Inspection on 31/01/06 for St Anthony`s Cheshire Home

This inspection was carried out on 31st January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

St Anthony`s Cheshire Home 21/08/06

St Anthony`s Cheshire Home 27/09/05

St Anthony`s Cheshire Home 06/01/05

St Anthony`s Cheshire Home 30/06/04

Similar services:

Aston Court Nursing Home

Breme

Ravenhurst

Westmead

Ashcroft Hollow Nursing Home

Bricklehampton Hall Nursing Home

Briar Hill House

Radbrook Nursing Home

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

CARE HOME ADULTS 18-65 St Anthony`s Cheshire Home Stourbridge Road Penn Wolverhampton West Midlands WV4 5NQ Lead Inspector Lynne Gammon Unannounced Inspection 31 January 2006 10:45 St Anthony`s Cheshire Home DS0000022368.V283430.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address St Anthony`s Cheshire Home DS0000022368.V283430.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 Adults 18-65. 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 Anthony`s Cheshire Home DS0000022368.V283430.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service St Anthony`s Cheshire Home Address Stourbridge Road Penn Wolverhampton West Midlands WV4 5NQ 01902 893056 01902 326376 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) www.leonard-cheshire.org.uk Leonard Cheshire Mrs Elizabeth Olwen Keenan Care Home 35 Category(ies) of Physical disability (35), Physical disability over registration, with number 65 years of age (12) of places St Anthony`s Cheshire Home DS0000022368.V283430.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th September 2005 Brief Description of the Service: St Anthony’s Cheshire Home is located on the A449 between Wolverhampton and Wombourne. The Home was established in 1961 to provide care for all ages that have a physical disability. The Home is a mixture of styles including very modern purpose-built, mainly single room accommodation spread out on ground floor level in extensive grounds, surrounded by countryside of outstanding beauty. The general philosophy of care is to promote a sense of independence in a personal, individualised environment. The Home is superbly equipped and very organised, whilst presenting an informal yet professional quality of care. There is however opportunity for friends and married couples to share an ample sized, comfortable room if so wished. St Anthony`s Cheshire Home DS0000022368.V283430.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was carried out on the 31st January 2006 at 10.45 a.m. using the National Minimum Standards for Adults (18 – 65) as the basis for the inspection. The total time spent for the inspection, including pre and fieldwork, amounted to 10 hours. The inspection included a tour of the home, inspection of records, observation and discussions with service users and staff. Since the last inspection on 27th September 2005, no complaints nor any incidents or reports of abuse of any kind had been received and no requirements or recommendations, against the regulations or the minimum standards, were outstanding from the last inspection report. What the service does well: What has improved since the last inspection? The home had recently had a new front door which was easily accessible for all service users, even wheelchair users and a new physiotherapy room was in the process of being redecorated during the inspection. St Anthony`s Cheshire Home DS0000022368.V283430.R01.S.doc Version 5.1 Page 6 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 Anthony`s Cheshire Home DS0000022368.V283430.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection St Anthony`s Cheshire Home DS0000022368.V283430.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 5 The Statement of Purpose and Service User Guide needed to be amended to provide sufficient information for prospective service users to make an informed decision about the suitability of the home for them. Contracts were in place for each service user and they received confirmation that the home could meet their needs prior to moving in. EVIDENCE: The Statement of Purpose and Service User Guide were inspected and did not include all of the required elements as set out in Schedule 1 of the Care Homes Regulations Act 2001 and Standard 1 in the National Minimum Standards for Care Homes for Adults (18 – 65), and therefore it is a requirement of this report that these documents be updated to provide sufficient information for prospective service users prior to moving into the home. The registered manager confirmed that prospective service users were told that the home could meet their needs prior to moving in, however, it is a requirement of this report that written confirmation be provided that the home can meet the individual’s needs and aspirations. St Anthony`s Cheshire Home DS0000022368.V283430.R01.S.doc Version 5.1 Page 9 An actual contract for a service user was examined and seen to include details regarding: a trial period, fee structure, services covered by the fees, those items/services not covered by the fees, invoices, temporary absence, insurance, management of the home, consultation, termination, death, complaints procedure, etc. This document was titled ‘Terms and Conditions of Residency’ and had been signed by a representative on behalf of the service user and dated. St Anthony`s Cheshire Home DS0000022368.V283430.R01.S.doc Version 5.1 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 8 and 10 There was a clear and consistent care planning system in place and developed in conjunction with service users. This system provided staff with the information they needed to meet service user’s needs satisfactorily. Staff supported and enabled service users to make their own decisions and service users were consulted regularly to effectively participate in the running of the home. Service users were satisfied that information about them was safe and secure. EVIDENCE: All key standards were inspected at the previous inspection on 27/09/05 and found to be satisfactory. A sample of care plans were examined during this inspection and were found to be detailed and well organised to provide staff with information to understand and meet individual needs. Care plans were reviewed monthly and risk assessments were completed as required and also reviewed monthly, including physiotherapy assessments. Health care needs were met very well and records showed that service users had access to other health care professionals. Index of goals, including setting of short term goals St Anthony`s Cheshire Home DS0000022368.V283430.R01.S.doc Version 5.1 Page 11 were also documented very well. General risk assessments were also detailed and reviewed annually or more frequently if required. Within the care plans, there were details of a range of rules, procedures, roles and responsibilities etc, which had been dated and signed by both the service user and a staff member as evidence that they had been explained and understood. Also seen was a consent form to receive the service as detailed in the ISP (Individual Service User Plan) and also signed by the service user. Gender preferences of staff undertaking personal care were also documented and signed by the service user. Service users were consulted on and participated in all aspects of life in the home. Service users decided that they would like to have a cat in the home and therefore, a cat was purchased which had brought a great deal of pleasure to those living in the home. Service user’s meetings took place regularly and the Chairperson of the meetings was a service user. A recent meeting which took place this month discussed a number of issues, one being about the provision of smoking facilities within the home. The home had consulted on this and was in the process of analysing the information gathered from the service users on three possible options to resolve this ongoing issue. The registered manager had also contacted the Health and Safety Officer from Leonard Cheshire who had recently visited the home to assess the situation. Individual service user plans were accurate, secure and confidential. They were stored in the nurse’s office and parts of them were duplicated and held in the service user’s bedrooms. Inspection of the service user’s ISP’s showed evidence that information about them was handled in accordance with the Data Protection Act 1998. Consent forms, signed by the service users were seen detailing whom they agreed could have access to their records. Service users and their families had access to the home’s policy and procedure on confidentiality and were able to contribute to the development and review of all policies and procedures. St Anthony`s Cheshire Home DS0000022368.V283430.R01.S.doc Version 5.1 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11 and 16 The home provided service users with opportunities for personal development including independent living skills and social skills and daily routines promoted individual choice and independence. EVIDENCE: Service users were supported by the home to develop their skills and where possible, were encouraged to make their own bed, collect own towels, take control of their own hygiene etc. These were seen detailed in the ISP. The activities co-ordinator confirmed that she had been working closely with the local College with a view to some service users undertaking an Assertion/Confidence Building course there. The activities co-ordinator also provided evidence of an excellent questionnaire which she had devised and begun to use, to establish the social/educational needs of the service users. She confirmed that once completed she would then be able to work towards arranging access to courses and organise in house events which would meet the current needs of the service users. St Anthony`s Cheshire Home DS0000022368.V283430.R01.S.doc Version 5.1 Page 13 Service users were able to participate in a gardening session from the college once per week, twp service users were going on a cruise this year and eight others were also having a holiday break. Staff were observed knocking on service user’s doors before entering and positive interaction was noted throughout the day between staff and service users. St Anthony`s Cheshire Home DS0000022368.V283430.R01.S.doc Version 5.1 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 21 The health care needs of the service users were being met with evidence of good multi agency working. End of life needs were handled respectfully and in full compliance with service user/relatives requirements. EVIDENCE: The personal and emotional needs of the service users were fully identified in the individual service user plans. Service users received the necessary health care, receiving regular treatment when needed and also attended screening and outpatient appointments. Staff monitored the health of the service users very well. Recently, staff had made an appointment for a service user to see a Community Psychiatric Nurse regarding the death of two of her close friends. Records showed service users saw opticians, phlebotomists, social workers, and the clinical nurse (for flu vaccines, etc), GP and other health professionals on a regular basis. The home also monitored the weight of service users on a monthly basis. The majority of staff had undertaken a Palliative Care Foundation Course and the home had two members of staff who were trained to deliver palliative care training. ISP documentation was updated accordingly to meet the needs of the service users in terms of end of life requirements and included observing St Anthony`s Cheshire Home DS0000022368.V283430.R01.S.doc Version 5.1 Page 15 religious and cultural customs. One service user from an ethnic minority group had a record in her care plan that she was a seven-day Evangelist with no specific requirements for death detailed. Some service users had wills stored in the safe within the home; others had wills held by family members. Discussions with staff members and service users evidenced that the ageing, illness and death of a service user would be treated with dignity and respect. St Anthony`s Cheshire Home DS0000022368.V283430.R01.S.doc Version 5.1 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 The home had a satisfactory complaints system with evidence that service users felt that their views were listened to and acted upon. Staff’s excellent knowledge and understanding of Adult Protection issues provided a safe environment to protect service users from abuse. EVIDENCE: The home had a complaints procedure that was available to service users who were aware of how to complain and felt that their views were sought and listened to. The home had received one complaint concerning respite facilities and this had been responded to appropriately and in a timely manner, resulting in a change to one of the home’s procedures. The general manager stated that Leonard Cheshire Homes had recently purchased a specialist IT software package which had already been used to develop the complaints procedure into a draft picture format to enable greater understanding of the procedure for some service users who may have difficulty understanding the written word. There had been no incidents or allegations of abuse received by the home or the Commission for Social Care Inspection since the last inspection. The home had an Adult Protection procedure and all staff received training in abuse awareness. St Anthony`s Cheshire Home DS0000022368.V283430.R01.S.doc Version 5.1 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 All standards were inspected on 27/09/05 and were overall satisfactory. However, some of the environment appeared tired and in need of refurbishment which was due to be addressed in the near future. The standard of cleanliness within the home was very good. EVIDENCE: A tour of the home evidenced homely, bright, comfortable and individually personalised rooms, which were very clean and large enough to promote independence for the service users. The communal rooms were in need of refurbishment and redecoration and the General Manager confirmed that planned maintenance for the dining room and lounge were due to commence before the end of the financial year. This refurbishment would also include new carpets and curtains in these rooms. In addition to this, a number of windows downstairs at the front of the home were due to be repainted/replaced at the same time with the rest of the windows being refurbished during 2006/07. St Anthony`s Cheshire Home DS0000022368.V283430.R01.S.doc Version 5.1 Page 18 The home had recently had a new front door which was easily accessible for all service users, even wheelchair users and a new physiotherapy room was in the process of being redecorated during the inspection. It was noted that smokers had moved out of the main dining room and had temporarily been given the use of a smaller lounge until the consultation regarding the smoking facilities in the home was concluded. Locks had been put on bathroom doors to ensure that the privacy and dignity of the service users was maintained. St Anthony`s Cheshire Home DS0000022368.V283430.R01.S.doc Version 5.1 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 and 33 Staff had clearly defined job descriptions and sufficient skilled staff were in place to meet the needs of the service users. EVIDENCE: Discussions with staff showed that they were aware of the needs of the service users and how those needs should be met. Staff had developed relationships with the service users and were observed communicating freely with service users who appeared to be at ease when approaching the staff. There were two regular volunteers whose contribution in terms of helping out at specific events was greatly valued. The volunteers did not undertake any tasks that were the responsibility of paid staff. Staffing levels were examined and on the day of the inspection, the registered care manager and the care supervisor were on duty all day plus one registered nurse with three senior carers and nine care assistants in the morning and one registered nurse and five care assistants in the afternoon. In addition to this, there was: a cook, a kitchen assistant, a dining room assistant, two administrators, a training and development officer, an activities co-ordinator and a maintenance person. Domestics and laundry staff were on contract to the home. These staffing levels were found to be satisfactory to meet the needs of the 35 service users living in the home at that time. The home rarely St Anthony`s Cheshire Home DS0000022368.V283430.R01.S.doc Version 5.1 Page 20 used agency staff and four new members of staff commenced employment at the home on 12th December 2005 and were in the process of completing their induction period. St Anthony`s Cheshire Home DS0000022368.V283430.R01.S.doc Version 5.1 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39, 40, 41 and 43 The home’s quality assurance processes ensured that service user views were taken into account and used to measure the success of the home in the delivery of the service. Records held were accurate and secure and policies and procedures were in place covering the required topics to safeguard service user’s rights and best interests. The management of the home ensured that effective systems were in place for the benefit of the service users. EVIDENCE: There were excellent quality assurance processes within the home and the home regularly reviewed aspects of its performance through a programme of self-review and consultations, which included seeking the views of, service users, staff and relatives. The care supervisor provided evidence of auditing 5 individual service user plans each month and also audited health and safety, infection control and supervision records monthly too. In addition to this, the registered care manager and general manager conducted regular audits. Staff group meetings took place every 3 months and minutes were seen from the St Anthony`s Cheshire Home DS0000022368.V283430.R01.S.doc Version 5.1 Page 22 last meeting on 17th January 2006. A further meeting for team leaders was noted for 2nd February 2006. As stated previously, service user meetings took place every two to three months and were chaired by a service user. Records for the protection of service users, individual records and home records were seen to be secure, up to date and in good order. Policy and procedural documentation was inspected and the inspector was impressed with the quality and range of these and noted they were reviewed regularly. Service users and family members had access to this documentation as required. Financial planning, budget monitoring and financial control systems were in place in the home. The registered care manager provided a monthly budget report to the general manager and a stringent monthly monitoring system was in place. Insurance cover was seen, expiry date March 2006 and the level of cover was a minimum of £5 million. St Anthony`s Cheshire Home DS0000022368.V283430.R01.S.doc Version 5.1 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 2 X 3 2 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 3 32 X 33 3 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 X 4 X 4 LIFESTYLES Standard No Score 11 3 12 X 13 X 14 X 15 X 16 3 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 4 X 3 X X 4 3 3 X 3 St Anthony`s Cheshire Home DS0000022368.V283430.R01.S.doc Version 5.1 Page 24 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. 1. Standard YA1 Regulation 4(1)(c) Requirement Timescale for action 30/04/06 2. YA3 14(1)(d) To update the Statement of Purpose and Service User Guide to provide sufficient information for prospective service users to make an informed decision about the home. To provide written confirmation 31/01/06 to service users that their needs can be met prior to moving into the home. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations St Anthony`s Cheshire Home DS0000022368.V283430.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Anthony`s Cheshire Home DS0000022368.V283430.R01.S.doc Version 5.1 Page 26 - 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. 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