Inspection on 05/01/06 for St Annes Court

This inspection was carried out on 5th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 04/10/05

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 Dorset BH2 6PD Lead Inspector Jo Palmer Unannounced Inspection 5th January 2006 10:00 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 DS0000003983.V276392.R01.S.doc Version 5.1 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. DS0000003983.V276392.R01.S.doc Version 5.1 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 DS0000003983.V276392.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th October 2005 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. DS0000003983.V276392.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection on 5th January 2006 lasted for two and half hours. Amanda Billington, the registered manager was present throughout and provided necessary information and access to records. This was a brief inspection the purpose of which was to monitor progress in addressing requirements and recommendations of the last two inspection visits and to review practices in relation to some of the National Minimum Standards. Not all standards were assessed and the reader is referred to the report of the last inspection dated 4th October 2005, which can be obtained either from the home or from www.csci.org.uk The last inspection of St Anne’s Court took place on 4th October 2005; additionally a brief inspection visit was made on 18th November in response to some concerns raised from an anonymous source. This inspection has noted that requirements made from the additional visit have been satisfactorily addressed, and no further action is required. The inspector spoke with six residents, one visitor, the cook, one care assistant and the manager, toured the premises and examined relevant records. What the service does well: The last inspection reported that the home’s admission procedure was satisfactory and residents had sufficient information to enable them to consider that St Anne’s court was able to meet their needs. These standards were not assessed during this inspection. Care plans are generally but not always in place detailing residents needs in a manner that respects their individuality and addresses their health and welfare needs. Residents spoken with confirmed that their personal care needs were well met by a kind and caring staff group who make arrangements for medical attention with community based health services as required. Residents confirmed that a caring staff group treats them respectfully and with kindness. Comments included: ‘Staff are wonderful’, ‘they are always ready to help’, ‘staff come quickly whenever they are needed’. Medication systems are in place to ensure the safety of medication administration, storage, receipt and disposal. Records are accurately maintained. Residents confirmed that a caring staff group treats them respectfully and with kindness. Comments included: ‘Staff are wonderful’, ‘they are always ready to help’, ‘staff come quickly whenever they are needed’ DS0000003983.V276392.R01.S.doc Version 5.1 Page 6 The cook was spoken with who was both enthusiastic and caring about her role, a variety of well prepared meals are served using fresh produce which residents confirmed are always enjoyable. A complaints system is in place that leaves residents confident that any concerns will be sensitively managed. St Anne’s court provides a clean and well-maintained environment where residents are able to live with their own belongings around them, all areas of the home provides sufficient space for residents to move around freely, spend time alone or use communal space and benefit from each others company. There are sufficient numbers of staff on duty and residents confirmed that they are responsive to their needs and there is always somebody available. New staff are currently being safely recruited. What has improved since the last inspection? Requirements and recommendations of the last two inspection visits were assessed and the following noted: • • • Although not fully addressed, Miss Billington is currently recruiting night carers and will ensure that a full and detailed rota is produced when they are in post. (Standard 27) The linen store has been reviewed and now provides satisfactory storage for clean and used linen. (Standard 38) The procedures for administration of medication has been reviewed and no longer necessitates double dispensing by staff and medications are only removed from their original containers at the point of administration. (Standard 9) The electrical socket in the kitchen has been repaired and moved to a safer location. (Standard 38) Miss Billington is aware of the need to keep up to date, accurate employment records and ensure that all relevant checks are carried out. (Standard 29) The manner in which daily care is recorded has been reviewed and now provides for a confidential system of record keeping. (Standard 7) • • • DS0000003983.V276392.R01.S.doc Version 5.1 Page 7 What they could do better: This inspection has identified the following areas where improvement is needed: • All residents must have an up to date care plan detailing how resident’s needs are to be met and where necessary, an up to date, regularly reviewed, moving and handling plan. When it becomes necessary for a care plan to be reviewed, this must be done in a timely fashion that does not leave residents without a current care plan for a period of time. Where a resident is receiving wound care from a district nurse, a contingency plan must be available in order that staff have adequate instruction of the action necessary should the dressing become damaged or soiled between the nurses visits. Risks associated with accidental scalding from exposed pipe-work and radiators must be individualised and must follow Health and Safety Executive guidelines for both assessing the risks and implementing the correct control measures. The last inspection made the requirement that the method of cleaning commode pans was reviewed and that commode pans should not be washed in residents baths. Miss Billington confirmed that there are currently no residents requiring the use of a commode although consideration would be given to this requirement should it become necessary. The requirement is repeated as a recommendation. • • • 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. DS0000003983.V276392.R01.S.doc Version 5.1 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 DS0000003983.V276392.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were assessed. Standard 6 is not applicable. The last inspection reported that standards 1, 2 & 3 were met. EVIDENCE: DS0000003983.V276392.R01.S.doc Version 5.1 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 the following standard(s): 7, 8, 9 & 10 The personal care, health and welfare needs of residents are set out in individual care plans and although not totally specific in some instances, provide staff with sufficient detail of the care they need to deliver. Where care needs change, the system of review must be more robust. Good contact is maintained between the home and resident’s GPs in order to meet general health care requirements. Medication is well managed in accordance with prescribing instructions and Royal Pharmaceutical society guidelines. EVIDENCE: Three residents care files were examined. These demonstrated that basic personal and health care needs are addressed and indicated the resident’s level of independence in respect of self-caring activities. One care file was out of date in respect of a resident who had become increasingly more frail and required more care than was outlined in the care plan. Specifically, this resident now required assistance with moving and handling; the available moving and handling plan dated June 2005 stated that the resident was independent in this activity with out assistance. This resident was also receiving wound care from a district nurse. Whilst not able to provide nursing care, staff at St Anne’s Court must have instruction available regarding DS0000003983.V276392.R01.S.doc Version 5.1 Page 11 management of the wound site, for example, if the dressing should become soiled or damaged between the district nurses visits. Records of care provided on a daily basis have been reviewed following a requirement of the last inspection. Miss Billington stated that the system now proves beneficial and provides a good diary of events and significant details of the residents lives in the home for easier and more confidential reference. Examination of these evidenced that all care is delivered as planned and detail is provided to demonstrate how care needs are being met. Following previous requirements, the system for managing medication has been reviewed, brief examination of medication storage and records demonstrated that good practice is now adopted and medication is well managed, stored and administered securely. Residents spoken with confirmed that a caring staff group treats them respectfully and with kindness. Comments included: ‘Staff are wonderful’, ‘they are always ready to help’, ‘staff come quickly whenever they are needed’. DS0000003983.V276392.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15. The last inspection reported that standards 12, 13 & 14 were met. The meals in this home are good offering both choice and variety and catering for special dietary needs. EVIDENCE: Residents spoken with confirmed that the provision of meals was good; several stating that it was ‘excellent’, and that there was a plentiful supply and dishes were always well presented and appetising. The cook was spoken with who confirmed the arrangements for provision of meals in the home. A four-week rota is used from which to plan lunch and evening meal. The rota provides a set meal ingredient such as chicken, trout, gammon etc. From this, cook then prepares an appropriate dish and although residents stated that they did not always know what they were getting, each meal was always enjoyable. The manner in which cook prepares the chicken for example, is based on a knowledge of resident’s likes and dislikes and Miss Billington confirmed that residents are consulted with regard to their preferences regularly. Residents are asked daily what they would like from the menu and alternatives are provided to the main menu. Cook confirmed that she always uses fresh ingredients and always makes her own dishes; this was evident from the kitchen stores which were well stocked. Individual diets are catered for and any special dietary requirements. Staff have access to the kitchens and supplies in the evening in order to make any light snacks that residents may request. DS0000003983.V276392.R01.S.doc Version 5.1 Page 13 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 the following standard(s): 16 The last inspection reported that standard 18 was met. Residents are confident that their concerns will be listened to and taken seriously. EVIDENCE: The last inspection reported that a complaints procedure was in place and available to residents. Residents spoken with confirmed that they would know who to go to if they had any concerns but all those spoken with reported that it had not been necessary to raise any concerns as they felt they had nothing to worry about. One complaint received by the Commission from an anonymous source resulted in an additional visit to the home in November 2005. Some of the issues raised resulted in requirements being made, this inspection evidenced that the registered persons had taken this seriously and addressed all requirements satisfactorily. DS0000003983.V276392.R01.S.doc Version 5.1 Page 14 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 the following standard(s): 20, 21, 23, 24, 25 & 26 Residents live in a comfortable, clean environment with their own belongings around them and bedrooms, bathrooms and communal areas provide sufficient room for residents. Although hazards have been assessed, management of hot surfaces needs to be considered further using recognised guidelines from the Health and Safety executive. EVIDENCE: During a tour of the premises to meet with residents, many areas of the home were seen. All were clean, well maintained and decorated to a good standard. Resident’s bedrooms are personalised to varying degrees with residents that were spoken with confirming that they were able to bring in many items of their own to make their rooms feel more homely. Communal areas of the home also have a personal feel with appropriate furnishings, carpeting, decoration and personal touches such as pictures, ornaments etc. The dining room was pleasantly laid for lunch with each table provided with napkins, condiments and water jugs. DS0000003983.V276392.R01.S.doc Version 5.1 Page 15 There are sufficient numbers of toilets and bathrooms around the home and each room has en-suite facilities. Bathrooms provide sufficient equipment to enable appropriate assistance. Risk assessments have been carried out by room number identifying the individual considerations of the resident occupying the room. These were seen and noted to provide limited detail of control measures necessary to reduce risks of accidental scalding from hot surfaces. A tour of the premises noted some radiators to be extremely hot to touch. Following the visit, the inspector sent a copy of the guidelines issued by the Health and Safety Executive on assessing risk and applying appropriate control measures for hot surface temperature regulation. At the additional visit to St Anne’s Court in November in response to some concerns that had been raised, it was noted that resident’s commode pans were cleaned in their baths, requirement was made that this must not happen in accordance with basic hygiene and infection control procedures. Miss Billington confirmed that where this had been the case, domestic staff always ensured that baths were thoroughly cleaned afterwards, Miss Billington also confirmed however, that the one resident who used a commode at night had since passed away and therefore this process was no longer necessary. The requirement in respect of this has therefore been disregarded although it has been recommended (under standard 38 – Health and Safety) that alternative means of cleaning commode pans is sought in readiness for the next resident who may require the use of a commode during the night. DS0000003983.V276392.R01.S.doc Version 5.1 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 & 29 The home employs enough staff to meet the needs of residents, Miss Billington is aware of the principles of good recruitment practice for the protection of residents. EVIDENCE: The last inspection reported that standards 27, 28 & 30 were met, the additional visit in November identified that the staff rota was not complete and requirement was made. This visit evidenced that both requirements made in respect of standard 27 and 29 were in the process of being addressed. Miss Billington confirmed that additional night care staff are in the process of being recruited, this staff member will then complete the night rota evidencing sufficient numbers of staff in the home during each night shift. Until new staff are in post, Miss Billington continues to be the additional night carer on a sleep in/on call basis. Since the requirement made under standard 29 regarding staff recruitment practices was made, no new staff have been employed. Miss Billington confirmed that she is now recruiting and has applicants for new night care worker posts, as the applicants are only in the first stages of the recruitment process, there is no documentation held although Miss Billington demonstrated an awareness of all the relevant documentation that was necessary to be obtained in respect of the regulations and safe practices. DS0000003983.V276392.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35 & 38 St Anne’s Court has a policy of not managing residents personal finances. Some issues of health and safety have been satisfactorily addressed. EVIDENCE: Miss Billington confirmed that the home does not get involved in any resident’s financial affairs and that all residents have representation through their Power of Attorney in relation to this. The home holds no money or valuables on behalf of residents. The additional visit to St Anne’s Court in November 2005 raised some concerns about storage of used bed linen, exposed wires from an electrical socket and the manner in which commode pans are cleaned (see standard 26) This visit evidenced that the storage facility for clean and used laundry had been reviewed and is now satisfactory, the electrical socket has been repaired and moved to a safer location and the cleaning of commode pans is not currently an issue as the resident it concerned no longer lives at the home. It has been recommended however that alternative methods of cleaning commode pans is sought in case any future residents require the use of a commode. DS0000003983.V276392.R01.S.doc Version 5.1 Page 18 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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X X 3 3 X 3 3 2 2 STAFFING Standard No Score 27 3 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X 2 DS0000003983.V276392.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement 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. Where a resident is in receipt of wound care from a district nursing service, the registered persons must ensure 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. All residents must have a robust, individual assessment of any risks of accidental scalding posed by unguarded radiators and pipe- work. Risk assessments must address individual considerations including the person’s mobility, history of falls, skin sensitivity, etc as identified in the Health and Safety Executive guidelines. Control measures to ensure risks are reduced or eliminated must be explicit and be available for staff reference DS0000003983.V276392.R01.S.doc Timescale for action 1 OP7 15 31/03/06 2 OP8 15 31/03/06 3 OP25 13 31/03/06 Version 5.1 Page 20 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 OP38 Good Practice Recommendations It is recommended that alternative means of cleaning commode pans is sought prior to the next resident who may require use of a commode. DS0000003983.V276392.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Poole Office 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 DS0000003983.V276392.R01.S.doc Version 5.1 Page 22 - 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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