Inspection on 18/05/06 for St Andrews Residential Care Home

This inspection was carried out on 18th May 2006.

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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

St Andrews Residential Care Home 26/06/07

St Andrews Residential Care Home 05/01/06

St Andrews Residential Care Home 22/09/05

St Andrews Residential Care Home 03/03/05

St Andrews Residential Care Home 12/08/04

St Andrews Residential Care Home 03/03/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE St Andrews Residential Care Home 184 London Road Headington Oxford Oxfordshire OX3 9EE Lead Inspector Andy McGuckin Unannounced Inspection 16th & 18th May 2006 09:30 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 St Andrews Residential Care Home DS0000013138.V294264.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. St Andrews Residential Care Home DS0000013138.V294264.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Andrews Residential Care Home Address 184 London Road Headington Oxford Oxfordshire OX3 9EE 01865 741752 01865 452705 stephen.longthorp1@btinternet.com 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) St Andrews Residential Care Home Limited Mrs Barbara Dixey Care Home 23 Category(ies) of Dementia - over 65 years of age (23), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (23), Old age, not falling within any other category (23) St Andrews Residential Care Home DS0000013138.V294264.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The total number of persons that may be accommodated at any one time must not exceed 23. 5th January 2006 Date of last inspection Brief Description of the Service: St Andrews is a residential home providing care, support, and accommodation to its residents. The home is registered for 23 residents over the age of 65. The home has 19 single rooms and two double rooms. Eleven bedrooms have the benefit of en suite facilities. The home is situated on the outskirts of Oxford city centre. The home is set back in its own grounds on a busy main route into Oxford. Local shopping and leisure facilities are available and the home has easy access to the city and beyond. The original home has been added to and extended. The garden has recently been landscaped and provides wheelchair access to all parts of the garden. The home is family run and has a homely atmosphere. The management and staff of the home have all been there for a number of years providing consistency of care for the residents. The home’s fees range from £2250 to £2580 per month. St Andrews Residential Care Home DS0000013138.V294264.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was a ‘Key Inspection’. The inspector arrived at the home at 9.30am and was there for 8 hours over two mornings. The inspector had to return to the home a second time to gain access to staff records. It was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s owner or manager, and any information that CSCI has received about the service since the last inspection. The inspector asked the views of the people who use the services and other people seen during the inspection or who responded to questionnaires that the Commission had sent out. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. What the service does well: The home provides prospective residents with good information on which to make a decision. The home has a good complaints process, residents spoken to felt able to comment on the service. The home is well maintained and provides a pleasant environment in which residents can relax. The home has sufficient experienced staff. The management of the home is good, with residents feeling looked after and safe. St Andrews Residential Care Home DS0000013138.V294264.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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 Residential Care Home DS0000013138.V294264.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 St Andrews Residential Care Home DS0000013138.V294264.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information provided by the home and the home’s admission policy is good. This home does not offer intermediate care facilities. EVIDENCE: The home has provided written information to enable service users to make an informed decision as to the suitability of the home. This document is presented in a way that is written in plain English and is easily understood. The home’s Service User Guide sets out what services are provided and which are not. The location and layout of the home are described, and the qualifications and experience of the staff are set out. Written contracts and terms and conditions are held on the administration file and where required a copy is given to the service user or their representative. Care plans are regularly reviewed to ensure that the home is meeting the needs of the service user. Service users are encouraged to spend some time at the home before coming on a trial period. One new resident is to come to the home today, it was not St Andrews Residential Care Home DS0000013138.V294264.R01.S.doc Version 5.2 Page 9 possible for her to visit prior to admission but her son has visited the home on previous occasions. Her room had been prepared for her arrival. The inspector viewed the information the home had collected as a care plan and was satisfied that this information was sufficient. St Andrews Residential Care Home DS0000013138.V294264.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The presentation of service user information remains adequate. The procedure for the administration and distribution of medication was found to be poor at inspection. The home did however take steps to ensure that the health and well being of the residents are protected in the future. EVIDENCE: The inspector case tracked four service users. The files present limited information but include care plans ands risk assessments. Previous recommendations that information is presented in a more holistic way have not been implemented. The inspector feels that the home is doing themselves a disservice by not presenting the full range of care that has been viewed as taking place. Evidence was found that as far as is possible service users’ needs are being met by the home. A random selection of medication records checked found errors and omissions. Medication had been signed for to say it had been administered when the medication was still in the box. Medication was found in the box that had been St Andrews Residential Care Home DS0000013138.V294264.R01.S.doc Version 5.2 Page 11 refused or not required, this had also been signed to say it had been taken. The manager undertook an immediate investigation and produced a satisfactory report outlining the circumstances surrounding this situation. The manager has made changes to the procedure for the administration and distribution of medication. The inspector was satisfied that the manager took speedy and appropriate action to implement changes to ensure the future safety of the service users. The manager will need to monitor the administration of medication to ensure that the practice in the home follows the new medication policy and procedure. Service users and their families spoken to informed the inspector that they felt the home treated them with respect and dignity. Privacy is given a high priority and service users are able to choose to be alone if they so wish. The home seeks the views of service users as regards to their wishes in the event of serious illness or death. This information is held in a confidential file. St Andrews Residential Care Home DS0000013138.V294264.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. 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 good range and choice of activities. EVIDENCE: The inspector spoke to four service users and received completed questionnaires from a number of residents or their representatives. Feedback indicated that service users find that the home meets their lifestyle expectations and that where possible the home satisfies the social, cultural and religious interests and needs. On the day of the inspection one resident had received communion, another resident had been out shopping with a member of staff. Visitors to the home are made to feel welcome and within reason there are no restrictions on visiting times. Care plans showed that care is provided in a manner chosen by the service user. The home has recently employed a full time cook, which frees up the manager’s time and has proved very successful with service users with many positive comments being received on the questionnaires. Food used in the kitchen is mainly fresh and locally sourced. The cook has her own budget within which to work and she informed the inspector that she felt able to work within this budget and provide quality meals. The inspector was informed that if service users require food to be St Andrews Residential Care Home DS0000013138.V294264.R01.S.doc Version 5.2 Page 13 processed it is liquidised as one. The inspector recommends that each component of the meal be individually liquidised. St Andrews Residential Care Home DS0000013138.V294264.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and their representatives feel that the system for dealing with complaints is good. EVIDENCE: No complaints have been formally logged. The home does however have a policy and procedures to enable complaints, comments or compliments to be made about the service. The inspector was shown letters of thanks. Service users spoken to and feedback from questionnaires indicated that people were made aware of how to complain but would take any issues up with either the manager or proprietor in the first place. Feedback indicated that people were confident that these would be dealt with appropriately. No information regarding concerns or complaints has been passed to the commission by members of the public. St Andrews Residential Care Home DS0000013138.V294264.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Whilst the layout of the building could be improved it is fit for purpose and is being maintained to a good standard. EVIDENCE: Work has not been started to relocate the administrative section of the office to the main building, which resulted in the inspector having to return to view some of the documentation required for the inspection. A tour of the building did not highlight any major health and safety issues. Water tested at one sink was found to be very hot, this was addressed at the time by lowering the temperature on the thermostat. Hot water should be regularly tested to ensure it is not above the required temperature. As previously stated in inspection reports the layout of the building is very confusing for those not used to it. The inspector recommends that the layout is reviewed to take into account the removal of or opening up of the doors to the new part of the building. The exterior of the home is very well laid out and provides a pleasant St Andrews Residential Care Home DS0000013138.V294264.R01.S.doc Version 5.2 Page 16 area for service users to relax and exercise as it is disabled accessible and is completely enclosed to provide for service users’ safety. Bedrooms inspected showed varying degrees of personalisation; all bedrooms were appropriately fitted and furnished and were clean and hygienic. The home provides sufficient communal areas and has sufficient bathrooms and toilet facilities. St Andrews Residential Care Home DS0000013138.V294264.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 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. The home is managed and staffed by experienced, trained carers to a good standard. EVIDENCE: A random selection of staff files was inspected and some documents held for overseas staff had not been translated. All documentation relating to staff appointments must be translated into English so the employer can make an appropriate decision regarding recruitment. Contracts viewed did not reflect the current salary or hourly rate that is to be paid, this needs to be rectified. Four staff members were formally interviewed and related their experience of coming to work for the home. All staff had been formally interviewed with the appropriate checks and references taken up. The home has a trial period after which staff are made permanent. Staff are supervised formally at regular intervals. The home does not as yet undertake yearly appraisals. Salary increases are informal and at the discretion of the proprietor. Many of the current staff team have been here for many years and staff fed back to the inspector that they “love working here “, “very happy to be working here “,“I wish I had come sooner”. Staff spoken to were very positive about the training they received and many have gone on to do formal N.V.Q qualifications. The home is able to provide its own N.V.Q assessors. The manager is due to retire in January 2007 and no internal candidate has been identified and the inspector would recommend that the post be advertised St Andrews Residential Care Home DS0000013138.V294264.R01.S.doc Version 5.2 Page 18 externally as soon as possible to enable the current manager to professionally hand over to a new manager. Staff interviewed were in the inspector’s opinion experienced and trained to do the job expected of them. St Andrews Residential Care Home DS0000013138.V294264.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36,37,38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Overall, the home was found to be a well run and managed establishment. Both the proprietor and manager have been assessed as being of sound character. Service users spoken to were positive that the home was well run and that the management is approachable. The home was found to be run with the best interests of the service users in mind. The inspector needed to return to the home to inspect records required for the inspection process. The inspector did not inspect the financial records of the home but these are available if required. The home has limited involvement in service users’ finances. Where purchases are made on a service user’s behalf receipts are filed. Staff files showed that staff are being given appropriate support to do the job. During the inspection the inspector looked at several documents related to the business including policies and procedures, health and safety St Andrews Residential Care Home DS0000013138.V294264.R01.S.doc Version 5.2 Page 20 certificates, staff files and the complaints process, all of which were found to be satisfactory. St Andrews Residential Care Home DS0000013138.V294264.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 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 8 9 10 11 3 3 3 3 3 3 3 3 2 3 2 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 3 3 St Andrews Residential Care Home DS0000013138.V294264.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard OP9 OP37 Regulation 17 17 Requirement The registered manager must ensure that medication given is recorded accurately. Records required for the inspection process should be available for inspection at all reasonable times. All documentation relating to staff employment must be in English. Timescale for action 01/07/06 01/07/06 3 OP29 12 01/07/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2 Refer to Standard OP7 OP15 Good Practice Recommendations Residents’ care records could be presented in a more appropriate manner, for example, by using a Kardex system. Meals needing liquidising are done so in a more appealing way. DS0000013138.V294264.R01.S.doc Version 5.2 Page 23 St Andrews Residential Care Home 3 OP32 The proprietor takes steps to ensure that the manager’s post is advertised in good time leaving sufficient time for a professional handover. St Andrews Residential Care Home DS0000013138.V294264.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South, Cowley Oxford OX4 2SU 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 Residential Care Home DS0000013138.V294264.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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