Inspection on 20/03/07 for Grace Muriel House

This inspection was carried out on 20th March 2007.

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.

Other inspections for this house

Grace Muriel House 01/12/05

Grace Muriel House 01/04/05

Grace Muriel House 25/10/04

Grace Muriel House 19/07/04

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Grace Muriel House Tavistock Avenue St. Albans Hertfordshire AL1 2NW Lead Inspector Mrs Alison Butler Key Unannounced Inspection 20th March 2007 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.V333631.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. Grace Muriel House DS0000019396.V333631.R01.S.doc Version 5.2 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 post@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.V333631.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st December 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. For up to date fees for this service please contact the home direct. 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.V333631.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report has been written following a visit to the service and from information that has been gained from previous inspections or has been know to the Commission For Social Care Inspection. The majority of the time was spent observing and talking with residents and staff. Care records were also examined. What the service does well: What has improved since the last inspection? What they could do better: It is suggested that when advertising the daily activities this is done in a large/pictorial format to make it accessible to all residents. When receiving cash for the safe keeping of individuals from relatives, it is recommended that they receive a signature to ensure protection on both sides. Grace Muriel House DS0000019396.V333631.R01.S.doc Version 5.2 Page 6 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. Grace Muriel House DS0000019396.V333631.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 Grace Muriel House DS0000019396.V333631.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 Standard 6 is not applicable to Grace Muriel House. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information available to residents is comprehensive and a full assessment is carried out prior to admission. EVIDENCE: There is a comprehensive pre-admission assessment procedure to ensure the home is able to meet the needs of the residents. Visits to the home are encouraged to ensure the residents and/or their relatives are happy with the service the home provides. An information file is available in the entrance to the home and includes the Statement of Purpose, Service Users Guide, statement of terms and conditions, information on fees, complaints procedure and copies of previous inspection reports. Grace Muriel House DS0000019396.V333631.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, & 10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Quality of information recorded is good. Residents receive a good quality of care and are supported by knowledgeable and experienced staff. EVIDENCE: Care plans examined showed that good information is recorded including details of the action required by staff to meet the assessed needs. Care plans are reviewed monthly and any changes made as appropriate. The staff are to be commended on their care practice. Staff ensured that residents’ privacy and dignity is protected at all times and a good example of this was noted when a member of staff asked a resident to go with them for a talk before going out with their visitors. On returning to the lounge the resident shared with the residents in the lounge where she had been and what she did. The medication storage and records were well kept. Observation of the administration of medication after lunch confirmed that two members of staff carry out this task. Staff were seen to inform the residents what they were taking, they also monitored that they had taken it before signing the records. Grace Muriel House DS0000019396.V333631.R01.S.doc Version 5.2 Page 10 One resident’s tablets required splitting as they found it difficult to take as a whole, the member of staff carried this out with their bare hands; a tablet splitter or gloves must be worn to prevent contamination to both the residents and the staff. The manager informed us a tablet splitter was ordered during the inspection and was to be delivered that evening. Grace Muriel House DS0000019396.V333631.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Contact with family and friends are maintained. Autonomy and choice is promoted within the home. EVIDENCE: The home has an activities organiser and they are keen to ensure that the residents have a say in the type of activities on offer. A music and movement session was being held during the site visit and about eight residents were taking part. They paused part way through to have a cup of tea/coffee and a biscuit; this allows some conversations to take place. They very much enjoyed this session and felt it is of benefit in maintaining movement. An activity plan is available, although it is suggested that it is put into a user-friendly format (e.g. larger and/or pictorial). The inspector was invited to join the residents for lunch, which was a most enjoyable experience. They are offered a choice of main meal where vegetables are placed in dishes and residents are able to serve themselves. The tables were attractively decorated with cloths, napkins, condiments and flowers. Menu cards were placed on the tables so residents were able to refresh their memories on the choices available, some residents selected an Grace Muriel House DS0000019396.V333631.R01.S.doc Version 5.2 Page 12 alternative choice from the one they had made previously. This appeared to cause no problems for the cook. The residents were very complimentary about the food and said, “it is always well presented”. Following the main meal, a desert, fruit, cheese and biscuits is always offered followed by tea/coffee. Visitors to the home were offered hospitality on arrival; this is the usual protocol, which the residents confirmed. There is a hairdresser who visits the home weekly and residents are able to book to have their hair done. This too was happening during the site visit. Grace Muriel House DS0000019396.V333631.R01.S.doc Version 5.2 Page 13 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a complaint procedure and the Hertfordshire County Council Adult Protection Procedure in place. EVIDENCE: The complaint procedure is available in the front entrance and residents spoken to were fully aware to whom they could speak if the need arose to make a complaint. One resident stated “there is no reason to make a complaint as I am very happy with the care I get and things couldn’t be better”. Staff have received training in safeguarding adults and are aware of the procedure to follow should the need arise. They are also aware of the whistle blowing procedure. Grace Muriel House DS0000019396.V333631.R01.S.doc Version 5.2 Page 14 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. The home offers a safe, comfortable, clean and well-maintained environment. EVIDENCE: A tour of the home showed that it was well maintained and cleaned to a high standard. Residents commented that their rooms were always cleaned to their satisfaction. Policies and procedures are in place to prevent the spread of infection. There are appropriate hand-washing facilities with gloves and aprons also readily available. The residents were complimentary about the laundry services that they receive. Grace Muriel House DS0000019396.V333631.R01.S.doc Version 5.2 Page 15 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Robust procedures are in place to ensure that residents are protected at all times. The numbers and deployment of staff appear to meet the needs of the residents. EVIDENCE: Residents were very complimentary about the staff and the managers, stating “our needs are met and we can ask for assistance at any time” and “they are always very caring and kind”. Examination of staff files showed that all the relevant information had been obtained prior to their commencing employment. The training co-ordinator ensures an on-going training programme is in place and all staff receive a thorough induction. The staffing levels met the needs of the residents at the time of this inspection. Staff were seen to be very caring and ensure that residents privacy and dignity is safeguarded at all times. Grace Muriel House DS0000019396.V333631.R01.S.doc Version 5.2 Page 16 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 excellent. This judgement has been made using available evidence including a visit to this service. There is a good management structure in place. The health welfare and safety of residents, staff and visitors to the home is protected at all times. EVIDENCE: The manager has excellent management skills and communicates a clear sense of leadership. All statutory records were available for inspection and were well maintained. Residents are able to have their say in how the home is run and the manager is always available to speak to if necessary. The home handles small amounts of money on behalf of the residents; examination of the records showed these to be well kept. It is suggested that where deposits of cash are received from families, a signature is obtained against the record. A procedure for managing personal allowances is currently Grace Muriel House DS0000019396.V333631.R01.S.doc Version 5.2 Page 17 being written, as the long serving administrator is due to retire. A new administrator is in place, ready to receive a handover. The manager ensures that the Commission for Social Care Inspection is informed under regulation 37 any events that effect the well being of a resident. There are well-written risk assessments in place to ensure that the health and safety of all is protected at all times. Equipment is well maintained and serviced appropriately. Grace Muriel House DS0000019396.V333631.R01.S.doc Version 5.2 Page 18 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 SOCIALACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Grace Muriel House DS0000019396.V333631.R01.S.doc Version 5.2 Page 19 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 23 Requirement Staff must ensure that handling of medication is in line with current good practice Timescale for action 20/03/07 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 Grace Muriel House DS0000019396.V333631.R01.S.doc Version 5.2 Page 20 Commission for Social Care Inspection Hertfordshire Area 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. Extracts may not be used or reproduced without the express permission of CSCI Grace Muriel House DS0000019396.V333631.R01.S.doc Version 5.2 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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