Inspection on 22/06/05 for St Anne`s Residential Home

This inspection was carried out on 22nd June 2005.

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 Residential Home 16/05/08

St Anne`s Residential Home 17/05/07

St Anne`s Residential Home 20/11/06

St Anne`s Residential Home 15/11/05

St Anne`s Residential Home 18/01/05

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

CARE HOMES FOR OLDER PEOPLE St Annes Clifton Deddington Banbury OX15 0PA Lead Inspector Philippa MacMahon Announced 22 June 2005 nd The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. St Annes H57_H08_S62413_St Annes_V225485_220605_Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service St Annes Address Clifton Deddington Banbury OX15 0PA 01869 338295 01869 337752 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Prashant Brahmbhatt Heike Milner Care Home (CRH) 22 Category(ies) of Dementia - over 65 years of age (DE(E)) 22 registration, with number of places St Annes H57_H08_S62413_St Annes_V225485_220605_Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: St Anne’s care home is situated in the village of Clifton, near Deddington on the edge of the Cotswolds. The property is a most attractive old stone built cottage, which has been extended. St Anne’s was first registered as a care home in 1987 and is today home to 21 older people who suffer from forms of memory loss, Alzheimer’s and other types of dementia. Accommodation is provided in single and double rooms on two floors. All rooms have en-suite facilities. The communal spaces are well laid out and provide comfortable homely areas for all to enjoy. The grounds are most attractive and have a walk way which service users are able access and is a safe secure area St Annes H57_H08_S62413_St Annes_V225485_220605_Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection and the first since a change of ownership had taken place. The inspector spent a lot of time talking to the registered manager, Registered provider and his co-director, staff members, visiting health care professionals, residents and relatives. Examination of records, the medication system, care plans, and general observation of the running of the home were undertaken. The inspector received 15 Relatives/Visitors comment cards provided by the commission for social care inspection. Inspection of the environment was not carried out on this occasion however the inspector was able to observe that all areas of the home were cleaned to a high standard. At the time of this inspection the home was busy with the residents going about their daily activities. What the service does well: The group of people living at St Anne’s have special care needs, and the staff are skilled in meeting these. A relative commented “I am entirely happy with my mothers care, she appears happy, treated very well, her privacy is respected, she is well nourished, and is very safe.” Another commented, “I think the care and support received has been first rate. I think St Anne’s is a wonderful place!” There is a very homely feel, and the residents are the focus of the service provided. Family and friends are always made very welcome. St Annes H57_H08_S62413_St Annes_V225485_220605_Stage 4.doc Version 1.40 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 Annes H57_H08_S62413_St Annes_V225485_220605_Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection St Annes H57_H08_S62413_St Annes_V225485_220605_Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 All residents at St Anne’s have a pre-admission assessment carried out which identifies the care needs of the individual. EVIDENCE: The registered manager carries out all pre-admission assessments and these assessments were found in the care plans, and formed the basis of the care plan development. The registered manager is looking to making changes to the assessment form to make it easier to use. St Annes H57_H08_S62413_St Annes_V225485_220605_Stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9, Every resident has a care plan in which their care needs are identified, and the action required to meet those needs. The resident’s health care needs overall being met, with the exception of measuring the nutritional status, and a recommendation can be found in the appropriate section within this document. None of the service users is able to administer their own medication due to their continuing condition. The medication systems within the home need to be reviewed in the light of the evidence found by the inspector, to ensure the safe administration of medicines occurs at all times. A statutory requirement has been made and is listed in the appropriate section within this document. EVIDENCE: The inspector examined a sample of care plans and found them to be clear, up to date, and gave a good picture of the individuals care needs and how these would be met. Relatives and significant others help to develop the plans as the residents are not able to due to there continuing condition. St Annes H57_H08_S62413_St Annes_V225485_220605_Stage 4.doc Version 1.40 Page 10 The inspector met with the District Nurse who visits the home on a weekly basis, and she is satisfied that the care provided is of a good standard and that the residents are well looked after in all respects. The registered manager requested a continence assessment for individual residents and the District Nurses have completed this and appropriate action has been taken by the home in meeting needs of the individual residents. There is a very open communication between the staff, the Community nursing service and GP, and the care staff are very good at carrying out instructions. The District Nurse is keen to provide training to the staff to ensure that the care delivery is maintained. The residents are able to access the attractive grounds, and the inspector observed a number taking a walk during the inspection. The registered manager has arranged for an external organisation to provide physical activity classes, appropriate to the residents needs, once a month. There is no evidence of nutritional screening taking place and the inspector recommends that the registered manager should look into using the Malnutrition Universal Screening Tool “MUST” that is being implemented across Oxfordshire at the present time. The inspector examined the medication systems within the home and overall found them to be in good order, and supported by appropriate policies and procedures. However examination of the medicines administration record showed that there had been a change made to the original instruction in that the dose had been changed by the registered manager and not countersigned by the GP, The label on the medication showed the original dose. An immediate requirement was made and this is listed in the appropriate place within this report. There were a number of occasions when the medicines administration record showed that medication had not been given, with no reason identified. This is not in accordance with the British Pharmaceutical Societies guidelines for care homes, and a requirement is listed within this report. St Annes H57_H08_S62413_St Annes_V225485_220605_Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) The inspector did not make a judgement about this outcome as none of the outcomes were inspected. EVIDENCE: None of these standards were assessed on this occasion. St Annes H57_H08_S62413_St Annes_V225485_220605_Stage 4.doc Version 1.40 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) The inspector did not make a judgement about this outcome as none of the outcomes were inspected. EVIDENCE: None of these standards were assessed on this occasion. St Annes H57_H08_S62413_St Annes_V225485_220605_Stage 4.doc Version 1.40 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) The inspector did not make a judgement about this outcome as none of the outcomes were inspected. EVIDENCE: None of these standards were assessed on this occasion. St Annes H57_H08_S62413_St Annes_V225485_220605_Stage 4.doc Version 1.40 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 That the staffing levels and skill mix are appropriate to the care needs of the residents. EVIDENCE: The staff roster was examined and showed that the appropriate number and skill mix of staff were on duty at all times. St Annes H57_H08_S62413_St Annes_V225485_220605_Stage 4.doc Version 1.40 Page 15 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,38 Given the huge change that has occurred in the change of ownership and management of the home, it is well managed and there is good support from the registered provider. Safe working practices are in place. It is commendable that the home has appointed a care assistant to be fire marshal who is a volunteer retained fire officer outside her working hours at the home. St Annes H57_H08_S62413_St Annes_V225485_220605_Stage 4.doc Version 1.40 Page 16 EVIDENCE: Discussion with the registered manager, the Registered Provider and his co director, about the changes within the home and future development revealed that the registered manager is being offered a position within the group of homes as training co-ordinator. The directors have realised the need for a manager with a nursing background in caring for the group of people living at St Anne’s, and are actively recruiting at the present time. Discussion with individual staff members revealed that there are some difficulties in communication between the care assistants and the registered manager, but these have improved recently. The staff realise that it is very difficult to accept change when they have worked at the home for so many years with the previous owner/registered manager, who set very high standards. The staffs appreciate the weekly visits by the Registered Provider, and know that they can talk to him at any time. All the records required by regulation were examined and found to be in good order. All staff receive training in fire safety, moving and handling, and food handling. One of the care staff is a retained fire officer at the local fire station, and is the appointed Fire Marshall and trainer. There is a qualified appointed person for first aid on each shift. The registered manager recently attended a course on infection control within the care home setting. Laundry of bed linen has been contracted out, and only personal laundry is handled at the home. St Annes H57_H08_S62413_St Annes_V225485_220605_Stage 4.doc Version 1.40 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 3 3 x x x x x 4 St Annes H57_H08_S62413_St Annes_V225485_220605_Stage 4.doc Version 1.40 Page 18 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 9 Regulation 13(2) Requirement It is a requirement that the medication administration record must not changed by the staff unless it is countersigned by a GP within 24 hours. It is further required that where an omission code of O is used on the record that an explanation must be incerted of why a dose was not given. Timescale for action Immediate RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 8.9 Good Practice Recommendations It is recommended that the Registered Manager should look into using the Malnutrition Universal Screening Tool “MUST” that is being implemented across Oxfordshire at the present time. St Annes H57_H08_S62413_St Annes_V225485_220605_Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Burgner House 4630 Kingsgate 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 Annes H57_H08_S62413_St Annes_V225485_220605_Stage 4.doc Version 1.40 Page 20 - 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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