Inspection on 16/08/05 for St Anselm`s Nursing Home

This inspection was carried out on 16th August 2005.

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 Anselm`s Nursing Home 09/10/08

St Anselm`s Nursing Home 24/10/06

St Anselm`s Nursing Home 15/02/06

St Anselm`s Nursing Home 08/12/04

St Anselm`s Nursing Home 21/06/04

Similar services:

1 Marten Road

Daubeney House

Three Gables

Aldwick House

49 Glendale

The Springs Community

Crossways Community

Belle Vue Country House

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

CARE HOMES FOR OLDER PEOPLE St Anselms Nursing Home St Clare Road Walmer Deal Kent, CT14 7QB Lead Inspector Mary Cochrane Announced 16/08/05 at 09:30 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 Anselms Nursing Home H56-H05 S26117 St Anselms Nursing Home V234823 160805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service St Anselms Nursing Home Address St Clare Road, Walmer, Deal, Kent, CT14 7QB 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) 01304 365644 01304 380514 allsaints.nursinghomes@virgin.net Mrs Aileen Jordan Mr David Weller Registered Care Home 25 Category(ies) of Older People registration, with number of places St Anselms Nursing Home H56-H05 S26117 St Anselms Nursing Home V234823 160805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Mental disorder, excluding learning disability or dementia (MD) Dementia (DE) Date of last inspection 8th December 2004 Brief Description of the Service: St. Anselms is a registered nursing home which provides care for for up to 25 with mental health needs and dementia . The home is a large detached building, set in it’s own grounds, in a quiet residential area of Walmer, Deal. It is near to local shops and facilities, Walmer Castle and the sea, and is within easy reach of the towns of Deal and Dover.It is run by a partnership, with all of the Providers actively involved in the running of the Home. Two of the Providers were on the premises during the inspection, as well as the Registered Manager.Accommodation is provided overn 4 floors (lower ground, ground, first and second floors), and all floors can be accessed via a passenger lift.The building has had extensive renovative work and alterations over the last 2 years, The communal ares in the main building consists of a large lounge, conservatory and dining area. There is also another small quiet lounge area for service users. The home has a gatehouse which has recently been renovated to provide reception and office facilities, minimising disruption to Service Users in the main building.The home provides full laundry facitilties The grounds provide a number of pleasant areas for Service Users enjoy in the better weather. St Anselms Nursing Home H56-H05 S26117 St Anselms Nursing Home V234823 160805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an Announced inspection carried out in accordance with the Care Standards Act 2000 and under the new guidance of ‘Inspecting for Better Lives’. The inspection took place over a day on Tuesday 16th August 2005. The homes registered manager and registered provider/nurse director were available and helpful throughout the visit. The following methods of inspection and information gathering were used: discussion with manager, one-to-one discussion with staff, spending time with service users, observing interactions, care interventions and activities, reading and discussing individual support plans, risk assessments, selected policies, medication charts, and staff files. The home offers 24 hour nursing care to a maximum of 25 service users suffering from mental health needs or dementia illnesses. The majority of the service users are over 65. The home has a qualified registered nurse on duty at all times. At the time of the visit there were 24 service users in residence, all the service users were in the house at the time of the visit and were well kept and appeared cared for. Due to their illnesses many of the service users have difficulty understanding and communicating verbally. 9 of the service users were spoken to and they reported that they are happy and content living at the home. They claimed they are given the care, support and guidance that they require. The service users said that they get opportunities to go out and participate in various activities in the local community. They felt that they had a good relationship with the staff and other service users living at the home and that their views and wishes are respected and acted on. 8 staff members were asked their opinions about the home, the management, the training and support they receive and the ethos of the home. All spoke highly of the home and the management. They felt that every-one worked as part of a team and they were all supported and valued for their work. The management actively promote training and staff are encouraged to go on many courses related to their work and the role they perform. Staff claimed that they would not want to work anywhere else. Their views on the home will be reflected in the report. The commission received a comprehensive detailed and informative Pre Inspection Questionnaire from the home. The surveys and comments returned from service users and relatives prior to the visit all gave very positive comments about the standard of care delivered by the staff. On the day of the inspection 1requirement was made and 2 recommendations. The home does offers various activities, which can be enjoyed both within the home and in the local community. At the time of the visit the atmosphere in the home was relaxed, welcoming, and friendly. Both service users and care staff reported that they were happy to be at St. Anselms. St Anselms Nursing Home H56-H05 S26117 St Anselms Nursing Home V234823 160805 Stage 4.doc Version 1.40 Page 6 What the service does well: What has improved since the last inspection? At the previous unannounced inspection a requirement was made where the home had been asked to provide suitable fencing (or other protective barrier) on the top lawn, to prevent the risks of falls from this raised area. This had been done and the requirement met at this visit. No recommendations were made at the previous inspection. The home have now completed the renovation of the gatehouse which now provides office facilities. The drive up to the house has been laid with shingle and the window frames in the main building have been re-painted. St Anselms Nursing Home H56-H05 S26117 St Anselms Nursing Home V234823 160805 Stage 4.doc Version 1.40 Page 7 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 Anselms Nursing Home H56-H05 S26117 St Anselms Nursing Home V234823 160805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection St Anselms Nursing Home H56-H05 S26117 St Anselms Nursing Home V234823 160805 Stage 4.doc Version 1.40 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 standard(s) 1,3,4,5 The homes statement of purpose and service users guide are satisfactory and provide service users with the details of the services the home provides enabling them to make an informed decision about going to live at the home. The home ensures that a detailed assessment of needs is carried out for all prospective service users. The service users and their representatives know that the home will be able to meet their needs. EVIDENCE: The homes Statement of Purpose and Service Users Guide are up-to-date and reflect the current situation within the home. They contain all the required information out-lined in schedule 1 of the Care Homes Regulations. Prior to any admission to the home the registered manager undertakes a full assessment on all prospective service users to assess their needs and determine their suitability for living at St. Anselms. Information is gathered from hospital staff, care managers and relatives. The assessment is carried out St Anselms Nursing Home H56-H05 S26117 St Anselms Nursing Home V234823 160805 Stage 4.doc Version 1.40 Page 10 using the ‘Basoll’ system, which explores all the relevant areas of care including communication and behavioural needs, social needs, medical and psychiatric history, mobility and mental cognition. The assessment is then kept within the service users file and is the basis for the development of an individual care plan. This was evidenced at the time of the inspection. 1 new service user has recently taken up residence at the home and it was seen in the care files that a full and comprehensive needs assessment had been undertaken by the registered manager covering all aspects of care prior to her being offered a place at the home. It was evidenced that the home has the capacity to meet the assessed needs of the service users in their care. There was a good skill mix of staff on duty at the time of the inspection that had the skills, knowledge and experience to deliver care effectively. Staff were seen to communicate well with the service users and the atmosphere was relaxed. The service users who were spoken to were happy and content with the home and felt that their needs were being met. Specialist services are available to any of the service users as the need arises and some of the service users have on-going specialist interventions in place. St Anselms Nursing Home H56-H05 S26117 St Anselms Nursing Home V234823 160805 Stage 4.doc Version 1.40 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10,11 The homes provides care plans for all the service users. They need to contain up-to –date information on all aspects of health ,social and personal care to provide staff with the information they need to satisfactorily meet the service users needs. The systems for the administration of medication are good with clear and comprehensive arrangements being in place to ensure that service users medication needs are met. The privacy and dignity of the service users is up-held with wishes and views respected. EVIDENCE: A sample of care plans was looked at during the visit. The care plans contained the relevant information based on the homes initial assessment. However it was evidence that some of the care plans did not identify all the needs of the St Anselms Nursing Home H56-H05 S26117 St Anselms Nursing Home V234823 160805 Stage 4.doc Version 1.40 Page 12 service users. Identified health needs were not addressed in some of the plans and information was not documented in the plans when changes in treatment had occurred follow reviews from the consultant or the G.P. Risk assessments are in place. The risks pertaining to each individual service users are identified and the action to minimise the risk is recorded. Daily reports are completed at the end of each shift. The registered manager needs to ensure that staff writing the reports record the information concisely and accurately reflecting the events that occurred during the shift. Daily reports need to evidence that the staff are adhering to and following the individuals care plan. (See requirement no.1). The healthcare needs of the service users are monitored and met. Service users files evidenced that the home access the required heath-care services necessary to promote and maintain the health of the service users. Each resident is registered with a local G.P. and any area of concern related to health is referred to the G.P. Any concerns about tissue viability are assessed so that appropriate treatment and intervention is commenced as soon as possible. At the time of the visit none of the service users had any pressure sores and for those identified as at risk of developing pressure areas appropriate pressure relieving equipment was in place. The home has purchased several specialised beds for it most vulnerable service users, which are very homely and ordinary in appearance but offer the facility and function of a hospital bed. The staff have regular contact with the local specialist nurse who offers advise and assistance when necessary. The home monitors service users for any changes in their behaviour, mobility, cognition, weight, and abilities and observe for any emerging patterns. There are regular visits to and from the chiropodist, optician and dentist. The local Older Peoples Mental Health team is actively involved and reviews take place at a minimum of 6 monthly intervals. The staff are able to access the local psychiatrist at short notice if the need arises. It needs to be ensured that any identified changes or developments are recorded in the individual care plans. It was evidence at the time of the visit that the home keeps up to date with the continually changing requirements surrounding medication. A new pharmaceutical waste bin was insitu for the disposal of excess medication and also a controlled drugs destruction kit. At the present time there are no service users prescribed controlled medication and no one is self-medicating. Medication is stored in a locked clinical room, with separate cupboards for storage of external medication and controlled drugs. There is also a drugs fridge. At the time of the visit the lunchtime drug round was observed. Medication was administered safely and according to procedures. Each Service User’s medication is stored in a separate container in the trolley. The medication trolley was in good order, and medication was in date, and showed good stock rotation. The MAR charts were neatly signed, and accurately completed. There was a photograph of each Service User with the MAR charts. The Manager had drawn up a list of possible side effects for each Service User’s medication, so that all nursing staff are alerted to these. St Anselms Nursing Home H56-H05 S26117 St Anselms Nursing Home V234823 160805 Stage 4.doc Version 1.40 Page 13 There is a list of signatures for all nursing and care staff involved in giving or checking medication. It was noted that the temperature in the clinical room has been slightly high over the past 2 months ranging from 24c-28c. The registered manager is going to investigate ways of reducing this. Residents are well dressed in clothing appropriate for the season and appeared well kept. Staff were observed assisting service users in a flexible and supportive manner and were seen treating the service users with respect and understanding. Some members of staff were observed demonstrating good body language and communication skills when interacting with the residents. Where service users share a room screening is provided to ensure that privacy is not compromised. At the time of the visit it was evidenced that care and comfort is given to service users who are dying and they are treated with dignity and propriety. Spiritual needs are met and service users families are informed of the situation so they can make an informed decision about the action they wish to take. Policies and procedures are in place for managing dying and death. St Anselms Nursing Home H56-H05 S26117 St Anselms Nursing Home V234823 160805 Stage 4.doc Version 1.40 Page 14 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 encouraged to actively participate in life at St.Anselms. Routines of daily living are flexible and varied. The activities provided by the home are varied and meet the needs and interests of individual service users. The home needs to be able to produce evidence of the activities provided. Family and friends are welcomed into the home. Residents are encouraged to exercise choice and control over their lives with the help of families, friends and staff. A wholesome appealing and balanced diet is provided. The dietary needs of the service users are well catered for with a balanced and varied selection of food available that meets service users tastes and choices. EVIDENCE: Hobbies, activities and social preferences are discussed prior to admission. A life profile is written with assistance from the Service User. Activities are held in the home every day, and vary between group and individual activities. These include sit and keep fit exercises, reminiscence, games and singing afternoons, or one to one care using games or books. The Home has a good selection of library books, videos, C.D. that are frequently changed by Open Access at Kent County Council. This acts as a good resource tool for service users and staff. Aromatherapy sessions are available, and service users often St Anselms Nursing Home H56-H05 S26117 St Anselms Nursing Home V234823 160805 Stage 4.doc Version 1.40 Page 15 like to go out for walks by the sea, or in the town. At the time of the visit staff were seen playing dominoes and cards while others were having manicures. The home needs to ensure that daily activities recreational and leisure are planned more in advance and are more structured. This will allow both service users and staff to be prepared and will offer guidance and direction so to ensure that the activities that take place and are not just something that happens on the spur of the moment. The home needs to be able to evidence the activities and pursuits they offer the service users. This was discussed with the registered manager and nurse director at the time of the visit. They are going to look at ways in which they achieve this. (See recommendation no.1) Family and friends are encouraged to visit the home as often as they wish and some are actively involved. Visitors are invited to join in with barbecues or birthday teas, and are always welcome to join in any other activities. The service users spoken to felt that they were able to make choices in regards to their day-to-day lives. Some of the service users handle some of their own finances with the guidance and assistance from staff. The home has no involvement with the finances affairs of any of its’ service users. Service Users are encouraged to bring their own personal possessions into the home and an inventory is kept on each individual file The service users spoken to reported that they receive the care and support they need from the staff and they are treated well. One service user claimed that ‘’the staff will do anything for you and take you anywhere you want to go’’. Service users reported that they felt confident and safe with the staff. 2 service users had recently returned from a holiday organised by the home, which had been very sucessful and shortly 3 more service users will be going away. 2 service users had also been an a non landing trip to France (club class) which was enjoyed Routines at the home are flexible and varied. At the time of the visit one service user did not get up until before lunch, he claimed that he was able to go to bed when he wished and get up when he wanted to. Staff monitored the situation to ensure that this service user’ needs are being met. The home employs a full time cook. The cook reported that that service users are consulted on a daily basis about the menu to ensure that they get the food that they want and choices are also offered daily. Menus are planned 4 weeks in advance. Meal times are flexible and if a service user wishes to eat at a different time or in an area out-side the dining room this is not a problem. All the service users spoken to said that the food at the home was very good and they had no complaints. Staff are also provided with a meal. Snacks and drinks are available at all times and special diets are catered for. St Anselms Nursing Home H56-H05 S26117 St Anselms Nursing Home V234823 160805 Stage 4.doc Version 1.40 Page 16 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, The complaints process within the home is robust. Residents’ complaints are listened to, investigated, and appropriate action is taken EVIDENCE: The home has a complaints procedure on display in the entrance hall, and this is included in the Service Users’ Guide. It was evidenced from looking at the complaints record that 2 complaints had been made to the home in the past 12 months. Prompt action had been taken to investigate and handle complaints in a sensitive and appropriate manner. Due to the diagnosis of some of the service users, complaints can be unfounded and due to illness. It was noted that all complaints/concerns are handled seriously, and given due consideration. St Anselms Nursing Home H56-H05 S26117 St Anselms Nursing Home V234823 160805 Stage 4.doc Version 1.40 Page 17 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) 19,20,21,22,24,26 The standard of the environment within the home is good providing service users with an attractive, homely and safe place to live. EVIDENCE: St Anselms is a large detached property situated in its own grounds. It is located in a quiet residential area and has access to all the local amenities. There are other care establishments in the immediate vicinity. The home is suitable for it’s stated purpose and offers the service users living accommodation over 4 floors. There is a lift available to all floors. Since the last inspection all building works at the home have been completed. St. Anselms is well maintained throughout and maintenance and refurbishment in the house is ongoing. The garden is now fully functional again following the St Anselms Nursing Home H56-H05 S26117 St Anselms Nursing Home V234823 160805 Stage 4.doc Version 1.40 Page 18 building works and offers a safe and attractive environment for service users to enjoy in the better weather. There is a friendly and welcoming atmosphere and all areas both private and communal are comfortable, well furnished, homely and decorated to a satisfactory standard. Communal areas on the ground floor comprise a large lounge with a conservatory leading from it. The conservatory is used as the service users smoking area and a spacious and private veranda can be accessed from the conservatory. There is a separate dining room on the first floor, and a small quiet seating area adjacent to the lift. Furniture and fittings are of a satisfactory standard. The grounds provide an upper lawn and a large lower lawn, which can be used for sitting or walking, or for summer parties/barbecues. Service Users are supervised by staff when spending time outside, unless risk assessed as safe to be on their own. The Home is equipped with 2 bathrooms and a shower room. One of the bathrooms has an old “Century” bath, which is not in use at the moment, plans are in place to replace this bath with an up-to date version which will allow service users easier access to a bath serviced. The shower room is new, and has been refitted, with non-slip floor, and a shower surround, which enables staff to assist Service Users if necessary. One of the shared rooms has been fitted with a shower cubicle, providing a small en-suite facility. There are 4 additional toilets situated in different areas of the Home. The Home is fitted with a passenger lift, which provides access to all floors. There are 3 hoists available for assisting Service Users with reduced mobility, one is electric and two are manual. The home has several wheelchairs for use out of doors. Other equipment provided includes pressure –relieving mattresses and cushions, nursing beds where needed, commodes and grab rails. At the time of the inspection all bedrooms rooms were looked at. Many of them have recently been re-carpeted and all are decorated to a satisfactory standard. The rooms are clean and comfortable and all but one shared room were individualised and reflected the personalities of the service users. One of the shared rooms at the top of the house was bare and contained no apparent personal belongings. This was discussed with the manager at the time of the visit. Screens are in place in the shared rooms to ensure that privacy can be maintained when staff were undertaking personal care. It was noted in some of the rooms that incontinence pads were on display. It was suggested that these could be more discreetly stored in the rooms. The registered manager is going to address this. All doors now have locks in place. Service users are given a key to their rooms if they wish to have one subject to a risk assessment. This is assessed on an St Anselms Nursing Home H56-H05 S26117 St Anselms Nursing Home V234823 160805 Stage 4.doc Version 1.40 Page 19 individual basis. All locks have an overriding facility and spare keys are at hand for emergencies. The home was seen to be clean and hygienic on the day of the announced inspection. A slight odour was detected in one of the rooms on the top of the house, which the registered manager is aware of and will investigate. All laundry is carried out on the premises, and a full time lady is employed to manage this area. The laundry area is small, but is equipped with 2 commercial washing machines and a tumble dryer. There is a rotary ironing in an adjoining room for ironing the sheets, as well as an ordinary iron for clothes. The laundry lady was able to demonstrate infection control practises and was aware of the appropriate temperatures for washing soiled laundry. A red alginate bag system is used in the washing machines for soiled laundry. A system has been implemented using a separate basket for each Service User’s clean clothes. These are collapsible, so can be stacked away neatly at the end of each day. There are 2 sluices on the premises, with one of these containing an automated sluice machine. Hand washing facilities are prominently sited where clinical waste and infected material is being handled. St Anselms Nursing Home H56-H05 S26117 St Anselms Nursing Home V234823 160805 Stage 4.doc Version 1.40 Page 20 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 Staff morale is high resulting in an enthusiastic workforce that works positively with the service users to improve their whole quality of life. The arrangements for the induction of staff are good with the staff demonstrating a clear understanding of their roles. All staff have received the required training ensuring that the service users receive a good standard of care. EVIDENCE: The home employs 9 qualified staff including the registered manager and the nurse director and 16 health care assistants. There are also 2 cooks 4 domestic staff, an administrator and a part-time maintenance man. At the time of the inspection several members of staff were spoken to. All reported that they felt valued and appreciated for their role in the home. They reported that they were well supported by the management and were actively encouraged to undertake training and develop skills and knowledge, which would assist them in performing their job to a higher standard. One member of the care staff team reported that he had recently been on a course on dementia, which he found very beneficial when working with some of the client group at the home. Staff claimed that they felt part of a team who all worked together to collectively meet the needs of the service users. The ancillary staff also echoed St Anselms Nursing Home H56-H05 S26117 St Anselms Nursing Home V234823 160805 Stage 4.doc Version 1.40 Page 21 this. All spoke highly of the registered manager and nurse director. There were no complaints or concerns. At the time of the inspection there were 2 qualified nurses on duty and 3 health care assistance. One member of staff had phoned in sick but another staff member came on duty to cover the busy lunch time period. On the afternoon shift there were 4 staff members. There are 3 waking staff on every night. The number of staff on duty depends on the needs of the service users. If necessary the home will use agency staff. There was evidence to show that the number and skill mix of staff provided are able to meet the needs of the service users. The service users reported that there was always enough staff available to meet their needs, and nothing was too much trouble for the staff. It was observed that the staff are pleasant and happy in their work and were seen to be attentive and caring towards the needs of the service users. 50 of staff employed by the home have now received and obtained NVQ level 2 or above. A robust recruitment process is adhered to using equal opportunities. References are sought before employment is commenced and this was verified from looking at the staff files. The files were of a high standard and contained all the information required by the National Minimum Standards. CRB checks are in place for the majority of staff. However evidence of some checks was not on file. The homes administrator started to deal with this during the inspection so no requirement or recommendation has been made at this time. This be checked at the next visit, all staff receive a terms and conditions of employment. All staff receive a very comprehensive, thorough induction programme. Mandatory training was seen to be up-to date for all members of staff and was on-going. Specialist training is in place to ensure that all service users needs are met. St Anselms Nursing Home H56-H05 S26117 St Anselms Nursing Home V234823 160805 Stage 4.doc Version 1.40 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,36,38 The care home is fulfilling its aims and objectives to meet the service users needs. Service users are living in a home protected by effective leadership, guidance and direction to ensure consistent quality care. EVIDENCE: The Manager has RMN training, a Diploma in Care Management, and many years experience in caring for Service Users with mental health care needs. He is familiar with the illnesses associated with old age, and is committed to keeping up his own training with relevant courses. He had recently been involved in working with the “Essence of Care” scheme, which has involved linking and networking with other homes. At the time of the visit the registered manager was able to demonstrate his management and leadership skills. He was able to communicate a clear sense of direction and leadership, which the staff and the service users responded to. St Anselms Nursing Home H56-H05 S26117 St Anselms Nursing Home V234823 160805 Stage 4.doc Version 1.40 Page 23 The atmosphere is open, positive and inclusive. The staff and service users reported that they were well supported and responded in a positive, relaxed manner in the presence of the manager. Regular staff meetings are held. The manager needs to ensure that all staff receive regular supervision with a minimum of 6 sessions per year. At the time of the inspection records showed that staff were not receiving regular supervision sessions. (See recommendation no.2) The home provides a safe environment for service users to live in and staff to work in. Good working practices ensure the home is free of hazards. The company’ has an induction programme which is in line with TOPSS. Mandatory training is up to date and on going. The Safe working Practices in the home are satisfactory. Policies are in place to strengthen safe practices. All the relevant checks and inspection of equipment and system have been undertaken. The home has water temperature regulators on the baths and showers in the home. The home has not had tests for Legionella but will find a company to undertake the task. An accident book is maintained by the home and supplementary in-depth forms are completed in addition to this. Fridge temperatures were also evidence and are within the stated ranges. The registered manager is aware of RIDDOR and reporting incidences to the Commission under Regulation 37. COSSH products are locked away safely. Environmental risk assessments are in place. St Anselms Nursing Home H56-H05 S26117 St Anselms Nursing Home V234823 160805 Stage 4.doc Version 1.40 Page 24 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 x 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 x 3 x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 3 x x x 2 x 3 St Anselms Nursing Home H56-H05 S26117 St Anselms Nursing Home V234823 160805 Stage 4.doc Version 1.40 Page 25 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 7 Regulation 15(2) Requirement The home needs to ensure that the service users care plans identify all the needs and are up-dated as required to reflect the changing needs of the service users. Daily records need to contain accurate and relevant information that evidence that the care plan is being adhered to . Timescale for action 30/11/05 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. 2. Refer to Standard 12 36 Good Practice Recommendations Evidence is needed of the programme of activities provided by the home for the service users The home needs to ensure that all staff employed by the home receive regular supervision St Anselms Nursing Home H56-H05 S26117 St Anselms Nursing Home V234823 160805 Stage 4.doc Version 1.40 Page 26 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford Kent, TN23 1HU 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 Anselms Nursing Home H56-H05 S26117 St Anselms Nursing Home V234823 160805 Stage 4.doc Version 1.40 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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