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Inspection on 18/10/05 for St Anthonys Care Home

Also see our care home review for St Anthonys Care Home for more information

This inspection was carried out on 18th October 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Service users expressed satisfaction with care staff who were observed to present good skills and attitudes in their interactions with service users. There is a stable staff team that are undertaking appropriate training opportunities. The home provides single room accommodation that is comfortable and homely. The staff are ensuring that service users are accessing a range of health care services as required. Service users expressed approval of the catering arrangements; preferences and special diets are provided.

What has improved since the last inspection?

The registered providers have plans to develop and improve the facilities at the home. Mrs Lingham is the registered manager and the rota now provides a clear record to show she is at the home and in day-to-day control. Service users stated their approval of the replacement stair lift and how they could move in safety between floor levels.

What the care home could do better:

The registered providers must complete the agreed action plan regarding radiator covers and the regulation of hot water outlets. Other requirements are made regarding care plans, fire precautions, communal bathroom facilities, a call bell and recruitment procedures. The registered providers should supply a development plan to clarify proposals to meet these requirements and communicate the various progress through management reports to this commission.

CARE HOMES FOR OLDER PEOPLE St Anthonys Care Home St Anthonys Station Road Liskeard Cornwall PL14 4BY Lead Inspector Mike Stokes Unannounced Inspection 18/10/05 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 St Anthonys Care Home DS0000039204.V252321.R02.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. St Anthonys Care Home DS0000039204.V252321.R02.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service St Anthonys Care Home Address St Anthonys Station Road Liskeard Cornwall PL14 4BY 01579 342308 01579 342308 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) St Anthonys Limited Mrs Judith Helen Lingham Care Home 13 Category(ies) of Dementia - over 65 years of age (5), Old age, registration, with number not falling within any other category (13) of places St Anthonys Care Home DS0000039204.V252321.R02.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Service users to include 13 adults of old age (OP) Service users to include up to 5 adults over 65 years of age with Dementia (DE(E)) Total number of service users not to exceed a maximum of 13. Date of last inspection 14th April 2005 Brief Description of the Service: St.Anthonys is a care home providing accommodation and personal care for up to 13 older persons. It is situated near the centre of Liskeard and the local amenities that include shops, health centres and railway station. Bedrooms are provided on both the ground and first floors, with a stair lift to assist service users. Communal areas are provided for service users on the ground floor and include a lounge and dininng room. There is a large private garden at the rear and car parking at the front of the home. St Anthonys Care Home DS0000039204.V252321.R02.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection organised to look at the care standards in the home. I arrived at 10.00am and the inspection finished at 3.00pm. Mr and Mrs Lingham and staff assisted by providing information contained in records and discussion. Various service users were met at the home and discussed a range of topics about living in the home. I was able to meet the cook and observe the main midday meal presented for service users. A partial tour of the home was completed through the inspection process. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. St Anthonys Care Home DS0000039204.V252321.R02.S.doc Version 5.0 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection St Anthonys Care Home DS0000039204.V252321.R02.S.doc Version 5.0 Page 7 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): 1, 3 and 5. The registered person has provided a statement of purpose and service users guide that details the facilities and services available within the home. The registered manager will assess all prospective service users prior to admission to ensure that the home can meet their care needs. The home does not admit service users referred solely for intermediate care. EVIDENCE: The registered person has complied with a requirement to provide existing and prospective service users with the guide. Samples of service users records were inspected and detailed assessments are available. A discussion occurred with the registered provider and staff to ensure the assessment details are used to develop care plans and that they provide the basis of the care to be delivered. The registered provider was advised to keep clear records of service users admitted with dementia to demonstrate compliance with conditions of registration (13 older persons, of whom 5 may have dementia). St Anthonys Care Home DS0000039204.V252321.R02.S.doc Version 5.0 Page 8 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 and 10. The registered manager has provided assessment details for each service user and care staff record relevant details of care provided to service users. Although evidence was found that service users are accessing appropriate health care services, the registered manager is not recording a care plan that provides the individual basis for the care to be delivered and details of the action which needs to be taken to ensure that all aspects of the health, personal and social care needs of the service user are met. EVIDENCE: The requirement to develop care plans has not been met. The registered manager is responsible for the day-to-day organisation of the home and must demonstrate this by providing the assessment of service users needs and record the details of how this care is to be delivered. A discussion occurred to clarify procedures for consultation with service users; the recording and monthly review of care plans and an extended timescale is made. Service users are registered with GP’s at Dean Street and The Parade surgeries; and records show service users have access to support services as required. Some service users have private telephone lines in their rooms and a service user stated that visiting health professionals will always see her in the privacy of her bedroom. St Anthonys Care Home DS0000039204.V252321.R02.S.doc Version 5.0 Page 9 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): 12, 13, 14 and 15 Service users exercise their choice to enjoy the privacy of their own rooms or join other service users in communal areas for company or meals. Service users maintain contact with visiting relatives and friends at the home. Service users are predominantly dependent on these contacts to access community facilities and the registered manager will organise occasional visiting entertainers and group activities at the home. The meals provided in the home are good with special diets and choice catered for. EVIDENCE: Service users were met in communal areas or their own rooms. The records kept regarding service users that require assistance with their finances were inspected. A service user expressed approval that regular visits are received from relatives. The requirement regarding care plans must also include the details of service users social profile, interests and preferred activities should be recorded in the care plan, to demonstrate how opportunities for stimulation, contact with visitors and a choice of activities are provided for all service users. The main meal of the day was observed to be nutritious and appetising, with special diets and preferences catered for. St Anthonys Care Home DS0000039204.V252321.R02.S.doc Version 5.0 Page 10 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 and 18. The registered person has ensured that a complaints procedure has been issued to service users in the service users guide. The registered person and staff are to attend training in this area to ensure the safety and protection of service users is maintained. EVIDENCE: The registered person has policy and procedures for the protection of vulnerable adults. The registered person has organised staff attendance to the ‘No Secrets’ adult protection training to provided by the social services in 2006. St Anthonys Care Home DS0000039204.V252321.R02.S.doc Version 5.0 Page 11 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): 19, 21, 22, 23, 24 and 26. The registered person is intending to improve and develop facilities at the home. Service users will live in a safer and more comfortable environment when the action plan to gradually introduce radiator covers and regulators to all hot water outlets has been completed. EVIDENCE: The service users were seen to live in comfortable rooms that are individually decorated and personalised. Service users bring items of furniture and possessions to personalise their rooms. A maximum of 13 service users can be accommodated in 11 single and 1 double room (currently occupied as a single). Rooms are provided on the ground and first floor levels. The new stair lift reaches the last 2 steps at ground floor level and service users accommodated on the first floor have stated this improved facility assisted their mobility to move between floor levels. 4 rooms offer en-suite facilities. The recent provision of en suite facilities to a bedroom was inspected and the registered person is required to provide a call bell in this area. The registered person has submitted an action plan that states the gradual provision of radiator covers will be completed for all areas St Anthonys Care Home DS0000039204.V252321.R02.S.doc Version 5.0 Page 12 before 31/12/05. The plan also states that the gradual provision of regulators to all hot water outlets will be completed before 01/04/6. The registered persons sleep in a caravan parked in the car park at the front of the house. The registered person stated that the fire alarm is connected to the caravan and on call arrangements exist. The registered persons use a shower and toilet within the first floor bathroom that is required as part of the registered facilities for service users. Their use of this bathroom must not deny service users the use of this area and a requirement is made to complete the fitting of a hoist for assisted bathing and an appropriate heating source for this bathroom. It was noted that door wedges were being used at the home. A discussion occurred regarding the Fire Safety Officer report dated 04/05/05 that states the wedges must be removed. A requirement is made to comply with this report and provide appropriate hold open devices where required. The registered person discussed plans for a 4-bedded extension that will also include an improved laundry facility. A discussion occurred with the registered provider regarding the appropriate variation application required by this commission and consultation with various agencies. The registered persons should demonstrate their plans and response to comply with requirements by supplying a copy of their development plan to this Commission. The progress and compliance with this plan should then be recorded and included in monthly regulation 26 reports to this commission to demonstrate that the plan is being followed. St Anthonys Care Home DS0000039204.V252321.R02.S.doc Version 5.0 Page 13 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 and 30. Staffing levels are appropriate to meet the needs of service users. Induction training and other staff training opportunities are provided to ensure a competent workforce is provided. The registered person must ensure that all staff or volunteers entering the home with access to service users are CRB checked, to provide for the welfare of service users. EVIDENCE: The unannounced inspection showed appropriate staff numbers and skills mix available to provide for service users welfare. Training opportunities are provided and care staff have either completed, or are registered at NVQ level 2,3 and 4. The registered persons are complying with a requirement to clarify on the rota, Mrs Lingham’ s time spent at the home in the capacity as registered manager. The registered person discussed the arrangement where the partner of the deputy manager may assist her in moving and handling duties, when they are responsible and on call, in the absence of the registered persons. A discussion occurred with the registered provider regarding standard 29.6: - The recruitment of volunteers is thorough and includes police checks. Volunteers must also receive appropriate training for any duties involving moving and handling. A requirement to obtain appropriate checks has not been met and an extended timescale is given. St Anthonys Care Home DS0000039204.V252321.R02.S.doc Version 5.0 Page 14 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): 31, 35 and 38. The registered manager is experienced and working towards the completion of the Registered Managers Award. The registered provider has plans to develop facilities at the home and must also follow an action plan to comply with requirements made in this report. EVIDENCE: The registered persons can demonstrate appropriate checks occurring for various health and safety procedures including portable appliance tests, insurances, environmental health and the maintenance of fire precautions. The registered persons could demonstrate clearer leadership and communication through robust care planning procedures, the continued organisation of regular staff and service user meetings and providing monthly management reports to the Commission. St Anthonys Care Home DS0000039204.V252321.R02.S.doc Version 5.0 Page 15 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 3 X 3 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 2 2 3 3 X 3 STAFFING Standard No Score 27 3 28 X 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 X X 3 St Anthonys Care Home DS0000039204.V252321.R02.S.doc Version 5.0 Page 16 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 OP7 Regulation 15 Requirement Timescale for action 01/01/06 2. OP19 23 The registered person must provide a service user plan of care generated from comprehensive assessments for service users and provides the basis for the care to be delivered. The registered person must 01/01/06 comply with the Fire Safety Officer report dated 4/5/05. Door wedges must be removed and appropriate hold open devices provided, where required. The registered person must provide toilet, washing and bathing facilities to meet the needs of service users. Timescale of 31.5.05. not met. Proposals to supply heating and a hoist are required. A call bell must be provided in room 10 en suite facility. The registered person must ensure the recruitment of volunteers is thorough and includes police checks. 01/01/06 3. OP21 23(J) 4. 5. OP22 OP29 23 19 01/01/06 01/01/06 St Anthonys Care Home DS0000039204.V252321.R02.S.doc Version 5.0 Page 17 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 OP19 Good Practice Recommendations The registered persons should demonstrate their plans and response to comply with requirements by supplying a copy of their development plan to this Commission. The progress and compliance with the action plan should then be recorded and included in monthly regulation 26 reports to this commission to demonstrate that the plan is being followed. 2. OP33 St Anthonys Care Home DS0000039204.V252321.R02.S.doc Version 5.0 Page 18 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD 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 Anthonys Care Home DS0000039204.V252321.R02.S.doc Version 5.0 Page 19 - 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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