Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 19/06/07 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 19th June 2007.

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?

Management and staff have worked had to comply with all of the statutory requirements made at the last inspection in July 2006. Pre-admission assessments have been improved and are now vigorously completed on all potential new service users. Care planning documentation has been revised and updated to provide a comprehensive record of the care needs of each service user. A photograph of all service users appears on care plans and medicine administration records. Policies, procedures and the processes of recruiting staff have been improved. Application forms, references, CRB/POVA checks, records of interviews are all in place. Effective quality assurance and quality monitoring systems, based on seeking the views of service users and other stakeholders are in place to measure success in meeting the aims, objectives and statement of purpose of the home. Improvements have been made to the premises with the completion of a four bedded, en-suite extension. All radiators have now been covered and the temperature of hot water at tap outlets is regulated.

What the care home could do better:

Further improvements to the premises are planned and when complete will provide improved communal areas for service users. Based on the comments from a visitor, perhaps "built in time" when staff directly interact with service users on an emotional/personal basis will aid stimulation. Continue to review practice with the aim of yet more improvement.

CARE HOMES FOR OLDER PEOPLE St Anthonys Care Home St Anthonys Station Road Liskeard Cornwall PL14 4BY Lead Inspector Mike Dennis Key Unannounced Inspection 19th June 2007 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.V341949.R01.S.doc Version 5.2 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.V341949.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Anthonys Care Home Address St Anthonys Station Road Liskeard Cornwall PL14 4BY 01579 342308 01579 348549 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 16 Category(ies) of Dementia - over 65 years of age (5), Old age, registration, with number not falling within any other category (16) of places St Anthonys Care Home DS0000039204.V341949.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th July 2006 Brief Description of the Service: St.Anthonys is a care home providing accommodation and personal care for up to 16 older persons. It is situated near the centre of Liskeard and the local amenities 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 dining room. There is a large private garden at the rear and car parking at the front of the home. An extension to the building is now complete providing four extra bedrooms all of which are en-suite. Further improvements are planned. St Anthonys Care Home DS0000039204.V341949.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 20th. June 2007 over a 7 hour period. We met with Mr. Lingham, one of the registered providers, the staff on duty,4 service users and two relatives. During the course of the day we observed the service users being attended to by staff in a courteous and professional manner. We spoke with and case tracked 3 service users. They all confirmed that St. Anthonys was their chosen home. One service user stated that she wanted to be at this particular home due to its good reputation within the local community. All three were united in saying that they were perfectly content with the services provided and could not think of anywhere else that they would rather be except for back in their own homes. They told us that they were well cared for by both the registered providers and staff alike. Their privacy and dignity was respected at all times. (this was observed to be the case throughout the inspection). They all complimented the food provided. One service user stated that she did not like everything on the menu but followed this comment up by saying that an alternative was always provided. Each service user was asked if they were happy with their lifestyle. A common theme emerged. They told us that visitors were welcomed and that they had frequent contact with friends and relatives, who would sometimes take them out. They stated that the staff also provided opportunities for outings, activities and interests. One visitor felt that staff could spend more time in conversation with service users by way of helping stimulation. They were unanimous in stating that they felt safe at this home. All three were aware of the complaints procedure should the need arise to use it. They stated that the care they received was of a good standard. They further commented that the registered providers were quick to access other health professionals when the need arose. Service users informed the inspector that their expectations of being in a care home were being met. They expressed satisfaction with all aspects of the home. We inspected various records, policies and procedures and found them all to be of a satisfactory standard and in compliance with the regulations. The premises were seen to be clean, tidy and well furbished. St Anthonys Care Home DS0000039204.V341949.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? Management and staff have worked had to comply with all of the statutory requirements made at the last inspection in July 2006. Pre-admission assessments have been improved and are now vigorously completed on all potential new service users. Care planning documentation has been revised and updated to provide a comprehensive record of the care needs of each service user. A photograph of all service users appears on care plans and medicine administration records. Policies, procedures and the processes of recruiting staff have been improved. Application forms, references, CRB/POVA checks, records of interviews are all in place. Effective quality assurance and quality monitoring systems, based on seeking the views of service users and other stakeholders are in place to measure success in meeting the aims, objectives and statement of purpose of the home. Improvements have been made to the premises with the completion of a four bedded, en-suite extension. All radiators have now been covered and the temperature of hot water at tap outlets is regulated. St Anthonys Care Home DS0000039204.V341949.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. St Anthonys Care Home DS0000039204.V341949.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection St Anthonys Care Home DS0000039204.V341949.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,5, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information concerning the home is made available. Service users are fully assessed prior to admission to the home. Prospective service users and relatives are afforded the opportunity to visit the home to assess its suitability as to meeting their needs. This home does not provide Intermediate Care EVIDENCE: Up to date Statements of Purpose and Service User Guides were readily available. Service users confirmed a knowledge of these documents. Three service user files were inspected and case tracked. All contained information pertaining to pre-admission assessment, compiled by the management of the home. The process being that management collate as much information as possible from all relevant sources, ie. Social services, health practitioners, members of the family and the prospective service user St Anthonys Care Home DS0000039204.V341949.R01.S.doc Version 5.2 Page 10 themselves. Based on the information gathered a decision is made as to whether the home can offer the required care. This information forms the basis of the initial care plan, which is reviewed as necessary and regularly within required time limits. All service users are issued with contracts of care and statements of terms and conditions with the home. These documents clearly indicate when fee levels are to be reviewed. Policy documents indicate that prospective service users can visit the home before making the decision to move in. This was confirmed in conversation with visitors. Standard 6 is not applicable as the home does not provide intermediate care. The home does however have a dedicated Respite care bed. St Anthonys Care Home DS0000039204.V341949.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health care needs of service users are identified, planned for and met. Service users are treated with dignity and respect. The standard of care planning has improved and is now maintained to a good standard. Medication administration is followed in accordance to policies and procedures. EVIDENCE: The records for 3 service users were inspected and the plans of care seen have been improved and now comply with standards and regulations. St Anthonys Care Home DS0000039204.V341949.R01.S.doc Version 5.2 Page 12 A new system of care planning has been introduced. The basis of this system stems from the pre-admission assessment leading to the initial plan of care. This document is added to and changed as appropriate, and becomes an ongoing live document. Service users, relatives and staff give input. Risk assessments are in-built. Each individual plan details the care needs and the action to be taken in order to realise these needs. Each plan also details changes in medication, GP. community nurse and other ancillary professional visits. Evidence was provided to indicate that the services of community psychiatric nurses, speech therapists, ophthalmic practitioners, dentists and chiropodists all attend. Details of service users personal interest are also recorded. Service users are registered with GP’s at 2 Liskeard surgeries and one outlying health centre according to their personal choice. 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. Staff were observed to treat service users with respect and it was noted that staff knocked at bathroom and bedroom doors before entering. Medication practices are conducted appropriately. Records are up to date. We inspected the ‘controlled drugs’. An audit was undertaken and found to be correct. The quantities of drugs held were confirmed by the controlled drugs register. Service users and relatives spoken with confirmed a knowledge of their care plans. St Anthonys Care Home DS0000039204.V341949.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The routines of daily living and activities made available are flexible and varied. Service users are in control over their lives. Service users receive visitors at any reasonable time throughout the day Service users dietary needs are well catered for with a balanced and varied selection of food and drink available that meets tastes, and choices EVIDENCE: The routines of daily living within the home appear to be flexible to suit individual preferences. The home will offer various activities including trips out, occasional in house entertainment, keep fit, and it is reported that some service users enjoy some light gardening. St Anthonys Care Home DS0000039204.V341949.R01.S.doc Version 5.2 Page 14 Those spoken with claimed to be quite satisfied with their general routines, which included personal interests and hobbies, although one visitor felt that staff could provide better stimulation for service users. A good rapport with staff exists. The visitors book indicated that a steady stream of visitors attend the home. This was also evidenced by the number of visitors present on the day of inspection. Service users are able to have input into how the home is run through attendance at residents meetings. Service users appear to receive a varied, appealing and nutritious diet suited to individual needs, likes and requirements. The meal looked appetising and service users were seen to be enjoying it in a social manner. Portions were of a good size and suited to the individual. Several service users took lunch in the dining room whilst others preferred to take the meal in their own room. Special diets are catered for and choices are available. Hot and cold drinks are offered and available throughout night and day. St Anthonys Care Home DS0000039204.V341949.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints procedure is well publicised and would be used when required. The registered persons ensure that service users are protected from all forms of abuse with staff having knowledge through training of Adult Protection issues which helps to protect service users. EVIDENCE: The home has a complaints policy that meets all the requirements of Regulation 22. A complaints log is available to ensure that a record of all complaints is recorded and kept. No entries have been made since the last inspection. Details of the complaints policy are available in the statement of purpose and a full copy included within the service users guide The home has a policy in relation to adult protection, which includes information on whistle blowing. This policy references the Department of Health No Secrets guidelines and physical / verbal aggression by service users. Staff are made aware of this policy during induction and at training sessions. St Anthonys Care Home DS0000039204.V341949.R01.S.doc Version 5.2 Page 16 Four staff have attended external courses on “whistle blowing” and recognising abuse. St Anthonys Care Home DS0000039204.V341949.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The location and layout of the home is suitable for it’s stated purpose and provides a safe and well maintained environment. Suitable equipment is provided to meet service users needs. Bedrooms are well furnished and contain their occupants personal affects. The home was clean, hygienic and free from offensive odours providing an attractive and homely place to live. EVIDENCE: The home is close to public transport, local shops and facilities of Liskeard.. The detached building offers bedroom accommodation on the ground and first St Anthonys Care Home DS0000039204.V341949.R01.S.doc Version 5.2 Page 18 floors for service users. The home presents as a safe, well maintained and a homely environment for a maximum of 16 service users. The home is homely and domestic in nature. Bedrooms are suitably furnished and display the personal affects of the occupant. Nine rooms offer en-suit facilities. Service users stated they were happy with their living environment. Various aids and equipment is available to aid the care of service users. If a particular item becomes necessary it is obtained for use of the individual requiring it. Communal areas are well presented and comfortable. A stair lift aids access between floors. The home was clean, hygienic and free from offensive odours. Disposable gloves and aprons are available as required. Hand washing facilities were satisfactory. The home has an Infection Control policy. Recent improvements include a four bed extension which is now completed and in use. Further improvements to communal areas are planned. Radiator covers are fitted throughout and hot water is regulated according to guidance at tap outlets. A pleasant, level rear garden, laid mostly to lawn is available for service user use. Car parking is available at the front of the house. Kitchen and laundry facilities are satisfactory. Further improvements to these areas are planned. St Anthonys Care Home DS0000039204.V341949.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Recruitment policies and procedures are implemented. All staff are supported and Inducted through training opportunities. A positive number of staff are on duty to meet the service user’s needs EVIDENCE: On arrival at the home there were appropriate staff numbers and skills mix available to provide for service users welfare. 3 carers are provided during the morning and this is reduced to 2 carers in the afternoon. A cook and domestic staff support this arrangement. At night there is one waking member of staff and one asleep but on call. There is a stable staff group and training opportunities are provided in first aid, moving and handling, food hygiene 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 home’s employment policies and procedures are implemented. St Anthonys Care Home DS0000039204.V341949.R01.S.doc Version 5.2 Page 20 We inspected staff files and determined that all had completed application forms, references, CRB/POVA clearances, Statements of Terms and Conditions and job descriptions. St Anthonys Care Home DS0000039204.V341949.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,36,37,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management and staff of St. Anthony’s strive to maintain and improve a good quality of care and lifestyle for the service users and promote their health, safety and welfare. EVIDENCE: The registered manager is appropriately experienced and working towards the completion of the Registered Managers Award. 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 conducted a quality assurance survey in 2005 and again in December 2006. St Anthonys Care Home DS0000039204.V341949.R01.S.doc Version 5.2 Page 22 The results of these surveys are analysed and produced in tower graph form. Evidence that action is taken to improve the service was presented. The homes policies and procedures have all recently been updated. Written records are kept of all financial transactions. Service users manage their own finances. The registered providers maintain the health, safety and welfare of service users through implementation of policies and procedures. Records required by legislation are kept. A good rapport exists between management, staff and service users. Supervision of staff is undertaken and appropriately recorded. Appropriate recording of accident reports was evidenced. It is recommended that these reports are removed from the accident book and stored on each individual service users file. St Anthonys Care Home DS0000039204.V341949.R01.S.doc Version 5.2 Page 23 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 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 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 3 3 3 X 3 3 3 3 St Anthonys Care Home DS0000039204.V341949.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? None STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 OP37 Good Practice Recommendations When completed, Accident reports should be stored on each individual service users file. St Anthonys Care Home DS0000039204.V341949.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Devon Area Unit D1 Linhay Business Park Ashburton Devon TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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.V341949.R01.S.doc Version 5.2 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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!