Inspection on 19/04/06 for St Augustines Court Care Home

This inspection was carried out on 19th April 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

St Augustines Court Care Home 16/02/09

St Augustines Court Care Home 15/05/07

St Augustines Court Care Home 12/12/05

St Augustines Court Care Home 21/06/05

St Augustines Court Care Home 06/01/05

St Augustines Court Care Home 20/09/04

Similar services:

Trevayler Residential Care Home

Thornham Grove

Thistle Hill Hall

Conifer Lodge

Westwood Lodge

Egerton Lodge Care Home

Alfred Minto House Care Home

St Matthews Unit

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

CARE HOMES FOR OLDER PEOPLE St Augustines Court Care Home 105 - 113 Wells Road Nottingham Nottinghamshire NG3 3AP Lead Inspector Steve Keeling Key Unannounced Inspection 19th April 2006 08:15 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 Augustines Court Care Home DS0000058342.V287961.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 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 Augustines Court Care Home DS0000058342.V287961.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service St Augustines Court Care Home Address 105 - 113 Wells Road Nottingham Nottinghamshire NG3 3AP 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) 0115 9590473 0115 9412079 Southern Cross Care Homes No 2 Limited Catherine Anne Bruce Care Home 40 Category(ies) of Dementia (3), Dementia - over 65 years of age registration, with number (40), Mental Disorder, excluding learning of places disability or dementia - over 65 years of age (40) St Augustines Court Care Home DS0000058342.V287961.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Within the total number of 40 beds 3 beds maybe used for clients under the age of 65 years in the category of DE 12th December 2005 Date of last inspection Brief Description of the Service: St Augustines Care Home provides 40 places for older people with mental illness and Dementia who require nursing care. Within the total number of beds three people under the age of 65yrs may be accommodated. The home provides 14 double rooms and 11 single, there are no en-suite facilities. A passenger lift is installed to provide access to the first floor. All areas are accessible for people in wheelchairs. Sited close to the city centre and on a regular bus route to the city of Nottingham. There is also a range of local stores close by. The fees at the home range from £302 to £470 per week. St Augustines Court Care Home DS0000058342.V287961.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over a 5 hour period and involved one inspector. The main method of inspection was case note tracking, this is a method of selecting residents within the home and discussing with them their expectations and experiences of living within the home environment. The case tracking method also analyses the records of the service users to ascertain if the residents identified needs are being addressed appropriately within the care home setting and that their safety and well being is being maintained. On this occasion two residents notes were case tracked as a greater focus was placed on the environmental issues within the home. Also as part of the case tracking process, staff members within the home are informally interviewed to further evidence the quality of care afforded to the residents. It was evident that the newly registered manager and the care staff on duty at the time of the inspection are very committed to providing a high standard of care for the service users. The manager and staff within the unit were very helpful and cooperative thus ensuring that the inspection process progressed in a professional and efficient manner. The report indicates minimal comments from the residents, primarily due to the nature of the illness of those accommodated although a relative was interviewed at this inspection to glean further information as to the quality of care afforded to the service users. The relative stated that she felt confident that her relative was receiving excellent care from a dedicated team of staff. What the service does well: The home provides care for people with enduring mental illness and dementia, most residents exhibit challenging behaviours that cannot be managed in a residential environment. The home is benefiting from an ongoing refurbishment, which has included the replacement of carpets and flooring in the bathroom areas, redecoration of residents rooms and corridors within the home, resulting in an environment which is clean, safe and fit for purpose. St Augustines Court Care Home DS0000058342.V287961.R01.S.doc Version 5.1 Page 6 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 Augustines Court Care Home DS0000058342.V287961.R01.S.doc Version 5.1 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 Augustines Court Care Home DS0000058342.V287961.R01.S.doc Version 5.1 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): 3. 6 Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. The manager of the home performs effective pre-admittance assessments to ensure identified needs can be met at the home. The home does not provide intermediate care services. EVIDENCE: The pre-admittance assessments within the two case tracked notes were detailed in identifying the specific needs of the service users to maintain optimum independence and health within the home. The assessment process identified the physical and psychological needs of the residents and utilised a recognised assessment tool. The documentation appertaining to the pre admittance assessment, provided by Southern Cross Healthcare, is clear, concise and well presented. Both case tracked assessments were signed and dated by the assessor. St Augustines Court Care Home DS0000058342.V287961.R01.S.doc Version 5.1 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): 7.8.9.10. Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. The case tracking procedure revealed that the residents “holistic” needs are addressed through an individual care planning process utilising documentation provided by Southern Cross Healthcare. Residents or relative participation was not always evident within the care planning process. Residents are protected by the homes policies and procedures in relation to dealing with medication. Residents at the home are treated with respect and dignity and that their privacy is maintained although care plans are not stored effectively which could compromise resident’s privacy and dignity. EVIDENCE: The manager at the home has made significant progress in relation to the care planning process and it was evident that the case tracked care plans were effectively maintained in a clear, concise and very well organised. St Augustines Court Care Home DS0000058342.V287961.R01.S.doc Version 5.1 Page 10 It could be clearly evidenced that service users needs were assessed holistically and all identified needs were addressed effectively within the care planning process. The care plans are evaluated on a monthly basis or as required so that the changing needs of service users are fully met at the home. A discussion with a senior carer indicated that the information within the care plans is not always passed onto the carers at handover times and as such the residents needs could be compromised. The manager of the home was aware of this shortfall and reported an intention to address the situation with the qualified nursing staff employed at the home in the near future. The care plans are not securely stored at the home, which could result in the resident’s confidentiality being compromised. To address this shortfall the registered manager is required to ensure that care plans are secure within the home environment. The two case tracked notes did not evidence that residents or their representatives had been consulted in relation to the formation of the care plans. The manager of the home should as far as practically possible ensure that residents or their relatives are involved in the care planning process to make certain consent is obtained. It was ascertained that one case tracked resident did not have any relatives to sign the documentation and the second residents relatives had not visited recently to provide a signature of consent. At the time of the inspection no service users were responsible for the selfadministration of medicines. The manager at the home stated that should a service user wish to be independent in the administration of medicines the manager would perform a risk assessment, if the service user was deemed as being safe, the service user would be supported to be independent in relation to self-administration of medication if they choose to do so. The Medication Administration Charts were examined for both case tracked residents were examined at the time of the inspection and were appropriately filled out. Manager at home, to ensure an ongoing quality service performs monthly medication audits; at the last audit the result was 80 . Medication fridges are temperature monitored daily together with the medication room. Medications, dressing and medical equipment is stored effectively and well organised. In an attempt to promote ongoing education and quality a Pharmacist attends the home once yearly to provide training for staff at the home. St Augustines Court Care Home DS0000058342.V287961.R01.S.doc Version 5.1 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): 12,13,14,15 Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users have the opportunity and choice to participate in varied and stimulating social activities. Service users are able to maintain contact with family, friends, and representatives from the local community as they wish. Service users can exercise choice and control over their lives. Service users are provided with a wholesome, appealing and balanced diet. EVIDENCE: An activities coordinator is employed at the home for 25 hours per week. The activities coordinator is responsible for the provision of varied and stimulating social activities, such as music appreciation sessions, games, painting, dancing, the provision of guest entertainers and the provision of trips within the broader community. A record of the resident’s activities is maintained for all residents and could be evidenced within the resident’s personal documentation. St Augustines Court Care Home DS0000058342.V287961.R01.S.doc Version 5.1 Page 12 Both case tracked residents were unable to provide an account of the social activities provided at the home due to reduced cognitive abilities but a visiting relative confirmed that she had witnessed residents performing social activities such as painting and drawing, which residents can choose to participate in if they wish. It was evidenced on the day of the inspection that the residents had the choice of two main meals. The lunchtime meals appeared to be well balanced, nutritious and well presented. A daily menu is displayed for service users perusal on a menu board within the dining room area. A relative spoken with stated that she had not witnessed the quality of the food but believes the food is good. The manager at the home stated that no restrictions are in place in relation to visiting times. At the time of the inspection relatives and friends were visiting residents. A relative confirmed the open access policy at the home, as she stated that “ I can visit whenever I want to, I am always made welcome and the staff are friendly and respectful”. Due to the residents impaired cognitive abilities a full discussion in relation to aspects of respect and dignity could not be performed with the residents. It was evident that staff spoken with during the inspection had appropriate knowledge and understanding of the aforementioned principles as they had received training and guidance at the home. The inspector witnessed an interaction between a member of staff and a resident at the home, the resident was being assisted with her lunch in a very respectful way, the nurse was at the same level as the resident to aid the interaction and was encouraging without being demanding. St Augustines Court Care Home DS0000058342.V287961.R01.S.doc Version 5.1 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, 18, Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. The relatives and friends of service users are confident that their complaints are listened to, taken seriously and acted upon thus protection the residents from abuse. EVIDENCE: The Southern Cross complaints procedure is given to residents or their representatives on admission, the complaints procedure is also on display in the foyer of the home together with the home’s statement of purpose. Since the last inspection the Commission for Social Care Inspection has received three complaints/concerns, which were investigated by the area operational manager at Southern Cross, it was evident that the complaint investigation was performed in a professional and effectively manner and all three complaints were not substantiated. It was also established that the manager at the home is not investigating any complaints at this time, any complaints that are received are documented effectively together with resulting outcomes and actions. A relative of a resident was spoken with, she stated that she would feel comfortable in highlighting any concerns or complaints she might have to the manager of the home or any of the staff but did not have any concerns whatsoever. St Augustines Court Care Home DS0000058342.V287961.R01.S.doc Version 5.1 Page 14 The relative also confirmed that she had received a copy of Southern Cross complaints procedure when her husband had been admitted to the home. A staff member was spoken with at the time of the inspection and it was evident that she had and appropriate knowledge of the complaints procedure within the home and she confirmed that she had received training from the manager, in relation to complaint procedures within her initial induction period. St Augustines Court Care Home DS0000058342.V287961.R01.S.doc Version 5.1 Page 15 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. 26. Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. The planned upgrades to the home are now progressing effectively and the home is maintained to appropriate standard of cleanliness. EVIDENCE: The home is benefiting from an ongoing maintenance programme and it was evident the shortfalls identified at previous inspections are being addressed effectively. The home has a high standard of cleanliness and all areas smelt fresh. The carpeted areas in the corridors have been replaced with a non-slip flooring to aid the cleaning process and to achieve an aesthetically pleasing environment. An examination of maintenance documentation evidenced that mobility equipment; gas servicing, electrical equipments, legionella prevention, fire alarm tests, hot water outlet monitoring and Environmental Health Visits are St Augustines Court Care Home DS0000058342.V287961.R01.S.doc Version 5.1 Page 16 performed appropriately to ensure the home is safe for both residents and staff. An Environmental Health inspection performed on 22/09/05 highlighted the need to replace the kitchen floor as areas are raised and broken, the report also stated that the extractor fan is faulty and will require replacement. Following a discussion with the manager at the home it was established that the money has now been made available and the upgrade to the kitchen area will commence in the near future. St Augustines Court Care Home DS0000058342.V287961.R01.S.doc Version 5.1 Page 17 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. 30 Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. Staffing levels and skill mix at the home are appropriate in meeting the needs of the service users. The home utilises an appropriate recruitment policy, which is adhered to thus ensuring residents are supported and protected. Staff receive appropriate training to do their jobs effectively. EVIDENCE: On the day of the inspection 36 residents were at the home The staff rota evidenced that two qualified nurses were on duty supported by six carers throughout the morning and afternoon periods, throughout the night period 1 qualified nurse and three carers were on duty. The recruitment documentation of the last two members of staff to be employed at the home was checked and found to be satisfactory, both members of staff had undergone appropriate police checks and had provided two written satisfactory references. The documentation is well organised and clear. All staff receive an newly formulated induction programme with includes basic introduction to core values within the home, adult abuse awareness, complaints protocols, awareness of confidentiality issues, information appertaining to residents activities, training in relation to care planning, St Augustines Court Care Home DS0000058342.V287961.R01.S.doc Version 5.1 Page 18 pressure are care, caring for the resident within the home environment and training in relation to disciplinary and grievance procedures. The manager of the home provided a training matrix which evidenced that staff also benefit form mandatory training which includes Health and Safety, Moving and Handling, Infection Control, Protection of the Vulnerable Adults, Fire Training, Food Hygiene, control of Substances Hazardous to Health (COSHH) training, First Aid training, Record Keeping and Dementia Awareness. A senior carer spoken with confirmed that the training opportunities provided by Southern Cross are comprehensive in providing information and guidance for staff within the home thus providing a safe environment for residents and staff alike. St Augustines Court Care Home DS0000058342.V287961.R01.S.doc Version 5.1 Page 19 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, 35, 38. Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. It was evident that the manager at the home is professional, fit to be in charge and of good character. The home is run in the best interests of the service users and their health and welfare promoted and protected. Service users are protected from financial abuse and their financial interests are safeguarded. EVIDENCE: The manager at the home has recently attended an interview at the Commission for Social Care Inspection at which time she was assessed as fit for registration. It was evident that the manager is committed to the provision of a high standard of care to the residents at the home and her continued St Augustines Court Care Home DS0000058342.V287961.R01.S.doc Version 5.1 Page 20 guidance and direction has resulted in significant improvements within the home. The manager stated that she feels much more confident in the manager’s role and feels that she has addressed the shortfalls identified at previous inspections in relation to the care planning process and the home’s environment. It was established through conversations with the Southern Cross area manager that the manager at the home receives appropriate support within the company. Supervision is provided on a monthly basis. The manager also attends a internal management development course which highlights quality issues, leadership techniques and team building methodologies. The manager also benefits from a mentorship process from an experienced manager within the organisation of Southern Cross. The manager and the operations manager also perform Quality audits on a monthly basis to ensure any bad practice within the home is identified and rectified. At the time of the inspection it was evidenced that the service users monies are effectively managed. The home maintains separate written and electronic records of all monetary transactions and the service users monies are not “pooled” thus protecting the service users from potential financial abuse. It was also evident that secure facilities are available in which service users monies are stored individually in poly pockets. Should any resident have large sums of money accounts have been opened at Barclays Bank to ensure that any interest accumulated is paid to individual residents. . St Augustines Court Care Home DS0000058342.V287961.R01.S.doc Version 5.1 Page 21 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 X X 3 X x 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 X X X X X x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 St Augustines Court Care Home DS0000058342.V287961.R01.S.doc Version 5.1 Page 22 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. 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 OP7 Good Practice Recommendations The registered person shall ensure after consultation with the service user, or a representative of his, prepare a written plan as to how the service users needs in respect of his health and welfare are to be met. The registered manager will be required to ensure that care plans are secure within the home environment. Information within the care plans is not disseminated to care staff effectively and will require addressing by the manager. 2 3 OP7 OP7 St Augustines Court Care Home DS0000058342.V287961.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Augustines Court Care Home DS0000058342.V287961.R01.S.doc Version 5.1 Page 24 - 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!