Inspection on 30/04/07 for St Anne`s, Saltash

This inspection was carried out on 30th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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, Saltash 26/01/06

St Anne`s, Saltash 23/08/05

St Anne`s, Saltash 03/02/05

St Anne`s, Saltash 03/06/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE St Annes Plougastel Drive Callington Road Saltash Cornwall PL12 6DX Lead Inspector Mike Dennis Unannounced Inspection 30th April 2007 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 Annes DS0000009223.V335617.R02.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 Annes DS0000009223.V335617.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Annes Address Plougastel Drive Callington Road Saltash Cornwall PL12 6DX 01752 847001 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) sharon.blackwell@anchor.org Anchor Trust Mrs Georgina Mary Shiers Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33), Physical disability (3), Physical disability of places over 65 years of age (5) St Annes DS0000009223.V335617.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Service users to include up to 5 adults aged over 65 with a physical disability (PD[E]) Service users to include up to 3 adults aged over 50 years with a physical disability (PD) Service users to include up to 33 adults of old age (OP) Total number of service users not to exceed a maximum of 33 Date of last inspection 26th January 2006 Brief Description of the Service: St Annes is a purpose built home belonging to the Anchor Trust Housing Association. It provides care and accommodation for elderly people in individual rooms that are equipped to promote independence; whilst offering communal facilities, meals and activities. It is situated in a central residential area of Saltash, next to the Health Centre, library and leisure centre. Whilst too far for most service users to walk to the main shopping street in Saltash, there are small local shops and facilities near by. The home is next to a road with public transport services. St Annes DS0000009223.V335617.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 30th.April and the 1st. May 2007 over a 10 hour period of time. We met with the Registered Manager, staff on duty and a number of service users. During the course of the inspection we observed the service users being attended to by staff in a courteous and professional manner. We spoke with and case tracked 3 service users. They all confirmed that St.Annes was their chosen home. All three were united in saying that they were perfectly content with the services provided and could not think of anywhere else that they would rather be except for back in their own homes. They told us that they were well cared for by both the registered manager and staff alike. Their privacy and dignity was respected at all times. (this was observed to be the case throughout the inspection). They all complimented the food provided and stated that alternatives are provided as required. Each service user was asked if they were happy with their lifestyle. A common theme emerged. They told us that visitors were welcomed and that they had frequent contact with friends and relatives, who would often take them out. They stated that the staff also provided opportunities for outings, activities and interests. An activities co-ordinator is employed and daily events are publicised on a notice board. Based on observation and comments made, service users do not spend large amounts of time sitting in the communal lounge. They prefer the privacy of their own rooms where they entertain visiting guests or friends made within the home itself. Meal times and attendance of activities appear to be the main social gathering points. Those spoken with all seemed to have an interest to occupy their time. They were unanimous in stating that they felt safe at this home. All three were aware of the complaints procedure should the need arise to use it. They stated that the care they received was of a high standard. They further commented that the registered manager and staff were quick to access other health professionals when the need arose. Service users informed the inspector that their expectations of being in a care home were being fully met. They expressed satisfaction with all aspects of the home. We inspected various records, policies and procedures and found them all to be of a satisfactory standard and in compliance with the regulations. The premises were seen to be clean, tidy and well furbished. St Annes DS0000009223.V335617.R02.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: No requirements nor specific recommendations are made in response to this inspection. St Annes DS0000009223.V335617.R02.S.doc Version 5.2 Page 7 In discussion with the registered manager, she feels that group stimulation is of a very high standard. Individual stimulation is good but she feels there is still room for improvement. 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 Annes DS0000009223.V335617.R02.S.doc Version 5.2 Page 8 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 Annes DS0000009223.V335617.R02.S.doc Version 5.2 Page 9 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, 2, 3, 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information concerning the home is made available. Service users are fully assessed prior to admission to the home. Prospective service users and relatives are afforded the opportunity to visit the home to assess it’s suitability as to meeting their needs. This home does not provide Intermediate Care EVIDENCE: Up to date Statements of Purpose and Service User Guides were readily available. Service users confirmed a knowledge of these documents. St Annes DS0000009223.V335617.R02.S.doc Version 5.2 Page 10 Three service user files were inspected and case tracked. All contained information pertaining to pre-admission assessment and copies of contracts etc. The registered manager visits prospective service users prior to admission to complete the assessment process. The process will include information received from other agencies to assist in appropriate admissions to the home. Prospective service users are invited to see the home and are involved in the completion of the dependency assessment documents. They are asked to complete a comprehensive questionnaire/check list entitled “Is this home right for me”. The management team at the home ensure the published inspection reports are available to service users, visitors and discussed at staff meetings. Policy documents indicate that prospective service users can visit the home before making the decision to move in. Standard 6 is not applicable as the home does not provide intermediate care. St Annes DS0000009223.V335617.R02.S.doc Version 5.2 Page 11 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, 8,9,10, 11. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The health care needs of service users are identified, planned for and met. Service users are treated with dignity and respect. The standard of care planning set is high and is being maintained. Medication administration is followed in accordance to policies and procedures. End of life care is seen as important. EVIDENCE: St Annes DS0000009223.V335617.R02.S.doc Version 5.2 Page 12 From inspection of documentation it was evident that individual care needs are identified appropriately. From inspection of service users files, and in discussions it is evident that St. Annes encourages service users and their representatives to express their views in the formation of their care plans. The care plan specifies what actions staff should take to ensure that the care need is approached in a consistent manner. New care plan documentation is being introduced at this home which details all care required and given, in detail. It requires that all staff have to be involved by way of observing and recording the daily life, care and requirements of each service user. Daily evaluations are made and recorded. This provides a good trail of events and lifestyle. ‘Alert’ sheets are generated as necessary as part of the process. Health needs are met by the staff at the home and by external professionals to a high standard. Records of all health professional visits are recorded in detail. Staff were observed to treat service users with respect and it was noted that staff knocked at bathroom and bedroom doors before entering. General practitioners examine and treat all service users in the privacy of their own bedrooms. Medication practices are conducted appropriately. Records are up to date. We inspected the ‘controlled drugs’. An audit was undertaken and found to be correct. The quantities of drugs held were confirmed by the controlled drugs register. End of life care is given a high priority. Staff complete a four month (3 day a week) training course to equip them with the necessary skills to manage this sensitive and difficult time in peoples lives. It is reported that good links exist between the home and McMillan nurses. St Annes DS0000009223.V335617.R02.S.doc Version 5.2 Page 13 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, 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The routines of daily living and activities made available are flexible and varied. Service users are in control over their lives. Service users receive visitors at any reasonable time throughout the day Service users dietary needs are well catered for with a balanced and varied selection of food and drink available that meets tastes, and choices. EVIDENCE: The routines of daily living within the home appear to be flexible to suit individual preferences. The home will offer various activities including trips out. Staff were observed to be interacting with service users throughout both days of the inspection whilst being engaged in various activities and interests. A full daily program of events is publicised. Service users do mix in communal areas but many prefer to stay in their rooms, entertaining friends within the St Annes DS0000009223.V335617.R02.S.doc Version 5.2 Page 14 home and outside visitors. Those spoken with claimed to be quite satisfied with their general routines, which included personal interests and hobbies. A good rapport with staff exists. The visitors book indicated that a steady stream of visitors attend the home. This was also evidenced by the number of visitors present on the day of inspection. Service users are able to make informed decisions regarding their lifestyle, supported by staff as required. Service users appear to receive a varied, appealing and nutritious diet suited to individual needs, likes and requirements. The meal looked appetising and service users were seen to be enjoying it in a social manner. Portions were of a good size and suited to the individual. The majority of service users took lunch in the dining room at one of the two sittings. Special diets are catered for and choices are available. Hot and cold drinks are offered and available throughout night and day. We had long conversations with service users and their comments are detailed in the summary of this report. St Annes DS0000009223.V335617.R02.S.doc Version 5.2 Page 15 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 good. This judgement has been made using available evidence including a visit to this service. The complaints procedure is well publicised and would be used when required. The registered persons ensure that service users are protected from all forms of abuse with staff having knowledge through training of Adult Protection issues which helps to protect service users. EVIDENCE: The complaints procedure containing the Commissions contact number and address was displayed in the home and is detailed in the service users guide. The registered manager and staff ensure that day-to-day control and regular contact with service users provided the opportunity to monitor standards. The registered manager has provided appropriate ‘Protection’ policy, staff training and procedures. Many staff have also received adult abuse training to B.Tec. standards. There is a policy regarding staff accepting gifts from service users and precluding staff involvement in the making or benefiting from service users wills. The homes insurance provides for service users to make claims on personal items and for public liability. The home provides appropriate records regarding finances and items held on behalf of service users. St Annes DS0000009223.V335617.R02.S.doc Version 5.2 Page 16 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): 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. The location and layout of the home is suitable for it’s stated purpose and provides a safe and well maintained environment. Suitable equipment is provided to meet service users needs. Bedrooms are well furnished and contain their occupants personal affects. The home was clean, hygienic and free from offensive odours providing an attractive and homely place to live. EVIDENCE: St Annes DS0000009223.V335617.R02.S.doc Version 5.2 Page 17 The location and design of the home is good, situated near some of the town’s facilities and on a level site. The home offers level access, a passenger lift, specialist bathing equipment, pressure relieving equipment, call bell system, moving and handling aids and a variety of grab rails are provided. There are en suite bedrooms with showers in all rooms with additional assisted bathing facilities and toilets as well. Since the last inspection 5 additional bedrooms with en suite facilities and a bathroom with specialist assisted bathing equipment has been added. The communal spaces are well maintained and furnished. There is a wellmaintained garden for use in good weather and an upstairs vantage point where service users like to sit and observe the ‘outside world’. Service users informed us that they considered their accommodation to be of a high standard Rooms have been refurbished throughout the past 2 years and all heat control valves have been replaced. General maintenance is ongoing. The home presented as being very clean, hygienic and well cared for. St Annes DS0000009223.V335617.R02.S.doc Version 5.2 Page 18 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, 29, 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Recruitment policies and procedures are implemented. All staff are supported and Inducted through training opportunities. A positive number of staff are on duty to meet the service user’s needs. EVIDENCE: The staff rota indicates that there are at least one team leader plus 4 care assistants on duty throughout each day. These staff are supported by the manager, her two deputies, activity co-ordinator, catering, housekeeping and laundry staff. At night there is a team leader and care assistant on duty. The registered manager has a commitment to providing a trained workforce and individual staff files contain training schedules, 80 of staff have achieved an NVQ level 2 and above. Staff training has also been achieved in food hygiene, moving and handling, first aid, infection control, health and safety and associated topics to provide for the welfare of service users. The induction records for individual staff are signed and dated. There is a stable staff team that presents a low sickness record or staff turnover. St Annes DS0000009223.V335617.R02.S.doc Version 5.2 Page 19 Recruitment procedures were inspected. It was seen that all staff complete application forms, have interviews, references and CRB/POVA checks sourced. The staff spoken to were observed to exhibit appropriate attitudes in their interactions with service users and a positive regard for service users welfare. St Annes DS0000009223.V335617.R02.S.doc Version 5.2 Page 20 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, 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. The management and staff of St. Annes strive to maintain and improve a good quality of care and lifestyle for the service users and promote their health, safety and welfare. EVIDENCE: St Annes DS0000009223.V335617.R02.S.doc Version 5.2 Page 21 The registered manager has appropriate experience and has completed the Registered Managers Award. She is also an NVQ assessor and verifier with seven years experience in this role. The registered manager and the management team are continuing to develop the processes at the home to comply with good practice, standards and regulations. When changes are made to daily routines etc., the service users are consulted. St. Annes is one of a group of care homes owned by Anchor Housing and is supported by appropriate policy and administrative systems. A senior manager visits the home to provide independent monthly reports on the conduct of the home. Quality assurance and quality monitoring systems are implemented. The homes policies and procedures have all recently been updated. Written records are kept of all financial transactions. Service users manage their own finances. The registered providers maintain the health, safety and welfare of service users through implementation of policies and procedures. Records required by legislation are kept. A good rapport exists between management, staff and service users. Supervision of staff is undertaken and appropriately recorded. St Annes DS0000009223.V335617.R02.S.doc Version 5.2 Page 22 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 4 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 4 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 4 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 3 3 St Annes DS0000009223.V335617.R02.S.doc Version 5.2 Page 23 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 Annes DS0000009223.V335617.R02.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Devon Office Unit D1 Linhay Business Park Ashburton Devon 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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