Inspection on 27/07/06 for St Anthonys Care Home

This inspection was carried out on 27th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

St Anthonys Care Home 19/06/07

St Anthonys Care Home 18/10/05

St Anthonys Care Home 14/04/05

St Anthonys Care Home 01/11/04

St Anthonys Care Home 26/04/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE St Anthonys Care Home St Anthonys Station Road Liskeard Cornwall PL14 4BY Lead Inspector Mike Stokes Key unannounced Inspection 27th July 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address St Anthonys Care Home DS0000039204.V298550.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.V298550.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 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.V298550.R01.S.doc Version 5.2 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 18th October 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.V298550.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key unannounced inspection organised to look at the care standards in the home. The first day of inspection was on the 27/07/06 and a second visit was completed on 04/08/06 to meet Mr and Mrs Lingham. 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: Requirements are made in the following areas; to improve the quality of pre admission assessment procedures and plans of care; the registered person must report on the progress regarding the provision of safety features for hot water and radiator covers to protect service users; recruitment procedures have not been fully implemented and can potentially place service users at risk; the registered manager must complete the RMA; quality assurance procedures must be developed at the home and records kept in respect of service users. St Anthonys Care Home DS0000039204.V298550.R01.S.doc Version 5.2 Page 6 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.V298550.R01.S.doc Version 5.2 Page 7 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.V298550.R01.S.doc Version 5.2 Page 8 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 and 3. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The registered manager must provide evidence of holistic assessment that includes the service user, representatives and significant others such as social and health care services. EVIDENCE: Samples of 3 service users records were inspected and pre admission assessments were available in various levels of detail. The social services and health assessments were available for service users recently admitted to the home. A discussion occurred with the registered manager to ensure the home completes its own assessment procedures that are comprehensive and used to develop care plans, which provide the basis of the care to be delivered. The registered manager 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). The registered person has complied with a requirement to provide existing and prospective service users with a guide to the home. St Anthonys Care Home DS0000039204.V298550.R01.S.doc Version 5.2 Page 9 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. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. 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. The plan must demonstrate details of the actions, which need to be taken to ensure that all aspects of the health, personal and social care needs of the service user are met. EVIDENCE: The records for 3 service users were inspected and the plans of care seen do not comply with standards and regulations. No plan of care was available for one service user recently admitted to the home. The previous requirement to develop care plans has not been met and an extended deadline has not been complied with. An improvement plan will be required from the registered persons. 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. St Anthonys Care Home DS0000039204.V298550.R01.S.doc Version 5.2 Page 10 When I returned to complete the inspection process the registered persons had begun the process to provide plans of care in the appropriate format. The registered persons also demonstrated the new system for care plans that is available but not functional yet. Service users are registered with GP’s at 2 Liskeard 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. A visiting community nurse confirmed that appropriate liaison occurs with the home regarding nursing care required by service users. St Anthonys Care Home DS0000039204.V298550.R01.S.doc Version 5.2 Page 11 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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 and are predominantly dependent on these contacts to access community facilities. 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 and an exercise group was organised for 6 service users by a member of staff. The carer stated that the group encouraged movement and also provided stimulation for a social gathering and communication between service users. Other service users were relaxing in the privacy of their rooms. A service user expressed approval that regular visits are received from relatives; and service users are supported to attend church services, social activities and access community facilities. The requirement regarding care plans must also include the details of each service users social profile, interests and preferred activities. These should be recorded in the care plan, to demonstrate how opportunities for stimulation, contact with visitors and a choice of activities are provided. The main meal of the day was observed to be nutritious and appetising. A discussion occurred St Anthonys Care Home DS0000039204.V298550.R01.S.doc Version 5.2 Page 12 with the cook on duty and appropriate menus with special diets and preferences catered for. Service users expressed approval of the catering services provided. St Anthonys Care Home DS0000039204.V298550.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The procedures used at the home protect service users from abuse. EVIDENCE: The registered person has appropriate policy and procedures for the protection of vulnerable adults. The registered person has organised staff attendance to the ‘No Secrets’ adult protection training to be provided by the social services in September 2006. The registered person has ensured that a complaints procedure has been issued to service users in the service users guide. The records regarding service users that require assistance with their finances were inspected and are appropriately maintained. St Anthonys Care Home DS0000039204.V298550.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 24, 25 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The registered persons are investing in improvements to the environment. 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 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) and 4 rooms offer en-suite facilities. 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. The existing laundry facilities have been improved with the provision of new equipment. St Anthonys Care Home DS0000039204.V298550.R01.S.doc Version 5.2 Page 15 The registered person has submitted an action plan for the gradual provision of radiator covers and regulators to all hot water outlets. A written progress report regarding compliance with the action plan must be sent to this commission. 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 and their use of this bathroom must not deny service users the use of this area. The registered person is currently building a 4-bedded extension at the home that will also include an improved laundry facility and shower area for service users. A discussion occurred with the registered provider regarding the variation application to be approved by this commission and the various standards that must be met including additional communal space for the increased registered numbers. St Anthonys Care Home DS0000039204.V298550.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staffing levels are appropriate to meet the needs of service users. Induction training and other training opportunities are provided to ensure a competent workforce is provided. The recruitment procedures must be improved to provide for the welfare of service users. 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. 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 records regarding the recruitment of staff were incomplete and do not meet standards and regulations. A discussion occurred with the registered person regarding the lack of an application form, CRB checks and statement of employment details for an employee. The registered person is required to complete the CRB check and staff records in compliance with standards and regulations. St Anthonys Care Home DS0000039204.V298550.R01.S.doc Version 5.2 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 37 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The registered manager is experienced and working towards the completion of the Registered Managers Award. The registered persons have plans to develop facilities at the home and must also complete an improvement plan to comply with requirements made in this report. 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. A discussion occurred regarding the future need for detailed self-assessment procedures and these should be developed at the home. The registered persons must demonstrate clearer St Anthonys Care Home DS0000039204.V298550.R01.S.doc Version 5.2 Page 18 leadership and communication through providing robust care planning procedures, the organisation of staff and service user meetings and providing an improvement plan to this Commission regarding the requirements of this report. The records required to be kept at the home were reviewed and schedules 3 and 4 were discussed and checked. The registered manager is required to keep a photograph of service users and an inventory of service users furniture at the home. St Anthonys Care Home DS0000039204.V298550.R01.S.doc Version 5.2 Page 19 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 2 X X 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 x 3 x X 3 2 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X X X 2 3 St Anthonys Care Home DS0000039204.V298550.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? Yes 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 OP3 Regulation 14 Requirement The registered manager must ensure new service users are admitted only on the basis of a full assessment undertaken by people trained to do so, and to which the prospective service user, his/her representatives (if any) and relevant professionals have been party. The registered manager 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 plan must demonstrate details of the actions, which need to be taken to ensure that all aspects of the health, personal and social care needs of the service user are met. Previous timescale not met. The registered person has previously submitted an action plan for the gradual provision of radiator covers and regulators to all hot water outlets. A written progress report regarding compliance with the action plan DS0000039204.V298550.R01.S.doc Timescale for action 09/09/06 2. OP7 15 09/09/06 3. OP25 23 09/09/06 St Anthonys Care Home Version 5.2 Page 21 must be sent to this commission. 4. OP29 19 The registered person must 09/09/06 ensure the recruitment of all staff is thorough and includes Criminal Bureau Checks. The registered person must complete a review of these standards for the existing staff and confirm in writing that this is complied with. The registered manager must be 09/09/06 qualified, competent and experienced to run the home and meet its stated purpose, aims and objectives. The registered manager must confirm registration with the RMA and an anticipated date for completion. The registered manager must 09/09/06 ensure effective quality assurance and quality monitoring systems, based on seeking the views of service users, are in place to measure success in meeting the aims, objectives and the statement of purpose of the home The registered manager must 09/09/06 keep a photograph of service users and an inventory of service users furniture at the home Ref. Schedules 3 and 4. 5. OP31 9 6. OP33 24 7. OP37 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. Refer to Standard Good Practice Recommendations St Anthonys Care Home DS0000039204.V298550.R01.S.doc Version 5.2 Page 22 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.V298550.R01.S.doc Version 5.2 Page 23 - 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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