CARE HOMES FOR OLDER PEOPLE
St Annes Court St Anthonys Road Meyrick Park Bournemouth Dorset BH2 6PD Lead Inspector
Carole Payne Unannounced Inspection 19th January 2007 09:10 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 Court DS0000003983.V327269.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 Annes Court DS0000003983.V327269.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service St Annes Court Address St Anthonys Road Meyrick Park Bournemouth Dorset BH2 6PD 01202 551208 01202 551551 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Ian Billington Mrs Pamela Billington Miss Amanda Billington Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places St Annes Court DS0000003983.V327269.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 5th January 2006 Brief Description of the Service: St Annes Court is situated in a pleasant residential area of Bournemouth. The property backs onto Meyrick park and is a short drive from the town centre facilities. St Annes Court is registered to provide care and accommodation for up to 26 older people, nursing care is not provided although arrangements can be made through the community nursing services and GPs for those requiring some nursing or medical support. There are 20 single rooms and 3 double rooms on ground and first floor levels, all have en-suite facilities. A stair lift and passenger lift provide access between floors. A pleasant lounge area overlooks mature, well-maintained gardens, which are accessible to residents, and off road parking is provided to the front of the house although parking on the driveway is discouraged in order that the outlook from some residents rooms is not obscured. Roadside parking is permitted outside the home on St Anthonys Road. Current fees are £520 to £640. See the following website for further guidance on fees and contracts: http:/www.csci.org.uk/about_csci/press_releases/better_advice_for_peop le_choos.aspx St Annes Court DS0000003983.V327269.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The unannounced inspection was carried out on the 19th January 2007 and took a total of 10 hours, including time spent in planning the visit. The inspector was made to feel welcome in the home during the visit. This was a statutory inspection and was carried out to ensure that the twenty-three residents who are living at St Anne’s Court are safe and properly cared for. Requirements and recommendations made as a result of the last inspection visit and key standards met at the last inspection on 5th January 2006 were also reviewed. The premises were inspected, records examined and the daily routine observed. Time was spent in discussion with seven residents living in the home and three staff members on duty. Nineteen resident survey forms were received by the Commission for Social Care Inspection prior to the visit; seven comment cards from health and social care professionals who visit the home; twenty four relative / visitors’ comment cards and eighteen comment cards from General Practitioners. The home also returned a detailed pre-inspection questionnaire prior to the visit. Throughout the inspection and following the visit the management and staff team have demonstrated a positive and proactive commitment to addressing any issues raised and continuously improving the quality of life for people living at St Anne’s Court. What the service does well:
The high number of comment cards and survey forms received from people involved with the life of St Anne’s Court reflects the immense esteem and regard in which the service is held both by external health and social care professionals, relatives and friends and the people who live at the home. Comments from General Practitioners (GPs) included: ‘Highly commended.’ ‘Of all the care homes I have visited I believe that St Anne’s Court is one of the best in all areas of service and accommodation. I would have no hesitation in recommending it to anyone.’ ‘Clean, happy and lovely home.’ ‘Quality of service of a high level.’ St Annes Court DS0000003983.V327269.R01.S.doc Version 5.2 Page 6 Relatives / visitors to the home said: ‘Feel lucky to have found such a good home.’ ‘Nothing is too much trouble.’ ‘Staff are always smiling.’ Detailed pre-admission assessments ensure that no resident moves into the home without having their needs properly assessed. Residents say that the varied social opportunities arranged by the home meet with their social needs and provide an enjoyable quality of life. Families and friends are made welcome and feel that they are part of the life of the home, supporting residents to continue to enjoy and experience relationships that are meaningful to them. Relatives / visitors said ‘It is a pleasure to visit.’ ‘We visit and have lunch in the dining room.’ ’Wonderful home.’ ‘The friendly welcome shown for me is exemplary.’ Residents at St Anne’s Court are enabled to exercise choices and autonomy in their daily lives. A varied and nutritious menu provides residents with appetising meals, which are served in the convivial surroundings of their choice. People who live at St Anne’s Court can be confident that they can raise any issues or concerns they may have and will be listened and responded to. Residents benefit from living in a well maintained environment that is clean, pleasant and hygienic. Satisfactory staffing levels are maintained, ensuring that residents’ needs are satisfactorily met. A well-trained and conscientious staff team ensure that residents are safely cared for. Residents’ benefit from living in a well managed home. The manager is suitably qualified to carry out her responsibilities and demonstrates care and compassion in carrying out her duties. This is reflected in the commitment of staff members and the quality of life experienced by residents. The home is enhancing its quality assurance system to ensure that the home is run in the best interests of people living in the home. Residents’ financial interests are suitably safeguarded by the home. St Annes Court DS0000003983.V327269.R01.S.doc Version 5.2 Page 7 Good practice ensures that the health and safety of residents is suitably safeguarded at the home. What has improved since the last inspection? What they could do better:
It is recognised that the home has already responded in terms of action to address the issues detailed below, which reflects the proactive commitment of the service to meet residents’ needs. There must be confirmation in writing to the service user that having regard to the assessment the care home is suitable for the purpose of meeting the service user’s needs in respect of his health and welfare. Up to date moving and handling care plans must be available, to ensure the safety of residents. Where a resident is in receipt of wound care from a district nursing service it must be ensured that a care plan is in place detailing how the wound site is to be managed to ensure the integrity of the wound site. This requirement was not reviewed at this inspection. Medicines must be administered from the original packaging and may be placed into a pot for the purpose of handing to the resident; all medicines must be checked against the Medication Administration Record (MAR) chart and once administered the individual MAR chart must be signed. The reason for omission of any medication must be recorded.
St Annes Court DS0000003983.V327269.R01.S.doc Version 5.2 Page 8 The MAR charts must be signed to confirm that the medicine has been checked against the MAR chart on entering the home. The person checking the medication and the staff member verifying the entry must sign handwritten entries on the MAR charts. It is recommended that regular training be organised in the protection of residents from abuse, supporting the safety of people living in the home. Full satisfactory recruitment checks must be made. Applicants must not start work until two written references have been received. A check of the Protection of Vulnerable Adult’s register must be completed. Following receipt of a satisfactory check the member of staff may work under supervision in accordance with the Department of Health’s Protection of Vulnerable Adult’s guidelines until a Criminal Records Bureau check is received. 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 Court DS0000003983.V327269.R01.S.doc Version 5.2 Page 9 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 Court DS0000003983.V327269.R01.S.doc Version 5.2 Page 10 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): 3, 4 & 5 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Detailed pre-admission assessments ensure that no resident moves into the home without having their needs properly assessed. Written confirmation with the resident or their representative that, according to the assessment, the home is able to meet a prospective resident’s needs will support the service to reassure people that the home is able to cater for their needs. EVIDENCE: One resident who had recently moved into the home said that they were very happy with the service and had made ‘the right decision’ to move in. Another resident explained how difficult it was to give up a home, but said that they had ‘never regretted ’ taking the decision to move in.
St Annes Court DS0000003983.V327269.R01.S.doc Version 5.2 Page 11 Pre-admission assessments were viewed for two residents who had recently moved into the home. Full details regarding the person’s medical, social and personal history were recorded to enable the manager, or the deputy, completing the assessment to make an appropriate decision as to whether the home was able to meet the prospective residents’ needs. One resident returning a survey form said that they had seen a brochure and had a come for a trial stay and had then decided that St Anne’s Court was the right place for them to live. The home does not currently send a letter to the resident, or their representative, prior to moving in, confirming that, according to the assessment, the home is able to meet the person’s needs. It is also advised that the pre-admission assessment includes details of the people contributing to the completion of the assessment. A relative spoken with said that they had had the opportunity to come and look around the home and were in no doubt that ‘St Anne’s Court was the best home we saw.’ They said that they had been made very ‘welcome’ at the service. St Annes Court DS0000003983.V327269.R01.S.doc Version 5.2 Page 12 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The service has made progress in producing very clear care plans, which describe how residents’ personal and social needs are to be met. Up to date assessments and care plans for moving residents safely will ensure that care planning meets residents’ healthcare needs. Procedures for the administration of medicines at the time of the visit were poor. However the home has already been in contact with the Commission for Social Care Inspection since the visit stating that steps have been taken to ensure that procedures are adequate and safe. St Annes Court DS0000003983.V327269.R01.S.doc Version 5.2 Page 13 EVIDENCE: Care plans were viewed for three people living at the service. Assessments, including specific risk assessments are completed, which inform the development of a care plan, setting out clearly how people’s needs are to be met. The care plans were written concisely, providing helpful support to staff members carrying out care and support. The care plans had been updated monthly. However care records, including assessments and care plans, for two residents who require hoisting were not up to date and did not detail the person’s current manual handling needs, which incorporated the use of a hoist for some or all transfers. The deputy manager confirmed that both the relevant assessments and care plans would be immediately updated and a copy of the care plan for one resident has been forwarded to the Commission for Social Care Inspection since the visit. Seven residents responding in a survey form said that they always receive the care and support that they need. One said that this was usually the case. One resident said that they received such care ‘day and night.’ One resident said ‘they help me every day with washing and dressing…I love my bath.’ Assessments completed referred to residents’ healthcare needs. This includes a nutritional assessment. Records seen included reference to consultation with external healthcare professionals where necessary, including district nurses and an occupational therapist. Eleven residents responding in a survey form said that they always receive the medical support that they need, nine said that this was usually the case, one person said that this was because they never need to see a doctor. All eighteen General Practitioner comment cards said that they are satisfied with the overall care provided by the home. All, where applicable, said that if they give any specialist advice it is incorporated into the care plan. One General Practitioner said the care is’ very good.’ There was a requirement in the last report that where a resident is in receipt of wound care from a district nursing service, it must be ensured that a care plan is in place detailing for staff how the wound site is to be managed and to ensure the integrity of the wound site. Although a relevant care plan was not seen on this occasion, the manager has confirmed that should a care plan be required it will be ensured that it is in place. The supply of medicines received by the home from the pharmacy had not been checked in and signed by the staff member receiving the medication for two residents. Since the visit the home has forwarded copies of the Medication Administration Records (MAR) charts, which have now been signed by the staff member receiving the medicines. It is important that, in future, this is completed at the point of receipt. St Annes Court DS0000003983.V327269.R01.S.doc Version 5.2 Page 14 At the time of the visit medication was being put into pots, the medicines were signed for on the Medication Administration Records and then the medicines were taken in the pots and given to residents. If there is a problem, and for any reason the resident did not take the medication, the Medication Administration Record was amended. The home’s method of administering the medicines is used to ensure that medicines are given discreetly, preserving respect for the dignity of residents. However, it is important that medicines are given to one resident at a time, and that the Medication Administration Record is then signed for one resident at a time and when medicines may have been omitted it must be recorded at the time, together with the reason for the omission. Medication Administration Records must not be signed prior to the administration of medicines. Medicines must be administered in accordance with the Royal Pharmaceutical Guidelines for the Administration and Control of Medicines in Care Homes and Children’s Services.’ Medicines may only be put into a pot for the purpose of ‘handing it to the service user.’ The MAR chart and the pharmacy labels must be checked to ensure that they correspond and the person administering the medicine must sign the MAR chart for the individual resident immediately after administration. The home has responded expediently to this issue and amended the policy for administration of medication. The policy has been forwarded to the pharmacist inspector for any further advice on inclusions. One medicine had been received and a handwritten entry had been made on the Medication Administration Record. The staff member receiving the medicine and the staff member verifying the details had not signed this. At the time of the visit allergies or ‘none known’ had not been recorded on the MAR charts. The manager has confirmed that this has now been carried out. A completed risk assessment for the self – administration of medication was seen at the time of the inspection. A risk assessment for a resident, who had recently moved into the home, had not been completed. This has been confirmed as being in place following the inspection visit. Eye drops seen had been appropriately dated when they had a limited life on opening. The home does not currently have any controlled drugs and the deputy manager said that there were currently no residents taking medicines, which require refrigeration. Throughout the visit staff members were observed treating residents with great care and respect. A health and social care professional responding in a comment card said that staff members are ‘very caring towards each of their residents.’ A relative / visitor said that ‘staff are always polite and helpful.’ Residents are ‘given affection and care.’ Whenever residents approached any staff member they were responded to with smiles; requests for cups of tea, help with getting about the home and assistance at lunchtime, were responded
St Annes Court DS0000003983.V327269.R01.S.doc Version 5.2 Page 15 to companionably and helpfully. The home’s induction programme includes reference to the core values of care practice, including protecting people’s dignity. Staff members knock on residents’ doors before entering their rooms and introduced the inspector to residents. All General Practitioners returning questionnaires said that they are able to see residents in private. St Annes Court DS0000003983.V327269.R01.S.doc Version 5.2 Page 16 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. Residents say that the varied social opportunities arranged by the home meet with their social needs and provide an enjoyable quality of life. Families and friends are made welcome and feel that they are part of the life of the home, supporting residents to continue to enjoy and experience relationships that are meaningful to them. Residents at St Anne’s Court are enabled to exercise choices and autonomy in their daily lives. A varied and nutritious menu provides residents with appetising meals, which are served at times, that are convenient surroundings in the convivial surroundings of their choice. St Annes Court DS0000003983.V327269.R01.S.doc Version 5.2 Page 17 EVIDENCE: Five residents responding in survey forms said that there are always activities that they can take part in. Residents said ‘Enjoy all of it. It pleases us.’ ‘Makes a change to routine.’ ‘ I like my own company and peace and quiet but I know the others like going and they say it is always nice.’ ‘Sherry parties, bingo and quizzes are the ones I like.’ One resident said ‘I really enjoy my life here. It was the best decision I could have made.’ Eight residents said that they always like the activities, seven said usually and five said sometimes; three said that there were reasons of choice why they do not wish to participate. The preinspection questionnaire returned by the home detailed other social opportunities available to residents including musical events, parties, fundraising and extend. The home has a welfare officer who works for two and a half hours each week. The manager confirmed that it is hoped that these hours can be extended in the future. Twenty-four relative / visitor comment cards were returned. All said that they feel welcome in the home at any time. People said ‘It is a pleasure to visit them.’ ‘We visit and have lunch in the dining room.’ ’Wonderful home.’ ‘It is a pleasure to go there.’ ‘The friendly welcome shown for me is exemplary.’ One relative spoken with during the visit said that staff are always welcoming and offer a cup of tea. One relative / visitor to the home said on a comment card that they are always offered ‘tea and cake.’ They said that they feel confident that the home contacts them if they have any concerns regarding the care of their relative. Residents are offered choices about what they like to do during the day. During the day people living in the home were observed staying in their room and going out, according to their personal preferences. Care plans seen reflected people’s wishes about their daily lives. Lunch on the day of the visit was well presented and appetising. The dining room is attractively furnished and decorated, with tables set out in line with the preferences of residents. Care is taken to details to ensure that residents enjoy a pleasant dining experience in relaxed surroundings. Gentle background music is played alongside the intermittent conversation. Staff members provide discreet and unobtrusive support where needed. One resident spoken with said that they like to eat in the privacy of their own room. They said that the standard of food is very good. The pre-inspection questionnaire states that flexible mealtimes are offered with a varied menu. The cook said that she chats with residents regarding their individual menu choices. Fresh fruit and vegetables were available and fresh fruit is provided in residents’ rooms on request. The cook takes great pride in her work. She said that she very much enjoys coming to work and the pleasure that she gives residents in the standards of food prepared, was evident.
St Annes Court DS0000003983.V327269.R01.S.doc Version 5.2 Page 18 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): 16 & 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People who live at St Anne’s Court can be confident that they can raise any issues or concerns that they may have and these will be listened and responded to. Policies and procedures ensure that residents are protected from abuse. Regular training will support the home’s commitment to ensure the protection of residents living at the service. EVIDENCE: The home has a complaints policy, which is in the service’s Terms and Conditions of residency. All relatives / visitors returning comment cards said that they are aware of the home’s complaints procedure. Twelve residents returning survey forms said that they know who to speak to if they are not happy, nine said that this was usually the case. One resident said any problem ‘has always been dealt with promptly.’ Another resident said that they had ‘not got anything to moan about.’ ’I let the staff know if I am not happy about anything, and they always put it right.’ The pre-inspection questionnaire completed by the home states that there have been no complaints received by the service in the past twelve months.
St Annes Court DS0000003983.V327269.R01.S.doc Version 5.2 Page 19 A member of staff spoken with demonstrated that they had an awareness of what to do should there be an allegation of abuse in the home. The preinspection questionnaire completed by the service confirms that the home has appropriate adult protection policies and procedures in place. Staff members starting work in the home read relevant policies and procedures as part of their induction to the service. Some members of staff had also undertaken adult protection training as part of their study towards National Vocational Qualifications. It is recommended in this report that regular formal adult protection training takes place as part of the home’s routine programme of training. St Annes Court DS0000003983.V327269.R01.S.doc Version 5.2 Page 20 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 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ benefit from living in a well maintained environment that is clean, pleasant and hygienic. EVIDENCE: All areas of the home seen at the time of the visit were maintained to a good standard. Communal areas are tastefully decorated and furnished, offering comfortable living areas including a pleasant dining room. The home benefits from a pleasant garden to the rear of the property, with a patio area, offering a high degree of privacy and seclusion. Individual rooms seen were personalised. The last inspection highlighted concern regarding hot surfaces. No surfaces evidenced during this visit presented a risk of scalding to residents.
St Annes Court DS0000003983.V327269.R01.S.doc Version 5.2 Page 21 Staff members seen during the inspection observed good practices in terms of infection control. Staff members were seen washing their hands and wearing protective equipment according to the tasks being undertaken. There was a recommendation in the last report that there be suitable facilities in place for the cleaning of commode pans. The manager stated that there were no residents at the time of the visit that required the use of a commode. The manager has contacted the Health Promotion Unit as advised and has confirmed that advice will be followed to support safe practice and minimise the risk of cross infection in the future, should a resident need to use a commode. Nineteen people returning survey forms said that the home is always fresh and clean. One resident said ‘First class.’ Another resident said ‘a high standard of decoration and cleanliness.’ One relative / visitor said ‘the management should not lose sight of the ongoing maintenance and modernisation of the property and cleaning schedules.’ Another relative / visitor said the home is ‘always clean.’ The home has undertaken its own survey of residents and has used the feedback to look at how the service can be improved. Laundry arrangements have been highlighted as an area of concern in one resident comment card returned to the Commission for Social Care Inspection. The service is fully committed to improving the systems for laundering and has made enquiries regarding training for staff members. Residents spoken with at the time of the inspection said that they are satisfied with the laundry service. St Annes Court DS0000003983.V327269.R01.S.doc Version 5.2 Page 22 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 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Satisfactory staffing levels are maintained, ensuring that residents’ needs are appropriately met. A well-trained and conscientious staff team ensure that residents are safely cared for. Recruitment practices seen at the time of the inspection were poor. However, the manager has responded expediently and has put in place the necessary checks required in relation to ensuring the safe recruitment of current applicants. EVIDENCE: Rosters seen and staffing levels on the day of the visit reflected that the home ensures that there are sufficient staff members on duty to meet the needs of residents. Since the last inspection an additional member of staff has been recruited to work at night so that there are two awake care staff members working at night. St Annes Court DS0000003983.V327269.R01.S.doc Version 5.2 Page 23 The pre-inspection questionnaire completed confirms that seven members of staff have a National Vocational Qualification in Care (NVQ) at level 2 or above. One member of staff has an NVQ at level 3 and one has an NVQ at level 4. Recruitment practice has been highlighted in a previous recent report issued to the home. At the last inspection the manager demonstrated that she was aware of the checks required. Recruitment records were seen for two members of staff working at the home. There were no written references on file for one member of staff. There was a single note of verbal references taken. Both members of staff had started work prior to the receipt of a satisfactory Criminal Records Bureau check or check of the Protection of Vulnerable Adults register. The staff member could have started work following the receipt of a satisfactory check of the Protection of Vulnerable Adult’s register under supervision. Following the visit the manager has confirmed that proper checks are being taken for a current applicant and that all necessary checks will be undertaken in the future. The manager has also confirmed that the application form has been updated to state that one reference must be from the most recent employer. In addition to this a reference from the most recent employer when the applicant worked with vulnerable adults, if applicable, must be sought. The home has a detailed induction programme. It was advised that it is confirmed that this meets with Skills for Care, the National Training Organisation’s guidelines and that this is stated on the record. The preinspection questionnaire and individual files seen reflected evidence of training undertaken. St Annes Court DS0000003983.V327269.R01.S.doc Version 5.2 Page 24 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 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from living in a well managed home. The manager is suitably qualified to carry out her responsibilities and demonstrates care and compassion in carrying out her duties. This is reflected in the commitment of staff members and the quality of life experienced by residents. The home is enhancing its quality assurance system to ensure that the home is run in the best interests of people living in the home. Residents’ financial interests are suitably safeguarded by the home. Good practice ensures that the health and safety of residents is suitably safeguarded at the home.
St Annes Court DS0000003983.V327269.R01.S.doc Version 5.2 Page 25 EVIDENCE: The manager of the home holds the Registered Manager’s Award. The immense response to questionnaires sent out to people involved with the life of the home reflects the quality of life provided to residents living at St Anne’s Court. People feel confident that they live in a well-managed environment, which they can call home. A General Practitioner comment card, complimented the ‘sensitive management of the home.’ Throughout the visit residents came and chatted with the manager and the deputy and consulted them for advice. One resident said ‘She is the skipper of our ship and she keeps everything on an even keel.’ As well as ensuring that questionnaires and survey forms were sent out to people involved with the life of the service prior to this inspection, the home has undertaken its own survey and has made plans about how the service can be improved. A comments and suggestions box enables people to make comments about the service that they receive. The manager confirmed in writing following the inspection her commitment to continuously improving the quality assurance system, which has been developed. The manager confirmed that no personal monies are held by the home on behalf of residents. The pre-inspection questionnaire completed confirms that regular routine checks take place of the fire systems in the home and the maintenance of facilities and equipment in the home. Staff members receive regular training in aspects of health and safety. St Annes Court DS0000003983.V327269.R01.S.doc Version 5.2 Page 26 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 X X 3 1 3 X HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 1 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 St Annes Court DS0000003983.V327269.R01.S.doc Version 5.2 Page 27 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. Standard OP4 Regulation 14 Requirement The registered person shall not provide accommodation to a service user at the care home unless The registered person has confirmed in writing to the service user that having regard to the assessment the care home is suitable for the purpose of meeting the service user’s needs in respect of his health and welfare. 2. OP7 15 An up to date care plan must be available for staff reference detailing how resident’s needs are to be met and these must be kept under review, on the premises. For the protection of service users and staff, an up to date moving and handling care plan must be available and reviewed regularly. Some progress has been made in meeting this requirement. Previous timescale 31/03/06 not met.
St Annes Court DS0000003983.V327269.R01.S.doc Version 5.2 Page 28 Timescale for action 05/02/07 31/03/07 3. OP9 13 The registered person shall make 31/03/07 arrangements for the recording, handling and safe administration of medicines into the care home 1) Medicines must be administered from the original packaging and may be placed into a pot for the purpose of handing to the resident; all medicines must be checked against the Medication Administration Record and once administered the individual MAR chart must be signed. The reason for omission of any medication must be recorded. 2) The MAR charts must be signed to confirm that the medicine has been checked against the MAR chart on entering the home. 3) The person checking the medication and the staff member verifying the entry must sign handwritten entries on the MAR charts. The registered person shall not employ a person to work at the care home unless Full satisfactory recruitment checks have been made. Applicants must not start work until two written references have been received. A check of the Protection of Vulnerable Adult’s register must be completed. Following receipt of a satisfactory check the member of staff may work under 4. OP29 19 31/03/07 St Annes Court DS0000003983.V327269.R01.S.doc Version 5.2 Page 29 supervision in accordance with the Department of Health’s Protection of Vulnerable Adult’s guidelines until a Criminal Records Bureau check is received. 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 OP18 Good Practice Recommendations It is recommended that regular training is organised in the protection of residents from abuse, supporting the safety of people living in the home. St Annes Court DS0000003983.V327269.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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
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