Inspection on 03/05/05 for St Andrews Care Home

This inspection was carried out on 3rd May 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.

Other inspections for this house

St Andrews Care Home 29/06/07

St Andrews Care Home 12/10/06

St Andrews Care Home 15/11/05

St Andrews Care Home 22/11/04

St Andrews Care Home 17/08/04

St Andrews Care Home 16/02/04

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE St Andrews Care Home Great North Road Welwyn Garden City Hertfordshire AL8 7SR Lead Inspector Pat House Unannounced 03 May 2005 11:00 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 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 Andrews Care Home I52 s19533 st andrews v221795 030505 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service St Andrews Care Home Address Great North Road Welwyn Garden City Hertfordshire AL8 7SR 01707 324208 01707 324248 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Colley Care Limited (Trading as B & M Care) Carol Stevenson Care Home 70 Category(ies) of DE(E) Dementia over 65 39 registration, with number OP Old Age 31 of places St Andrews Care Home I52 s19533 st andrews v221795 030505 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 22 November 2004 Brief Description of the Service: St. Andrews is a care home for 70 older people, 39 of whom may also have a dementia. The building has three floors and a passenger lift. The bedrooms are all single occupancy and have en-suite facilities. There is ample parking to the front of the home and extensive landscaped gardens with courtyards and well kept flower beds. St. Andrews is located in a semi-rural area, between the villages of Digswell and Lemsford. It is near the A1M road and a short drive from Welwyn Garden City, with its wide range of shops and facilities. There is limited public transport nearby but the home has its own vehicle for the benefit of the residents. St Andrews Care Home I52 s19533 st andrews v221795 030505 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and two inspectors visited the home for most of one day. The Manager and staff in the home have worked hard and have fulfilled all the requirements and recommendations made at the last inspection. Since the present Manager has been in post, improvements have been made in most areas of the home and this is reflected in only one requirement being made from this inspection. Service users and visitors were spoken to and all praised the staff and said they were happy living in the home. What the service does well: What has improved since the last inspection? Staff have received training in the Administration of Medication and thorough procedures are now in place. Staff supervision is now taking place regularly and there is a more settled staff team in the home. General recording across the home has improved and the Manager is continuing to complete the process, with more general risk assessments and individual updates being put in place. St Andrews Care Home I52 s19533 st andrews v221795 030505 stage 4.doc Version 1.30 Page 6 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. St Andrews Care Home I52 s19533 st andrews v221795 030505 stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection St Andrews Care Home I52 s19533 st andrews v221795 030505 stage 4.doc Version 1.30 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 standard(s) 1, 3 and 4. Standard 6 does not apply to this home. The home provides up to date information for prospective residents so that they can make informed choices. Full assessments are made for all new service users to ensure all their needs can be met. EVIDENCE: The home’s Statement of Purpose and Service User’s Guide have been updated to include all recent changes made in the home. Copies are available in the home and are given to all prospective service uses and families. Records of recent service users were examined during the inspection and all had detailed pre-admittance assessments in place. All service user files contained up to date care plans. Staff spoken to said they had received all appropriate basic training as well as dementia training and copies of training certificates were seen on staff files. One service user is currently being monitored and will be re-assessed, as it is felt the home may not be able to continue meeting all identified needs. St Andrews Care Home I52 s19533 st andrews v221795 030505 stage 4.doc Version 1.30 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 standard(s) 7, 8, 9 and 10. All service users have details of their needs and treatments set out in individual plans to ensure that their health needs are fully met. The home has procedures for administering medication and for providing care, which help to protect service users and maintain their dignity. EVIDENCE: Staff in the home have been reviewing and updating all service user care plans. The plans have a good format and contain risk assessments, body charts and appropriate health information. The Manager said that not all plans are finished and is aware that some falls risk assessments and moving plans still need to be updated. However, actual procedures for moving and handling residents were observed and service users were questioned about staff practice, and in all cases safe techniques were being followed. Following care plan checks, staff were advised to provide more detail of doctors’ visits and in one case to seek advice and risk assess an electric recliner chair, owned by a resident. Special equipment has been provided for some service users who are at risk of developing pressure sores and skin monitoring is recorded. Special mattresses have been provided for individual needs. The home now has a new weighing machine and care plans have service user weight and health checks recorded. The doctor visits the home every week and service users confirmed that the District Nurse also provides regular input to residents. St Andrews Care Home I52 s19533 st andrews v221795 030505 stage 4.doc Version 1.30 Page 10 Those residents and visitors spoken to, confirmed that staff treat them with respect at all times and respect service user privacy. They also confirmed that residents have access to a telephone if they wish, always wear their own clothes and receive their mail unopened. Staff have now received accredited training in the Administration of Medication and a local company has provided training for booking medication in and out. Procedures for the administration of medication were observed and were sound and storage and recording was appropriate and accurate. St Andrews Care Home I52 s19533 st andrews v221795 030505 stage 4.doc Version 1.30 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 standard(s) 12, 13, 14 and 15. There are events and activities provided in the home which service users are satisfied with and have a choice in attending. The home provides a range of meals and snacks which are well balanced and plentiful. EVIDENCE: The home has an activities co-ordinator who has completed accredited training in the provision of activities. During the inspection service users in the lounge were taking part in a soft ball throwing exercise and were enjoying this. Service users confirmed that the co-ordinator lets them know what events are taking place and that there is a mobile library and mobile phone on a trolley which they can access. Church services are held regularly and newspapers are delivered each day for those who request this. The co-ordinator said she holds exercise groups in the home and has reminiscence and one-to-one sessions for appropriate service users. The co-ordinator maintains her own details of service user histories and preferences. Service users and visitors spoken to confirmed that they can have private visits if required and that relatives receive information about events at the home. There are details of help lines and advice bodies on notice boards in the home and one service user has recently been supported to contact Age Concern to request advocacy services. Service users can bring appropriate personal possessions with them into the home and the Manager now makes sure that inventories are completed and signed by service users or family members. St Andrews Care Home I52 s19533 st andrews v221795 030505 stage 4.doc Version 1.30 Page 12 The Manager is aware that service users can have access to personal records and has been approached for such access by a family member. The Manager is aware that access is given in line with the Data Protection Act. Service users confirmed that they enjoy the food in the home and have a choice of meals, which are chosen the previous day. There is a four-weekly menu provided which was seen and each unit in the home has written menus on display. There are small kitchenettes in the home where snacks and drinks can be made for service users and visitors and these areas were well stocked with supplies on the day. St Andrews Care Home I52 s19533 st andrews v221795 030505 stage 4.doc Version 1.30 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 17 and 18. Policies in the home ensure that service users rights are protected and procedures for dealing with Complaints and Adult Protection are meaningful and made clear to staff and service users who can be confident that any concerns will be listened to. EVIDENCE: The home has written policies and procedures for Complaints, Adult Protection and Whistle blowing. The Complaints Book had one recent complaint recorded which had been thoroughly dealt with. Staff at the home are aware of the home’s policies and one POVA issue has been recently dealt with by the Manager. Service users confirmed that they would have no hesitation in telling staff about any concerns they might have. Service users also confirmed that they were able to vote in elections if they wished. The home’s procedures for handling service users’ money will be checked at the next inspection. St Andrews Care Home I52 s19533 st andrews v221795 030505 stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26. The home is well maintained and kept clean, with procedures in place for infection control, to ensure service users live in a safe and pleasant environment. EVIDENCE: The home is regularly maintained by the company’s maintenance team and there is on-going decoration taking place throughout the building. Flooring in one bedroom, identified as needing repair at a previous inspection, has been replaced and there is a new chimney outlet for the tumble-dryer. The home was generally clean and well presented. The shower room was clean and tidy. Staff confirmed that disposable gloves are always available and that red and yellow bags are used for dealing with soiled linen and waste material. The washing machines have high temperature wash cycles available for infection control. There were no unpleasant odours in the home on the day of the inspection. The grounds looked very attractive and well planted and service users said they enjoyed the grounds in the good weather. St Andrews Care Home I52 s19533 st andrews v221795 030505 stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30. Recruitment procedures in the home are thorough and this, together with good levels of staff training, ensure service users are protected. There are adequate numbers of staff on duty in the home to meet the needs of the service users throughout the day and night. EVIDENCE: Service users generally thought there were adequate numbers of staff on duty in the home. On the day there were 13 care staff on duty as well as the Manager and Deputy. In addition there was an activities co-ordinator and an administrator on duty together with 6 domestic staff and two cooks and a domestic assistant in the kitchen. Recruitment files for the most recently employed staff were checked and all appropriate checks and evidence was in place. Induction training courses are provided for all new staff by the company and the written work and certificates involved are used towards NVQ training. Staff confirmed they were provided with high levels of training, including all basic courses and Dementia care training. The Infection Control Nurse had recently provided training for care staff, which those spoken to had found very useful. St Andrews Care Home I52 s19533 st andrews v221795 030505 stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 36 and 38. Regular staff supervision promotes good standards of care work in the home, to the benefit of residents. Generally service users are protected by health and safety procedures, but some potentially hazardous items were not being kept locked in the home, which created an unnecessary risk to residents. EVIDENCE: Staff confirmed they now receive regular, formal supervision and seniors are aiming at this taking place every two months. Supervision is recorded and signed and covers all appropriate aspects. Domestic staff said they felt included in the running of the home and felt supported by seniors. Evidence of service checks and maintenance was available in the home and staff confirmed they had regular fire equipment checks and drills. The Manager is planning to complete a new fire risk assessment for the building. General risk assessments for the home have been completed including assessments for staff who are pregnant. The Manager was advised to remove disposable gloves from areas where residents had access, to ensure service user safety. St Andrews Care Home I52 s19533 st andrews v221795 030505 stage 4.doc Version 1.30 Page 17 There were also toiletries and a razor in an unlocked cupboard in one bathroom, which must be removed and one store cupboard, containing COSHH products, had been left unlocked. Both areas could have presented a hazard to service users in the home. St Andrews Care Home I52 s19533 st andrews v221795 030505 stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 x x x x x 3 x 2 St Andrews Care Home I52 s19533 st andrews v221795 030505 stage 4.doc Version 1.30 Page 19 no Are there any outstanding requirements from the last inspection? 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 38 Regulation 13(4)(a) Requirement The Registered Provider must ensure that all potentially hazardous items and substances are locked away or kept out of communal areas in the home. Timescale for action 3rd. May 2005 and henceforth. 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. Refer to Standard Good Practice Recommendations There are none. St Andrews Care Home I52 s19533 st andrews v221795 030505 stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Mercury House 1 Broadwater Road Welwyn Garden City AL7 3BQ National Enquiry Line: 0845 015 0120 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 St Andrews Care Home I52 s19533 st andrews v221795 030505 stage 4.doc Version 1.30 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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