Inspection on 04/10/05 for St Annes Court

This inspection was carried out on 4th October 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 Annes Court 19/01/07

St Annes Court 05/01/06

St Annes Court 19/11/04

St Annes Court 21/06/04

St Annes Court 09/12/02

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

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 Annes Court St Anthonys Road Meyrick Park Bournemouth BH2 6PD Lead Inspector Jo Palmer Unannounced 04 October 2005 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 Court D55 S3983 St Annes Court V243572 041005 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service St Annes Court Address St Anthonys Road, Meyrick park, Bournemouth, Dorset, BH2 6PD 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) 01202 551208 01202 551551 Mr Ian Billington Mrs Pamela Billington Miss Amanda Billington PC Care Home only 26 Category(ies) of OP - 26 registration, with number of places St Annes Court D55 S3983 St Annes Court V243572 041005 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19 November 2004 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 currently are used for single occupancy and 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 ro residents and off road parking is provided to the front of the house although parking on the driveweay 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. St Annes Court D55 S3983 St Annes Court V243572 041005 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection on 4th October 2005 lasted for two and half hours. Amanda Billington, registered manager, was present, she and the deputy manager assisted with the inspection process. The purpose of this inspection visit was to monitor progress in addressing a requirement and recommendation of the last inspection and to review practices in relation to some of the National Minimum Standards and this inspection concentrated on the outcomes of care and services for residents. The inspector spoke with five residents, one visitor, the manager and the deputy manager and examined relevant records. Registered to accommodate twenty-six residents, twenty-three were accommodated at the time of inspection as three shared rooms are used for single occupancy. What the service does well: Information is available to prospective residents and those living at the home in the form of a Service User Guide that details the aims, objectives and philosophies of St Anne’s Court. Good supplementary information is available in the form of a brochure. Resident’s needs are assessed and care plans are produced detailing how assessed needs are to be met by staff, staff must ensure they have sufficient information about the persons needs prior to their admission to the home. Records evidenced that resident’s health care needs are met by visiting health care professionals; residents confirmed they felt their needs are met and they are able to make their own appointments if able. Residents confirmed that a kind and caring staff group uphold their right to privacy. Although social calendars were not inspected, it was evident through discussion with residents and the manager that there is sufficient stimulation for residents who either enjoy more active social and leisure pursuits and those less able. Family and friends are able to visit at any time and resident’s care records detailed the extent of their involvement, families and friends are being encouraged to visit the home. Residents confirmed that the provision of meals is good. Procedures are in place to ensure that any complaint received will be managed effectively and sensitively, no complaints have been received by the home since the last inspection. Procedures for the protection of residents are in place. Staffing numbers are sufficient and staff training opportunities are good. St Annes Court D55 S3983 St Annes Court V243572 041005 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 Court D55 S3983 St Annes Court V243572 041005 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 Court D55 S3983 St Annes Court V243572 041005 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) 1, 2 & 3. Standard 6 is not applicable. The home’s Statement of Purpose and Service User Guide provide detailed information about the care and services provided at St Anne’s Court. The registered persons must ensure that the admissions process is consistent to enable a thorough assessment of a persons needs prior to admission to establish whether those needs can be met at St Anne’s Court and that the home is a suitable place for the resident to move to. EVIDENCE: Amanda Billington, registered manager confirmed that prospective residents, on enquiry, are sent a copy of the home’s Statement of Purpose, Terms and conditions of residency, a sample menu and the home’s brochure. Once residents come to the home to view, or to move in, a copy of the resident’s handbook is available which contains all relevant information about the care and services provided along with copies of previous inspection reports. A pre-admission assessment form is available on which a persons needs can be recorded prior to their admission to the home. The purpose of this assessment St Annes Court D55 S3983 St Annes Court V243572 041005 Stage 4.doc Version 1.40 Page 9 is for staff to identify a persons needs and establish whether the home is a suitable place in which these needs can be met, prior to the person deciding to move in. Records were examined relating to one person recently admitted to the home; this person had a community care assessment undertaken as part of the single assessment process between the local authority and primary care trust. Where a person is admitted under care management arrangements and has a community based assessment, there is no requirement for the registered persons to undertake their own assessment on the understanding that a persons needs have already been identified and the home has agreed to meet those needs. In this instance however, the community care assessment had been undertaken in relation to the person whilst living in their own home and identified measures needed to support the person to find a residential care home placement; the assessment did not identify what needs the person had that St Anne’s Court would need to aim to meet. The deputy manager confirmed that this persons needs were presenting differently in the home than they had prior to admission as recorded on the community care assessment. Whilst it is common that a person may present differently in different environments such as hospital or their own home, a baseline assessment must be undertaken particularly in relation to physical care needs such as mobility, continence care, skin care and any identified health problems. No requirement or recommendation is made in relation to this although the registered persons are advised to ensure that where a person is admitted under a community care arrangement, the care manager is asked for an up to date assessment identifying why the person will be best placed at St Anne’s Court and how the care manager has identified that the person’s needs can be met there. St Annes Court D55 S3983 St Annes Court V243572 041005 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 & 10 Resident’s health and welfare needs are identified in personal care plans following a period of assessment and regular review and systems are in place for consultation with residents and their representatives regarding their care. Medication management supports residents dignity although methods employed are not in accordance with Royal Pharmaceutical Guidelines. Resident’s right to privacy is supported through care delivery, relationships with staff and confidential record keeping practices. EVIDENCE: The deputy manager confirmed that on, or prior to admission, a persons needs are usually assessed, care files examined demonstrated that most had these assessments. Following this process, a plan of care is produced identifying how each assessed need is to be met. Care plans examined identified the need to be met although provided basic instruction for staff detailing how to meet these needs. However, the deputy manager explained that staff use care plans in conjunction with other assessment documentation, for example, where a care plan informs staff to meet a personal care need for bathing by ‘offering assistance’, this refers also to the risk assessment identifying specific moving and handling needs, whether equipment is required to help the person in and out of the bath and how many staff are required to undertake the task safely. St Annes Court D55 S3983 St Annes Court V243572 041005 Stage 4.doc Version 1.40 Page 11 All aspects of a persons health and welfare need are addressed in this fashion although the registered persons are advised to ensure that detail is more specific to individual requirements such as whether the person requires full assistance with washing or limited assistance with washing back, feet etc if they can manage for themselves. Also clear identification of resident individual preferences could be included such as respect for the person’s dignity i.e.: leaving them alone to relax if they wish and any documented evidence regarding risks associated with this if identified. Records examined evidenced that residents are able to hold appointments with community health care professionals as required, GPs, chiropodists, district nurses etc visit the home as required. Residents spoken with confirmed that they are able to see their doctor in private or attend their local surgery as they are able. Staff keep records of care provided daily in a diary format, this enables one shift to hand over to the next with an ‘at a glance’ reference. Any significant occurrences are then copied into the individual resident’s care record. This form of reporting, whilst providing an easy aide memoir for staff, is not in the best interests of resident confidentiality and it has been recommended that records are held on separate sheets for each resident. Therefore, if a resident asks to see their records, they will not be able to see sensitive information held on other residents. Systems of medication management are in place that are not recommended by the commission although support resident’s rights to privacy and dignity. A system of double dispensing is used which results in medication being dispensed from its original containers into named pots for residents, medicines are dispensed in this way for the whole day. The pots are then taken to each resident discreetly at the correct administration time rather than carrying out one large ‘medicine round’ at meal times. Royal Pharmaceutical Guidelines state: Section 4.2 For a care home member of staff to administer a medicine it must have a printed label containing the following information: •Service users name. •Date of dispensing. •Name and strength of medicine. •Dose and frequency of medicine. Section 6.2.3 Medication should never be removed from the original container in which a pharmacist or dispensing doctor supplied it until the time of administration. The best way of administering medicines to a service user is directly from the dispensed container, medication can be placed in a small pot after removing it from the dispensed container as a way of hygienically handing it to the service St Annes Court D55 S3983 St Annes Court V243572 041005 Stage 4.doc Version 1.40 Page 12 user. Medication should never be secondary dispensed for someone else to administer to the service user at a later time or date. Residents spoken with confirmed that in all respects, they are treated fairly by a kind and committed staff group who recognise their rights to maintain their dignity and privacy. St Annes Court D55 S3983 St Annes Court V243572 041005 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 & 15 Residents are able to benefit from self-determined activity as far as their health and general abilities allow, they are supported in maintaining contact with their friends, family and the local community and in making decisions about their lives in the home. Dietary needs of residents are well catered for with a balanced and varied selection of home cooked food that meets their individual tastes and choices. EVIDENCE: A written schedule of activities, or ‘activities programme’ was not examined although it was evident from discussion with residents that there is a good level of stimulation provided through varied individual or group activities. Residents confirmed that they are able to sit in the lounge and dining areas of the home and enjoy each others company, two residents stated how nice it was not to have a television in the lounge, facilitating conversation and interaction. Residents confirmed that they are able to make decisions and choices in the home with regard to what time to get up, go to bed and how to spend their day. Choices are also available regarding meals, although a set midday meal is provided; an alternative are available if a person does not choose to take the main meal. Breakfasts and suppers are served by individual choices, residents spoken with stated that meals were very good and home cooked meals are prepared using fresh produce. St Annes Court D55 S3983 St Annes Court V243572 041005 Stage 4.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 A written complaints procedure leaves residents in no doubt that steps will be taken to deal with any complaint or concern they may have. Staff are trained with regard to adult protection matters, procedural guidance is available to ensure staff awareness of procedures to protect residents from harm. EVIDENCE: The home’s complaints procedure is contained in the Service User Guide and terms and conditions of residency. Miss Billington confirmed that no complaints have been received by the home; none have been received by the Commission. Miss Billington demonstrated an understanding of the process of reporting and resolving complaints should they arise. Key staff have received training entitled ‘Elder Abuse’ which promotes an understanding of forms of abuse and incidents when it can occur, Miss Billington confirmed that a copy of the policy ‘No Secrets’ is held in accordance with local authority guidance and procedural guidance is available for staff. No incidents have been reported to the Commission. St Annes Court D55 S3983 St Annes Court V243572 041005 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these standards were assessed, the last inspection reported that all accommodation standards were met and that St Anne’s Court is well maintained, furnished to a high standard and all rooms have en-suites. EVIDENCE: St Annes Court D55 S3983 St Annes Court V243572 041005 Stage 4.doc Version 1.40 Page 16 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, 28, 29 & 30 The deployment and number of available staff is sufficient to meet the needs of the residents. The home has not been proactive in respect of following through robust employment procedures. St Anne’s Court has a commitment to staff training. EVIDENCE: Rota’s examined demonstrated the numbers of staff on duty and their roles. Two rota’s are used, one is a weekly rota demonstrating contracted hours and usual shift patterns worked by staff, the second is a working rota demonstrating any changes for holidays, sickness or change requests from staff. The two rota’s show that there are between three and four care staff on duty each morning including the manager and deputy manager, a breakfast assistant comes in at 8.00am and four room assistants are on duty from 9.00am until 1.00pm. Two care staff are on duty in the afternoon and evening and one at night. The manager is also available throughout the night on an on call basis. Staff recruitment procedures are in place to ensure that people employed are suitable to work with the resident group. The file of the most recent employee demonstrated that an application detailing the past work history, qualifications etc. was held and that suitable references had been obtained along with proof of the qualifications claimed. This person is not a UK national and the registered persons have experienced difficulty in obtaining a Criminal Record Bureau (CRB) check. Where overseas persons are employed however, the registered person must ensure that they obtain a criminal record check from St Annes Court D55 S3983 St Annes Court V243572 041005 Stage 4.doc Version 1.40 Page 17 the persons country of origin until such time as a UK CRB check is available, the person has been employed at St Anne’s Court for approximately 8 months when the CRB application was made, the registered persons must now take proactive measures to follow this through. This member of staff has not had a POVA* First check Ten members of staff have attained level 2 NVQ or equivalent, some of these have attained level 3. All staff have been trained in areas relevant to, and necessary for, their working practice including moving and handling, infection control, first aid, health and safety and food hygiene. Key staff have attended training in elder abuse. Miss Billington confirmed that all courses are updated regularly. A training package is available for all new staff that is run in accordance with National Occupational Standards for care staff; new employees complete the induction and foundation training in their first six months at the home. *POVA _ Protection of Vulnerable Adults, a list held by the Secretary of State that identifies persons who are not suitable to work with vulnerable adults. St Annes Court D55 S3983 St Annes Court V243572 041005 Stage 4.doc Version 1.40 Page 18 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) None of these standards were assessed, the last inspection reported that the management team were very experienced, there was a positive and open management approach, quality assurance measures were in place and the home complied with health and safety requirements. EVIDENCE: St Annes Court D55 S3983 St Annes Court V243572 041005 Stage 4.doc Version 1.40 Page 19 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 3 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x x x x St Annes Court D55 S3983 St Annes Court V243572 041005 Stage 4.doc Version 1.40 Page 20 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 29 Regulation 19 Requirement All staff must have an up to date CRB certificate before they are confirmed in post. Where it is not possible to obtain such a certificate immediately if the person employed is from overseas, the person must work with a named supervisor at all times until such time as certificate is received. No member of staff can start employment until a POVA First check has been made. The safety of the procedure for the administration of medicines must be reviewed and risk assessed. For care staff to give a medicine it must be labelled with the service user’s name, the name, form, strength, dose and frequency of the medicine. Timescale for action 2. 9 13 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 D55 S3983 St Annes Court V243572 041005 Stage 4.doc Version 1.40 Page 21 St Annes Court 1. 7 2. 9 In order to keep records both confidentially and in accordance with Data Protection legislation, it is recommended that the registered persons consider altermnative methods of recording residents daily care. Medication should never be removed from the original container in which the pharmacist or doctor supplied it until the time of administration and should never be secondary dispensed for someone else to administer to a service user at a later time or date. St Annes Court D55 S3983 St Annes Court V243572 041005 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Unit 4, New Fields Business Park Stinsford Road Poole BH17 0NF 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 Court D55 S3983 St Annes Court V243572 041005 Stage 4.doc Version 1.40 Page 23 - 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. 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