Inspection on 08/08/07 for St Andrews, Paignton

This inspection was carried out on 8th August 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

St Andrews, Paignton 24/12/09

St Andrews, Paignton 29/06/09

St Andrews, Paignton 13/01/09

St Andrews, Paignton 28/01/08

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 Key Unannounced Inspection 8th August 2007 08:30 St Andrews DS0000018429.V343420.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.V343420.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.V343420.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 Post Vacant Care Home 21 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (21), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (21) St Andrews DS0000018429.V343420.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 01/03/07 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 £257.00 and the highest £1064.00. St Andrews DS0000018429.V343420.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was undertaken over 6 hours during August 2007. 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. Three residents were consulted individually in private and others were seen in a group. Three of the care team were also interviewed and the proposed registered manager assisted the inspector throughout the inspection. What the service does well: What has improved since the last inspection? Three healthcare professionals were consulted about the home and they were all supportive and felt the service at the home had improved. The care records examined at this inspection were much more comprehensive and included risk assessments and they provided a good foundation for the service to be delivered. A substantial investment has been made in the building with new carpet being laid in the lounge, dining room and all the stairs, landings and corridors. This has made a great improvement to the environment provided for residents. New carpet has also been provided in some of the resident’s bedrooms and there is an active redecoration programme in place. A new member of the care team has been recruited to provide social elements to residents’ care, this person is able to take residents out on trips and to events and also provides activities in the home. St Andrews DS0000018429.V343420.R01.S.doc Version 5.2 Page 6 A new cook as also been recruited who is able to provided a varied menu and this has freed care staff to better fulfil their role in the home. A requirement was raised at the last inspection for the incomplete personnel records to be compliant with the legislation and this has been achieved. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. St Andrews DS0000018429.V343420.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.V343420.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. All the residents in the home have been reassessed to ensure that all their needs are met. No new residents have been admitted since the time of the last inspection. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The proposed registered manager has reassessed all the residents in the home and has a record of residents’ needs that is comprehensive and complete. This enables the home to produce a care plan that demonstrates how these needs can be met at St Andrews. No new residents have been admitted into the home since the time of the last inspection so there is no clear demonstration of how comprehensive the new system would be when used. St Andrews DS0000018429.V343420.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 are able to take appropriate reasonable risks and risk assessments are undertaken by the home and included as part of the care planning process. Care is delivered in a sensitive way and residents are respected and assisted to be as independent as possible. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Five care plans of residents were examined at this inspection; these had been developed further since the time of the last inspection and just need the addition of the details of the social care that is provided by the home. This would demonstrate a clear comprehensive ‘client centred’ approach being taken by the home to meet all residents’ needs in the areas of health personal and social as required by the legislation. It is acknowledged that the proposed manager has invested substantial time and effort along with healthcare professionals to ensure that the home has appropriate care plans for residents available that also includes risk assessments to enable an independent lifestyle. St Andrews DS0000018429.V343420.R01.S.doc Version 5.2 Page 10 All the healthcare professionals contacted at part of the inspection process advised that they had no concerns about the current service being provided at St Andrews. Residents stated that they agreed their care plans that contained all their needs and signed them. Assistance and support is provided, where needed, to residents to help them arrive at decisions. It was clear from observations made during the inspection process that care was delivered in a sensitive way and that residents were respected and assisted to be as independent as possible. One resident said, “I can always get help, I like it here” another remarked, “It is much better here than it used to be”. St Andrews DS0000018429.V343420.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 good. The home provides good opportunities for personal development and appropriate activities are provided. 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 has made substantial progress in providing appropriate activities and opportunities for personal development and some notable successes have been noted. Currently this element of care is not integrated into the care planning, this was discussed with the proposed registered manager who has agreed that this will be undertaken without delay. 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. Residents are able to use the facilities provided in the local community and can come and go as they wish. St Andrews DS0000018429.V343420.R01.S.doc Version 5.2 Page 12 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 advised, “The home is much improved and I go out on trips” another remarked, “The home is more relaxed, I like it. Since the last inspection a new cook has been retained who provides a wholesome diet for the residents with choice always available. A daily menu system is in place and residents can see what foods are available from a menu that is available in the dining room. At the time of the inspection the home was well stocked with food products and fresh produce was delivered on a regular basis. The residents consulted advised that they liked the food at the home. St Andrews DS0000018429.V343420.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 confirmed that they received help in a way they liked. The physical and emotional needs of residents are met. Residents are able to self medicate subject to a risk assessed approach. Appropriate protection is provided for residents by the way the administration of medication is undertaken. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All the residents consulted stated that they received assistance from the care team in a way they felt was useful and appropriate. It is noted that good progress has been made by the proposed manager of the home with some elements of care delivery that are particularly demanding. Emotional support is available for residents and will be detailed in the care planning process undertaken by the home. One residents advised, “This new manager is good and I feel I can rely on her” another remarked “We are all more relaxed now both the carers and the resident’s, I like it.” 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. St Andrews DS0000018429.V343420.R01.S.doc Version 5.2 Page 14 Residents that are able can self medicate subject to a risk assessed approach to ensure they have the capacity and are safe. 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 held under secure conditions in the home and low temperature storage was available where required. This approach ensures that the residents in the home are safe. St Andrews DS0000018429.V343420.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. Resident stated that their views were listened to, taken seriously and acted on. The home has an adult protection policy and procedure and carers have a good knowledge of how residents need to be protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Individual residents were consulted in private and others as a group during the inspection 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.V343420.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 was clean with reasonable standards of hygiene apparent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A complete tour of the building was undertaken inside and out as part of the inspection process. The redecoration programme running in the home continues and a substantial investment has been made in new carpets that have been provided in five bedrooms, the lounge and the dining room, hall, stairs and landings. The office has also been fitted with a new carpet. This has much improved the environment for residents. The environment in general was discussed with the proposed manager who advised that she would be working towards refurbishing the bathrooms and shower rooms, when this is completed a very good environment would be available. The residents that were consulted during the inspection advised that they liked their rooms and the facilities provided in the home. St Andrews DS0000018429.V343420.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 good. Residents are supported by competent, qualified staff. The home recruitment policies and practices ensures that residents are appropriately protected. An appropriate care team meets residents’ needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: St Andrews now has a complete care team supported by domestic help and a new cook. This enables the care team to focus on their task and improve the care for residents. At the time of the inspection there were sufficient staff hours available to provide appropriate care to the residents. Four staff were interviewed individually during this inspection, two of these were members of the care team. 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 proposed manager is arranging additional training for staff and a clear training programme is being produced. St Andrews DS0000018429.V343420.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.V343420.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. The manager of the home has yet to be registered with the Commission, however, residents’ benefit from a well managed home and they 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: The proposed manager has been effectively managing the home since the time of the last inspection, but to date has not been registered by the Commission. 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. 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.V343420.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 has much improved the service provided and should now enable the home to progress and provide a good service to the residents. St Andrews DS0000018429.V343420.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 3 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 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 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.V343420.R01.S.doc Version 5.2 Page 22 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. Standard Regulation Requirement Timescale for action 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.V343420.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. 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