This inspection was carried out on 1st December 2005.
CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.
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.
CARE HOMES FOR OLDER PEOPLE
Grace Muriel House Tavistock Avenue St. Albans Hertfordshire AL1 2NW Lead Inspector
Alison Jessop Unannounced Inspection 1st December 2005 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 Grace Muriel House DS0000019396.V268099.R01.S.doc Version 5.0 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. Grace Muriel House DS0000019396.V268099.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Grace Muriel House Address Tavistock Avenue St. Albans Hertfordshire AL1 2NW Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01727 863 327 01727 812 402 past@abbeyfieldstalbans.co.uk The Abbeyfield St. Albans Society Limited Mrs Annette Gibbons Care Home 37 Category(ies) of Old age, not falling within any other category registration, with number (37) of places Grace Muriel House DS0000019396.V268099.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 1st April 2005 Brief Description of the Service: Grace Muriel House is a residential care home for older people situated on the outskirts of St Albans. It is owned by The Abbeyfield St Albans Community Care Society Ltd, which is a voluntary organisation. The home accommodates up to 37 residents, one of which offers a respite facility. All rooms are single and 17 have en-suite facilities. Two adjoining rooms with a partition door can be opened to accommodate couples. The home is tastefully furnished with individual pieces offering a comfortable, homely environment. There is a large lounge and separate dining room on the lower floor and a further lounge with a small dining area is also available. On the upper floor there is one lounge and an activity room/hairdressers. There are two passenger lifts. There is safe access to a charming garden from the ground floor lounge. The garden is very well maintained and offers a tranquil area for residents to relax, with plenty of shaded areas. There is a pond with a fountain and a pleasant summerhouse surrounded by tidy lawns and flowerbeds. The front of the home is tidy and provides ample off road parking. Grace Muriel House DS0000019396.V268099.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over two hours by two Regulatory Inspectors. The majority of core standards were inspected during the first inspection in April 2005, and therefore only the remaining core standards were looked at. Time was spent talking to service users and staff, records and care plans were also scrutinised. What the service does well: What has improved since the last inspection? What they could do better: Grace Muriel House DS0000019396.V268099.R01.S.doc Version 5.0 Page 6 Although environmental risk assessments had been carried out, these had not been dated and contained quite basic information, particularly for the use of recliner chairs. During the inspection bottles of antibacterial cleaner, air freshener and deodoriser was found in the toilet/shower room. A requirement has been made for these to be stored safely as this could be a potential risk to service users, particularly those who have dementia. Water temperatures in one of the bathrooms had exceeded recommended maximum levels. This had been identified by staff during routine water testing and has been reported to contractors who have ordered parts to fit. 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. Grace Muriel House DS0000019396.V268099.R01.S.doc Version 5.0 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 Grace Muriel House DS0000019396.V268099.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were inspected on this occasion. EVIDENCE: Grace Muriel House DS0000019396.V268099.R01.S.doc Version 5.0 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8 & 10 Care plans contain comprehensive information and are regularly reviewed ensuring that service users needs continue to be met. EVIDENCE: Feedback from service users about the care they receive was commendable. One service user said ‘we get good care, it is the best home there is.’ One service users care plan stated that the family had requested for her not to be sent to hospital. It was suggested that a clear protocol should be agreed with the service users family, which would be available for staff to follow in the event of an emergency. One service user has a colostomy and care staff have received stoma care training from the stoma nurse to be able to offer this specialist care. Although this is included in a care plan, direct instructions about what care is given is not available. The stoma nurse file has this information however no instructions to refer to this were in the care plan. Grace Muriel House DS0000019396.V268099.R01.S.doc Version 5.0 Page 10 Grace Muriel House DS0000019396.V268099.R01.S.doc Version 5.0 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15 The home offers a varied menu ensuring that a balanced diet is available. The dining room is spacious and homely and the tables are nicely laid. EVIDENCE: A service user stated that she would like to be offered a snack with her evening drink as no food is offered between 6pm and breakfast. Staff said that service users can request food at any time and it was agreed that a biscuit or other snack could be served with evening drinks without service users having to ask. Grace Muriel House DS0000019396.V268099.R01.S.doc Version 5.0 Page 12 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were inspected on this occasion. EVIDENCE: Grace Muriel House DS0000019396.V268099.R01.S.doc Version 5.0 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19. The home offers a pleasant, comfortable environment to its service users. The home is clean and attractively decorated and bedrooms offer a personalised, homely feel. EVIDENCE: The manager has commissioned an independent fire risk assessment, which was carried out in November. The results of this are imminent and a copy of the report must be sent to the Commission. A bedrail bumper is required to be repaired or replaced as foam was observed coming out of the covers. Grace Muriel House DS0000019396.V268099.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were inspected on this occasion. EVIDENCE: Grace Muriel House DS0000019396.V268099.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 & 38 Although environmental risk assessments are available these contain basic information and are not dated, therefore may not contain current or relevant information. EVIDENCE: Although the new registered manager was not available during the inspection it was evident that she has settled into her role well. Feedback from staff and service users and visitors was very positive. Risk assessments for the use of recliner chairs are available however information needs to be expanded, as risks are not clearly identified. There was also no evidence to suggest that the operational manual had been referred to. Grace Muriel House DS0000019396.V268099.R01.S.doc Version 5.0 Page 16 Antibacterial cleaner, air freshener and deodoriser was found in the toilet/shower room. These must be stored safely as this could be a potential risk to service users, particularly those who have dementia. Water temperatures in one of the bathrooms had exceeded recommended maximum levels. This had been identified by staff during water testing and has been reported to contractors who have ordered parts to fit. Grace Muriel House DS0000019396.V268099.R01.S.doc Version 5.0 Page 17 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 2 X X X X X X X STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X X 2 Grace Muriel House DS0000019396.V268099.R01.S.doc Version 5.0 Page 18 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. 2. 3. 4. 5. Standard OP19 OP19 OP38 OP38 OP38 Regulation 23(4)(a) 23(2)(c) 13(4)(c) 13(3) 13(4)(c) Requirement A Copy (summary) of the Fire Risk Assessment must be submitted to CSCI. The bedrail bumper must be repaired or replaced to protect the safety of the service user. Environmental Risk Assessments must be reviewed and dated. All hazardous substances must be stored securely. Water temperature’s that exceed 43°C must be Risk Assessed. Timescale for action 31/12/05 31/12/05 31/03/06 03/12/05 09/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP7 OP7 OP15 Good Practice Recommendations A protocol should be agreed with the family of a service user whose wishes are not to go into hospital as should form part of the service users care plan. Clear instructions should be available on care plans, to staff who have been trained to provide stoma care. A light snack should be offered to service users with their
DS0000019396.V268099.R01.S.doc Version 5.0 Page 19 Grace Muriel House evening drink. Grace Muriel House DS0000019396.V268099.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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