that the home goes to great lengths to accommodate the changing health and personal care needs of Residents experiencing personal deterioration and that this is evidenced in each individual’s care plan. The manager acknowledged that more could be done to improve the way in which information is recorded about residents needs could be updated to make it easier for all staff to follow. The care plans for four people living in the home were assessed. The information about each person’s needs was written clearly and reflected the individual’s preferences for how they wish to receive care and support. For Abbeyfield St George`s House DS0000015412.V368660.R01.S.doc Version 5.2 Page 11 example it was recorded for one person that when the resident wishes to have their bath they will ring for assistance and staff will come and run the bath and provide fresh towels. It was recorded for another person that they prefer baths and disliked showers. There was evidence within the care plans that residents are encouraged and supported to remain independent for as long as they can and care plans clearly indicated each person’s ability in relation to daily activities of living such as maintaining their personal care, mobility and eating and drinking. There was also detailed information about the care and support which staff provided to each individual. Staff review care plans on a regular basis and amend information where there has been a change to the person’s condition or the treatment, which they receive. Residents looked well cared for and said that staff are ‘very good’ ‘wonderful’ and ‘caring’ Staff carry out assessments for each resident so as to identify risks to their health and safety. Risks of falls, skin damage due to immobility or use of moving equipment, weight loss etc are assessed and a plan to minimise these risks is developed. For example it was recorded for one person that they did not use footplates on their wheelchair due to the risk to them of bruising and skin damage. Risks to the resident of not using footplates were recorded and a plan to manage these was implemented. We reviewed the information received from the home’s manager regarding any serious illness, injuries or other incidents affecting the welfare of residents. A review of this information showed us that there have been no serious injuries to residents since the last inspection. When residents do sustain minor injuries these and the events which led to the incident, are recorded and monitored so as to identify any trends or areas where risks may be minimised. There was evidence to show that where residents were capable of and wished to, that they could retain control of and administer their medicines and were provided with suitable storage space to store their medicines. Staff working at the home had received training in respect of the safe storage; administration and handling of medicines and a review of residents’ Medication Administration Records indicated that residents receive medicines as prescribed for them at the correct time. Medicines are stored securely within the home and records are maintained in respect of the receipt and disposal of medicines. During the inspection the administration of medicines at lunch and suppertime was observed. The member of staff administering medicines at lunchtime did so in a safe and appropriate manner ensuring that residents had taken their medicines before completing records. However the member of staff responsible for administering medicines at suppertime was observed to give medicines to another member of staff to give to residents and then complete records without checking that the person had actually taken the medicines. This practice is unsafe and not in line with the home’s policy and procedure. similar staff practices were previously raised as a safeguarding issue and measures had been implemented so as to ensure that staff administered medicines safely however some staff do not adhere to the homes policy. Abbeyfield St George`s House DS0000015412.V368660.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 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The shortage of staff in the home affects residents’ experience and enjoyment of social activities and meals. EVIDENCE: The manager told us in the Annual Quality Assurance Assessment that the home’s visiting policy is an open one with no visiting time restrictions and that residents are encouraged to develop their own routine and indeed, change this as and when they desire. The manager said that socialising, playing cards, reading, chatting, watching television, doing puzzles and talking to staff are just some of the daily activities that Residents participate in. The manager said that more could be done to increase the amount of activities for individuals. The way in which residents prefer to spend their time and the things they like to do are recorded in each person’s care plan. Residents said that they could spend their time in their bedrooms or the lounge or conservatory areas if they choose to. Residents have newspapers delivered daily or weekly if they choose and can spend time chatting, playing cards or watching television. However Abbeyfield St George`s House DS0000015412.V368660.R01.S.doc Version 5.2 Page 13 there were few planned activities for residents. The manager in post at the time of the last inspection said that they planned to arrange more activities for residents and to delegate to one of the care workers the activity co-ordinator role on a daily basis between the hours of 2pm until 5pm. However this had not been implemented. There are some events such as music entertainment. The current manager said that she would like to provide more opportunities for residents and to have a more structured plan for activities including some trips outside of the home but that current staff shortages prevented this at present. Some residents commented about activities. One said that ‘there is not always much to do in the home’. Another said ‘ I don’t really have anyone to talk to but I enjoy spending time in my room watching television and reading’. Visitors were observed to be welcomed into the home and two visitors who were spoken with said that they could visit at any time. People living in the home feel that their views are listened to and that staff act on what they say. Residents may attend local church services if they choose and services in the home have been discontinued following requests from residents. The home employs a cook and there are planned menus, which are reviewed and changed in light of resident’s preferences and the comments that they make. Residents are offered a choice of aperitifs each day t 11.30 and have a choice of meal. The lunchtime meal on the day of the site visit offered a choice of lamb chops or steak and kidney pie with a selection of vegetables and gravy served in terrines and serving bowls so that they can serve themselves where possible. Residents were offered a choice of coffee gateaux or bananas and custard for dessert. Some residents complained about the food. One person said ‘the sooner we get a proper cook the better’. Another resident complained that ‘the asparagus was overcooked’ and one person said ‘the lamb was inedible’. There have been a number of complaints made by residents about the food and the manager said that the home has not had a permanent cooks for four months and that they rely on agency staff at times. Views of residents who were spoken with about meals at the home were varied. Some people said that the food was ‘good’ or ‘ok’ and one person said ‘the food is not always good’ and another person said ‘sometimes the meat is tough’. When residents make comments about the food these are recorded and fed back to the cook so as to try and improve things. Abbeyfield St George`s House DS0000015412.V368660.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 7 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People’s concerns and complaints will be dealt with in a satisfactory way. EVIDENCE: The manager told us in the Annual Quality Assurance document that there is a comprehensive policy and procedure at the home for receiving and dealing with complaints and that all complaints are acted on promptly. On the day of the inspection the manager said that she deals with informal complaints and that more serious complaints are referred to the society’s head office. A member of the Society’s Board of Trustees has been appointed to deal with all complaints (including Safeguarding issues) in order to ensure that the Complaints Policy and Procedure is followed, and a consistent approach to dealing with these matters is maintained. Complaints and their outcomes are reported at Trustee level. A copy of the complaints log was requested and provided. The manager said that she had recently re – introduced this log as the previous manager had discontinued its use when she came to work at the home. The complaints log indicated that there had been eight complaints made since the last inspection. Five of the eight complaints related to meals and food. Residents complained on occasions that the meat was ‘too tough’ or ‘inedible’. On these occasions it was recorded that staff apologised to residents and spoke with the cook in order to prevent issues re-occurring. Of the other three complaints one related Abbeyfield St George`s House DS0000015412.V368660.R01.S.doc Version 5.2 Page 15 to a member of staff allegedly roughly handling a resident. Records did not indicate how this complaint was investigated and dealt with. The manager who had been working as a senior carer at the time of the incident could not say how the incident had been dealt with and said that the member of staff had since resigned and left the home’s employment. Records in respect of complaints did not indicate how these were investigated, or record the outcomes and responses to the complainant so as to evidence that concerns and complaints are managed in accordance with the home’s policy and procedure. It is accepted that these issues had occurred before the current manager was promoted and that since this time she has made improvements to how complaints are received and handled. Residents and relatives who were spoken with during the inspection said that they felt that if they needed to complain that the manager would deal with issues quickly and efficiently. One visitor said that ‘they have not needed to complain and that they had the opportunity to speak regularly with the manager when they visited the home and at planned meetings’. The manager told us in the Annual Quality Assurance Assessment that all staff have staff working at the home have received training in respect of safeguarding residents from harm, neglect and abuse and staff have access to the home’s ‘whistleblowing policy’ and the Department of Health’s ‘No Secrets document. There have been three incidents at the home since the last inspection where safeguarding alerts have been raised. One of these incidents was partly in respect of poor medication practices, whereby staff left medicines decanted in pots with residents without ensuring that the person had taken the medicines. it was noted that during the inspection one member of senior staff when administering medicines was adopting the same poor practices, which may put residents at risk. Three members of staff who were spoken with during the inspection confirmed that they had received safeguarding training. These members of staff could demonstrate that they were aware of safeguarding issues and how to act if they witnessed or suspected any ill treatment of residents. People who were spoken with said that staff are kind and caring and that ‘residents are treated very well’. Abbeyfield St George`s House DS0000015412.V368660.R01.S.doc Version 5.2 Page 16 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 good. This judgement has been made using available evidence including a visit to this service. People living in the home benefit from safe, clean and comfortable accommodation, which suits their needs. EVIDENCE: The manager told us in the Annual Quality Assurance Assessment “the maintenance and cleaning procedures ensure that we provide a safe, comfortable, clean and homely environment, which meets statutory requirements”. During the inspection a brief tour of the premises was carried out. Residents have access to comfortable seating areas on both floors and a conservatory, which leads out on to a courtyard style garden area. There is a dining area adjacent to the kitchen and staff serves meals from a serving hatch. Since the last inspection work had been carried out to refurbish and modernise the kitchen area. Some work had started to redecorate the Abbeyfield St George`s House DS0000015412.V368660.R01.S.doc Version 5.2 Page 17 lounge area on the first floor. This had not been completed at the time of the inspection, however the manager said this area of the home is not well used and this was seen to be so on the day of the inspection. All residents have single bedrooms, which have en suite toilet and hand washing facilities. In addition there are four bathrooms and one shower room. Hot water temperatures are tested each month and recorded. These records indicated that hot water temperatures are regulated, and hot water temperatures in bathrooms assessed during the inspection were maintained close to 43 degrees Celsius, which is recommended so as to minimise risk of scald to residents. Resident’s bedrooms, which were viewed, were clean and bright. Residents’ own personal belongings such as small items of furniture, photos and ornaments were seen in bedrooms. Two cleaners are employed to work thirty hours per week between Monday and Friday. On the day of the inspection all areas of the home, which were viewed, were clean. The home was generally free from unpleasant odours, however there were some isolated odours in some residents’ bedrooms. The manager said that she was aware of these and that the residents’ carpets had been recently cleaned. The manager said that the society employs two maintenance people to support its homes in the region. Records were available to show that essential repair and maintenance of equipment such as hoists, wheelchairs and passenger lifts were carried out as needed. As part of the ongoing programme for maintaining and improving the environment the carpets to the main lounge / dining area are to be replaced and improvements are to be made to the sluicing area so as to increase the capacity for proper waste disposal. Residents and visitors who were spoken with on the day of the inspection commented that the home was clean and well maintained. Residents made positive comments about the home. One said that their bedroom was ‘nice and bright’. Others said that the home was ‘comfortable’ and ‘homely’ Abbeyfield St George`s House DS0000015412.V368660.R01.S.doc Version 5.2 Page 18 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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living in the home are well cared for. However staffing numbers are not sufficient to meet the resident’s needs at all times. EVIDENCE: The manager told us in the Annual Quality Assurance Assessment that staffing levels are determined in accordance with the dependencies of the people living at the home and that recruitment of staff is planned so as to ensure that appropriate levels are maintained. However at the time of the inspection the manager reported that staffing levels at the home were insufficient due to staff leaving and a lack of suitable applicants applying for advertised posts. This has meant that on occasions there are less staff on duty and the manager covers, which takes her away from her management duties. The home employs the services of a local employment agency for temporary staff to cover some staff absences but this is not always possible if the manager is informed of the absence at short notice. The majority of people who were spoken with said that staff are ‘very good’ and ‘are usually available when needed’. Some residents commented that ‘at times there seems to be a shortage of staff in the home’. This person said that ‘sometimes when I am wet there is no one to help me’. Other residents said that ‘staff do the best they can with the time that they have’. One member of staff said ‘we could do Abbeyfield St George`s House DS0000015412.V368660.R01.S.doc Version 5.2 Page 19 with more staff at lunch time to assist the number of residents who need help with feeding’. The manager told us in the Annual Quality Assurance Assessment that all staff are recruited robustly. The recruitment files for four people who had been employed to work in the home since the last inspection were assessed. There was evidence that the recruitment process was thorough and that all of the relevant checks such as references from previous employers, Criminal Records Bureau (CRB) disclosures and PoVA First checks had been carried so as to determine that candidates were suitable to work with elderly people. There was evidence that staff who are employed at the home had undertaken a period of induction which gave them information about the home and specific policies and procedures. There was no evidence that staff undertook an induction that is in line with Skills for Care Common Induction Standards, which would help ensure that staff carry out tasks, and work in a way which reflects nationally recognised good practice and would benefit the people living in the home. One member of staff who had been employed at since the last inspection was spoken with. This person said that they had they had provided proof of identity, information and referees from previous employment and that the manager had carried out a CRB disclosure before they started work in the home. This person said that they enjoyed working in the home and that ‘the manager and senior staff are very supportive’. There is an ongoing programme for staff training and development. Abbeyfield St George`s House DS0000015412.V368660.R01.S.doc Version 5.2 Page 20 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, & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is well managed. However due to staff shortages the manager cannot always act on comments made by residents so as to improve standards in the home. EVIDENCE: The manager told us in the Annual Quality Assurance Assessment that a new manager of the home was formally appointed from 1st June 2008. This appointment took the form of an internal promotion and it is expected that the home will derive maximum benefit from this approach. Abbeyfield St George`s House DS0000015412.V368660.R01.S.doc Version 5.2 Page 21 The Society and the new Manager are currently considering the possibility of altering the management structure within the home via the creation of a Deputy Manager post. During the site visit, the manager appeared to be enthusiastic and committed to making improvements in the areas where shortfalls had been highlighted. There recent changes of manager and loss of staff have impacted upon the management of the home and the manager regularly works in a senior carer role so as to ensure that these issues have a minimal impact on the service that residents receive. The manager said that there was ‘a lot to sort out following the departure of the previous manager from the home’. Some of the policies and procedures had not been followed such as recording of complaints. The manager had re-introduced these procedures. Staff and residents have commented that there have been a lot of changes in staff in the last eighteen months since the manager of many years left the home. This has unsettled some people who feel that standards have dropped. However those people spoken with felt that the current manager was good and that they knew them and the home well. Residents are supported to remain independent and to manage their own financial affairs if they are capable of doing so. There is safe and secure storage space for resident’s monies if they wish for staff to keep small amounts of ‘pocket money’ for them. Records were examined and noted to be wellmaintained and appropriate checks were carried out so as to minimise the risk of mishandling of residents monies. The home is well maintained and there is evidence that checks are carried out on fire safety and detection equipment and devices, gas and electrical installations and other equipment required by residents such as the passenger lift. Hot water temperatures are checked regularly and maintained at a suitable temperature so as to minimise the risks of scalds to residents. The manager said that there is maintenance support and that issues are dealt with promptly. There is an ongoing plan for the improvement of areas of the home and this has included the refurbishment and modernisation of the kitchen area. There was no formal process in place for obtaining the views of residents, their relatives and other stakeholders so as to monitor and improve services provided by the home. The manager said that the support manager who usually arranges this has left the organisation. Regular relative and residents meetings are held and there were records available of the minutes. Issues raised reflect the findings of this inspection including dissatisfaction with the meals; staff shortages and some general drop in standards. Abbeyfield St George`s House DS0000015412.V368660.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 3 Abbeyfield St George`s House DS0000015412.V368660.R01.S.doc Version 5.2 Page 23 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 OP9 Regulation 13 (2) Requirement Staff must administer, handle and store medicines in the home in accordance with the homes policy and procedure so as to safeguard residents and reduce the risk of mishandling of medicines. Complaints must be investigated, responded to and outcomes recorded in line with the homes policy and current regulation. Staff must be employed in suitable numbers to meet the assessed needs of people who live in the home. A system for monitoring the services provided must be implemented to improve and maintain the quality of experiences for residents. Timescale for action 30/10/08 2 OP16 22 30/10/08 3. OP27 18 (1) (a) (b) (c) 24 (1) (a) (b) 30/10/08 4. OP33 30/10/08 Abbeyfield St George`s House DS0000015412.V368660.R01.S.doc Version 5.2 Page 24 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 Abbeyfield St George`s House DS0000015412.V368660.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact 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. 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