Inspection on 17/07/07 for St Anne`s (Holsworthy)

This inspection was carried out on 17th July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 Anne`s (Holsworthy) 07/11/06

St Anne`s (Holsworthy) 24/01/06

St Anne`s (Holsworthy) 25/08/05

St Anne`s (Holsworthy) 01/12/04

St Anne`s (Holsworthy) 23/06/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE St Anne`s (Holsworthy) Whitstone Holsworthy Cornwall EX22 6UA Lead Inspector Elaine Bruce Key Unannounced Inspection 17th July 2007 10:30 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 Anne`s (Holsworthy) DS0000009221.V345520.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 Anne`s (Holsworthy) DS0000009221.V345520.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Anne`s (Holsworthy) Address Whitstone Holsworthy Cornwall EX22 6UA 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) 01288 341355 01288 341355 Mrs Helen Medland Mr Herbert John Medland Mrs Dawn Parnell Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places St Anne`s (Holsworthy) DS0000009221.V345520.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Service users to include up to 28 adults of old age (OP) Two waking night care staff must be available on the premises Total number of service users not to exceed a maximum of 28 Date of last inspection 7th November 2006 Brief Description of the Service: St Annes offers care and accommodation to people in need of care by reason of old age. It is situated in the village of Whitston which is midway between Launceston, Bude & Holsworthy. The home, which is privately owned, is relatively new having been created from redundant farm buildings. It provides rooms of a good size, all with ensuite facilities for the service users. There are large communal areas in different parts of the home for the use by all. Externally the courtyard around which the home is built is tarmacd with a water feature. There is good car parking available. St Anne`s (Holsworthy) DS0000009221.V345520.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key inspection at St Annes was an unannounced inspection and took place over five and a half hours. The registered manager was on duty and therefore able to assist the inspector during the course of the day. Both the registered providers visited the home to speak with the inspector. An inspection of the premises took place as did an inspection of care records, policies and procedures, staff files, medication and meals provided. A number of people in the home were spoken to during the course of the day, generally the comments from the people in the home were very positive. Case tracking took place of four people. At this time the home is running at nearly full occupancy and the registered provider discussed his plans to extend the home. He is fully aware of the requirements of legislation for this process. The home is able to offer short term stays as well as longer and is also able to offer a day care facility in it’s spacious communal areas. The range of weekly fees are from £305 to £370. What the service does well: What has improved since the last inspection? St Anne`s (Holsworthy) DS0000009221.V345520.R01.S.doc Version 5.2 Page 6 Improvements are noted to the adult protection training to the staff that is taking place at the home. Improvements are also noted to the induction training that new staff are receiving. The manager has accessed and is using the good practice Skills for Care documentation. 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 Anne`s (Holsworthy) DS0000009221.V345520.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 Anne`s (Holsworthy) DS0000009221.V345520.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Comprehensive procedures prior to admission to St Annes ensure that the people being admitted will have their needs met. EVIDENCE: The home has a statement of purpose document in place that meets all the requirements of The Care Homes Regulations (2001). The statement of purpose document is available in the home as is the service user guide. This information is provided to the people and their family member or representative. St Annes is run on a Christian philosophy but it is noted that the statement or purpose document states “although this home is Christian based, all denominations are welcome”. St Anne`s (Holsworthy) DS0000009221.V345520.R01.S.doc Version 5.2 Page 9 All potential new admissions to the home are assessed by the registered manager. A pre admission assessment and document is completed and signed and dated as required by the national minimum standards. Where the assessment has been undertaken through care management arrangements the registered manager has accessed a copy of their assessment. The home offers respite care as well as longer stays. A large number of the service users who are admitted to the home have lived locally. The home offers respite care as well as longer stays. A large number of the people who are admitted to the home have lived locally. St Anne`s (Holsworthy) DS0000009221.V345520.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The people at St Annes can be confident that they will be treated with respect and that their personal and health care needs will be met. EVIDENCE: Each person at the home has a care plan in place identifying problems and the action required to address these care needs/problems. Reviews of care plans are taking place but it is noted that some of the original care plans are now very much out of date and should now be commenced again. The daily records support the care plans and all the staff are involved in this recording. The care staff also evidence in a “bath” book personal care delivery and on personal care records. Some improvement to some of the daily record entries could be made for example “alright day” is a poor entry that gives very little information on whether care needs have been met and how that person has spent the day. St Anne`s (Holsworthy) DS0000009221.V345520.R01.S.doc Version 5.2 Page 11 Advice from health care professionals and other agencies is sought when required. Specialist equipment is provided as required. Risk assessments and moving and handling assessments are also in place. Information on nutrition is included in care planning although it is noted that more attention could be given to the regular weighing of the people in the home. Health care professionals attend the home when required. On the day of the inspection the optician was assessing someone for new glasses. Medication is stored in a locked and secure trolley in the staff room. All the staff who have medication administration duties have received medication administration training. Administration records were found to be completed appropriately on the day of the inspection as were the records in relation to the controlled drugs at the home. An audit of medication received into the home is now in place. Documentation is held in the front of care planning to guide staff on practice which respects the dignity and privacy of the people in the home. The people in the home spoke about the kindness of the staff. St Anne`s (Holsworthy) DS0000009221.V345520.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The routines in the home are relaxed, relatives and friends can be confident that they are welcomed and social activities are arranged. Dietary needs of the people at the home are well catered for with a balanced and varied selection. EVIDENCE: The social care needs of the people at St Annes are identified in their care plans and the daily records (and activity book) evidence that these needs appear to be being met. Information is included in care planning on family history. Improvements are noted to the records kept on daily life in the home since the inspection on the 7th November 2006. A number of activities at St Annes are available for people to join in with should they so wish. Bingo, quizzes, walks in the garden, exercises and knitting classes are all available. A key board player visits the home weekly to St Anne`s (Holsworthy) DS0000009221.V345520.R01.S.doc Version 5.2 Page 13 entertain everyone. A trip from the home has just recently taken place to Widemouth Bay and this appears to have been enjoyed by all. Regular church services (fortnightly) take place in the home. The mother of the registered provider visits the home regularly and plays the piano. On the day of the inspection she was running a verbal quiz with a number of people joining in. Books are freely available in the home (to include books with large print). Visitors to the people in the home are encouraged and a number of visitors were in the lounge having coffee with their relative on the day of the inspection. The people in the home can entertain their visitors in their own room or if they prefer one of the communal areas which are very spacious. All visitors are asked to sign the visitors’ book which is displayed in the entrance of the home. All the people in the home expressed positive comments on the standard of the meals being provided at the home. A record of the meals provided is in place and a choice is available at all times should someone dislike the main choice. A good breakfast choice is provided. The main meal of the day is served at 1.00pm and on the day of the inspection this was roast lamb with roast potatoes, cauliflower and broccoli cheese, peas and gravy. To be followed by treacle tart and custard. The staff sit with the people during their meal to offer help and support where required and observe that people are eating and enjoying their meal. The kitchen at the home is very spacious and well equipped. The main cook is qualified to the basic food hygiene certificate level and has undertaken “safe training, better quality” training. St Anne`s (Holsworthy) DS0000009221.V345520.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The people at St Annes can be confident that any concerns or complaints are treated seriously and they will be protected from abuse. EVIDENCE: The complaints policy and procedure is included in the service user guide which has been given to each person in the home. It is recommended that in addition to this the home should consider displaying the document in the home for reference. A good practice adult protection policy and procedure is in place to guide staff on safe practice. It is recommended that this documentation is updated to clarify the role of the Adult Social Care Department in protection alerts. The majority of the staff have now undertaken adult protection training and the manager has worked hard to move this forward. St Anne`s (Holsworthy) DS0000009221.V345520.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people at St Annes live in a pleasant, well-maintained home that is comfortable, warm and clean. EVIDENCE: St Annes has been carefully converted from farm buildings into a care home, to a high standard. Corridors are spacious (and in some cases long) as are all the bedrooms and communal areas. The whole building has a pleasant and spacious feel with easy to follow circulation areas and safety features included for the protection of the people living there. Externally and internally the home is very well maintained. St Anne`s (Holsworthy) DS0000009221.V345520.R01.S.doc Version 5.2 Page 16 The registered providers have plans to increase the number of bedrooms at the home by building an extension later in the year. They are fully aware of the requirements of legislation to undertake this task. Part time cleaning staff are employed at the home. The cleaner was spoken to during the course of the inspection. She explained her cleaning routine in that each bedroom is cleaned once per week. The home was found to be very clean on the day of the inspection. The laundry is provided with suitable equipment to meet the washing requirements of the home. St Anne`s (Holsworthy) DS0000009221.V345520.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The people at St Annes are cared for by capable and kind staff who receive regular training. Recruitment procedures must be thorough to ensure that people are not placed at risk at any time. EVIDENCE: On the day of the inspection there were four care staff members on duty. This included one senior carer with medication responsibilities. The cook was on duty and a kitchen assistant, a cleaner and the manager. All staff members are identified on the staff rota. Staff are encouraged to obtain NVQ qualifications and three out of the four carers on duty all had NVQ qualifications. In addition statutory training is taking place to include fire drill training, moving and handling and first aid. Some training that has taken place is not always fully evidenced and the manager has plans to improve the recording system. A discussion took place with the manager on correct recruitment procedures to include a criminal records bureau check, as one staff member was working without this being in place, although it had been sent for. St Anne`s (Holsworthy) DS0000009221.V345520.R01.S.doc Version 5.2 Page 18 All new staff receive induction training which is based on the Skills for Care documentation. The manager has worked hard to get this up and running in the home. The people in the home spoke positively about the staff although they did state there has been a number of staff changes recently which was confirmed by the manager on the day of the inspection. St Anne`s (Holsworthy) DS0000009221.V345520.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The people at St Annes live in a safe home. The management and staff team strive to provide an environment where people are treated with respect. More attention is now required to administration. EVIDENCE: The registered manager has obtained her registered managers award qualification. She is on call at all times when not working in the home. She is available to help with care delivery when required but recently has spent a lot of time in the office to improve administration. She is supported in her duties by the registered providers who are very involved in the running of the home. St Anne`s (Holsworthy) DS0000009221.V345520.R01.S.doc Version 5.2 Page 20 She is also supported by senior care staff who have been given specific responsibilities. It is recommended that the registered providers give consideration to the purchase of a computer and internet access for the management and staff. This would allow them to access good practice information and possibly improve systems generally. There has been no quality assurance/monitoring taken place at the home. This was identified in the inspection report of the 7th November 2006. Staff meetings are taking place at the home and the minutes are available to all to read. The people in the home are encouraged to undertake responsibility for their finances. This information is provided in the statement of purpose. There is no documented staff supervision taking place in the home at this time. This was discussed in detail with the manager with suggestions made as to how this can be evidenced. Health and safety policies and procedures are in place with staff members having specific responsibilities for these duties. St Anne`s (Holsworthy) DS0000009221.V345520.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 x 3 x 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 Standard No Score 16 2 17 x 18 2 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 1 x 3 1 x 3 St Anne`s (Holsworthy) DS0000009221.V345520.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 OP33 Regulation 24 Requirement The registered person shall establish and maintain a system for reviewing and improving the quality of care provided at the care home. The registered person shall ensure that persons working at the care home are appropriately supervised. Timescale for action 31/10/07 2. OP36 18(2) 31/10/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 4. Refer to Standard OP7 OP8 OP16 OP18 OP33 Good Practice Recommendations To update any old original care plans and improve the content of some of the daily records. To weigh the people at the home regularly to ensure that their nutritional needs are being met. To display the complaints policy and procedure in the home. To update the adult protection policy and procedure to ensure that correct procedures are at all times followed. An objective assessment of the homes effectiveness and DS0000009221.V345520.R01.S.doc Version 5.2 Page 23 St Anne`s (Holsworthy) quaility should be undertaken. The registered providers may find it beneficial to seek advice from a consultant regarding this. 5. OP36 To continue to develop and commence formal staff supervision. 9. OP27 To review the staffing levels at the home to ensure that the care needs of the service users are being met at all times. To ensure that correct recruitment procedures are in place at all times. To ensure that all training is evidenced at all times. 10. 11. OP29 OP30 St Anne`s (Holsworthy) DS0000009221.V345520.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Devon Area 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 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!