Inspection on 28/01/08 for St Andrews, Paignton

This inspection was carried out on 28th January 2008.

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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

St Andrews, Paignton 24/12/09

St Andrews, Paignton 29/06/09

St Andrews, Paignton 13/01/09

St Andrews, Paignton 08/08/07

St Andrews, Paignton 01/03/07

St Andrews, Paignton 10/10/06

St Andrews, Paignton 16/05/06

St Andrews, Paignton 13/12/05

St Andrews, Paignton 20/06/05

St Andrews, Paignton 13/10/04

St Andrews, Paignton 19/05/04

Similar services:

Trevaylor Manor

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

Claremont Nursing Home

Althea Park House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 St Andrews 24 St. Andrews Road Paignton Devon TQ4 6HA Lead Inspector James Rose Unannounced Inspection 28th January 2008 09:00 St Andrews DS0000018429.V358428.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address St Andrews DS0000018429.V358428.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 Adults 18-65. 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 DS0000018429.V358428.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Andrews Address 24 St. Andrews Road Paignton Devon TQ4 6HA 01803 559545 01803 391582 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) Mr John Davies Mrs Paulette Davies Mrs Delia Williams Care Home 21 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (21) of places St Andrews DS0000018429.V358428.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home providing personal care only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: 2. Mental disorder, excluding learning disability and dementia- Code MD The maximum number of service users who can be accommodated is 21. 8th August 2007 Date of last inspection Brief Description of the Service: St Andrews is a care home for up to 21 younger or older adults with mental health needs. The building is situated in a residential area of Paignton, within walking distance of the sea front, shops and amenities. There is level access through a small front garden, with one step inside the lobby area to access the house. There is also a concreted area and lawn to the back of the home. The home has a lower ground, ground, first and second floor with stairs throughout. This may cause difficulties for residents with mobility problems, as there are no bathing/shower facilities on the ground floor. An external fire escape connects all floors. On the lower ground floor there is a laundry, storeroom, bedroom, shower/bathroom, and lounge/staff sleep-in room. On the ground floor there are bedrooms, a kitchen, toilet, office, dining room and lounge. The first floor has a shower room, bathroom, and bedrooms, and on the second floor there are bedrooms and a toilet. Two of the bedrooms are doubles. The costs per week for residential care at St Andrews are: Lowest £364.00 and the highest £534.00. St Andrews DS0000018429.V358428.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 that the people who use the service experience adequate quality outcomes. This unannounced inspection was undertaken over 5.5 hours during January 2008. Evidence was also obtained from three healthcare professionals, from psychiatric services, district nursing services and the doctor that provides a service to the home. Samples of the care records were examined and a complete tour of the building was undertaken with all rooms seen and observations were also made during the inspection process of the way care was delivered to residents. Four residents were consulted individually in private and others were seen in a group. Two of the care team were also interviewed and the registered manager assisted the inspector throughout the inspection. What the service does well: What has improved since the last inspection? What they could do better: Currently the home does not have a full care team and advertisements are being placed to recruit more staff. At the time of the inspection the domestic help person was off sick and the care staff are covering this work. The home used to employ a member of staff to provide activities for the residents; this person has now left and has not been replaced. There are some maintenance issues outstanding in a bathroom and a shower room and a requirement has been raised in this report to ensure the work is completed. The care planning undertaken by the home was examined and the development of the social elements had not been developed as discussed at St Andrews DS0000018429.V358428.R01.S.doc Version 5.2 Page 6 the last inspection. This was again discussed with the registered manager who has agreed that the social elements of the care plans will be developed further to ensure the home is able to follow a ‘client centred’ approach to the service provided. A sample of the risk assessments that had been undertaken for residents were examined and some elements caused concern. A requirement has been raised in this report for a review of the risk assessments in place to be undertaken to ensure the approach taken is appropriate. It is noted that the risk assessments in place have been agreed with healthcare professionals, this approach is good practice and should be maintained. When a risk assessment has been completed and a clear inappropriate risk is identified action must be taken by the home to ensure their duty of care is discharged. Care should be taken with these processes to ensure residents are able to take responsible risks. T Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. St Andrews DS0000018429.V358428.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection St Andrews DS0000018429.V358428.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is adequate. There are adequately detailed assessments in place for each resident in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Samples of the assessments undertaken by the home were examined and these contained all the needs of residents, this enables the home to provide an appropriate service. Four residents were consulted individually during the inspection and they all advised that all their needs were met by the service they received. One resident was keen to say that the manager had been able to get him on a course that he wanted to complete and another said that he had the freedom he wanted but felt that the manager would always be there to assist if he needed help. St Andrews DS0000018429.V358428.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is adequate. Residents were aware of their care plans and were able to make their own decisions with assistance if required, but the risk assessments in place need to be reviewed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Four care plans for residents were examined at this inspection. Residents that were consulted as part of the inspection process confirmed that they were involved in the care planning undertaken by the home and that they were able to make their own decisions with support if required. The social needs of residents were going to be developed further at the time of the last inspection but this has not been achieved. This was discussed with the registered manager at this inspection and she has agreed to ensure this is undertaken. A sample of the risk assessments that had been undertaken for residents were examined and some elements caused concern. A requirement has been raised in this report for a review of the risk assessments in place to be undertaken to ensure the approach taken is appropriate. It is noted that the risk assessments in place have been agreed with healthcare professionals, this approach is good St Andrews DS0000018429.V358428.R01.S.doc Version 5.2 Page 10 practice and should be maintained. When a risk assessment has been completed and a clear inappropriate risk is identified action must be taken by the home to ensure their duty of care is discharged. Care should be taken with these processes to ensure residents are able to take responsible risks. St Andrews DS0000018429.V358428.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is adequate. The home provides opportunities for personal development and some activities are provided, however, further development of the care plans is required. Residents use the community facilities and have appropriate relationships and their rights are respected. The home provides a wholesome diet that is to the liking of residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home does provide appropriate activities and opportunities for personal development. This element of care is not integrated into the care planning and this was discussed with the proposed registered manager at the last inspection and she agreed that this will be undertaken, however this has not been achieved. This was discussed again and the registered manager has given an undertaking that this work will be completed. This approach will demonstrate that the home is using a ‘client centred’ approach to the social elements of care plans, which will considerably enhance the life of residents in the home. St Andrews DS0000018429.V358428.R01.S.doc Version 5.2 Page 12 Residents are able to use the facilities provided in the local community and can come and go as they wish. The home has an unrestricted visiting policy and procedure in place and residents confirmed that they could have visitors at anytime during the day. It was clear from observations made during the inspection that carers treated residents with respect and assistance was delivered in a sensitive way. One resident made a point of seeking the inspector out to say, “The home is much improved and the new manager is very caring and has fixed me up with a course” another remarked, “I believe things are much better now, I feel more relaxed”. The home was well stocked with foodstuffs and fresh produce was delivered on a regular basis. Since the time of the last inspection a new cook has been retained and all the residents consulted advised that they liked the meals provided at the home. St Andrews DS0000018429.V358428.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. Residents receive help in a way they liked and their physical and emotional needs are met. Residents are protected by the home’s policies and procedures for the administration of medication. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All the residents consulted during the inspection advised that they received support and assistance in the way that they liked. One resident said, “The manager always takes time to make sure I’m OK” another remarked “When I’m not well I know I can get help when I need it”. Residents emotional and physical health needs are met by the service provided at St Andrews. A local doctor that provides a service to the home, the community psychiatric nurse and the district nursing service were all contacted as part of the inspection process and they all expressed positive views about the service being provided currently at the home. Residents can self medicate subject to a risk assessed approach to ensure they have the capacity and are safe. St Andrews DS0000018429.V358428.R01.S.doc Version 5.2 Page 14 The recordings undertaken by the home of the administration of medication were examined as part of the inspection process. Medication was checked and booked in when received, complete records were maintained of the issue of medication and any unused medication was recorded and returned to the pharmacist. All medication was stored under secure conditions and low temperature storage was available where required. An appropriate system is in place for medication that is subject to the controlled process. The approach taken by the home ensures that the residents are safe. St Andrews DS0000018429.V358428.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. Should residents need raise an issue their views are listened to and the management of the home undertake appropriate action. Residents are protected from abuse, neglect and self-harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Four residents were consulted individually in private and others in small groups during the inspection and they advised that they felt the staff team listened them to and that their concerns were taken seriously and acted on and resolved for them. The home has an adult protection policy in place and carers were trained in its use. Two carers were interviewed during the inspection and they were both aware of the different types of abuse and what action should be undertaken if abuse was discovered in the home. St Andrews DS0000018429.V358428.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is adequate. The home provides a comfortable safe environment for the residents. The home is currently clean with reasonable standards of hygiene apparent. Some small items of maintenance were outstanding. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A complete tour of the home was undertaken inside and out as part of the inspection process. The redecoration programme running in the home continues. The environment in general was discussed with the proposed manager who advised that she would be refurbishing the bathrooms and shower rooms, this was discussed at the last inspection and a requirement has been raised here to ensure this is achieved. The residents that were consulted during the inspection advised that they liked their rooms and the facilities provided in the home. St Andrews DS0000018429.V358428.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. Quality in this outcome area is adequate. Residents are supported by appropriate staff, but currently the home has staff vacancies. The home recruitment policies and practices ensure that residents are appropriately protected and a training programme is in place for carers. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Currently St Andrews has vacancies in the care team and domestic help. Advertising is underway to fill these gaps. In the meantime the staff are covering this duty. At the time of the inspection there were sufficient staff hours available to provide appropriate care to the residents. Two staff were interviewed individually during this inspection they were appropriately qualified and clearly knew their role in the home. They were aware of the adult protection policy and procedure and knew the different types of abuse possible and what action should be undertaken if this was discovered. The registered manager has arranged a training programme for the care team to ensure they are able to fulfil their role appropriately. St Andrews DS0000018429.V358428.R01.S.doc Version 5.2 Page 18 The personnel files were examined as part of the inspection process and these contained all the required information to satisfy the legislation and demonstrated that residents were appropriately protected. St Andrews DS0000018429.V358428.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is adequate. Residents’ benefit from an appropriately managed home and are confident that their views are taken seriously and considered in the development of the service. The health, safety and welfare of residents is promoted and protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the time of the last inspection the manager has been registered. The care plans and risk assessments that have been produced with the assistance of healthcare professionals are much improved and only require a little further development in the social element to provide a comprehensive foundation for the individual care to be provided for each resident in the home. This was again discussed during the inspection and it has been agreed with the registered manager that this work will be undertaken without delay. Residents had confidence in the proposed manager and felt that their interests would be taken into account in the future development of the home. St Andrews DS0000018429.V358428.R01.S.doc Version 5.2 Page 20 The health and safety recording undertaken by the home was examined at the inspection. The fire precautions undertaken were clear and up to date. Appropriate recording was available of the testing of electrical appliances and the electrical installation certificate was produced. The proposed manager has developed the systems in the home and made improvements to the environment that have much improved the service provided. St Andrews DS0000018429.V358428.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 2 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 2 x LIFESTYLES Standard No Score 11 X 12 2 13 2 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X St Andrews DS0000018429.V358428.R01.S.doc Version 5.2 Page 22 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 YA9 Regulation 13 Requirement The registered manager must review risk assessments of residents and ensure that unnecessary risks to health or safety of service users are identified and so far as possible eliminated. The registered manager must ensure that the home is well maintained and kept in a good state of repair. Timescale for action 28/02/08 2 YA24 23 28/02/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations St Andrews DS0000018429.V358428.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 St Andrews DS0000018429.V358428.R01.S.doc Version 5.2 Page 24 - 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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