Inspection on 01/03/07 for St Benet`s Court

This inspection was carried out on 1st March 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.

Other inspections for this house

St Benet`s Court 09/03/09

St Benet`s Court 13/12/07

St Benet`s Court 28/06/06

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 Benets Court 32 College Road Newton Abbot Devon TQ12 1EQ Lead Inspector Clare Medlock Unannounced Inspection 1st March 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 Benets Court DS0000067041.V318393.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 Benets Court DS0000067041.V318393.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Benets Court Address 32 College Road Newton Abbot Devon TQ12 1EQ 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) 01626 354069 F/P 01626 354069 Mrs Nicola Rogers Mr Guy Perring Rogers, Ms Michelle Anne Stepney ** Post Vacant *** Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40), Physical disability over 65 years of age of places (40) St Benets Court DS0000067041.V318393.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home can accommodate 40 service users in the category of Physical Disability, over the age of 65 years The home can accommodate 40 service users in the category of Old Age 28th June 2006 Date of last inspection Brief Description of the Service: St Benets, is a large Victorian house situated on the southern slopes of Wolborough Hill Newton Abbot. It overlooks the attractive Decoy Woodland and nature reserve. The home is within a short drive from the town centre and local amenities including British Rail mainline station and direct access to the A38. St Benets offers en-suite facilities in the majority of the single and shared rooms. Residents are assisted moving around the home by the two passenger lifts, one stair lift, grab rails and ramps which offer freedom of movement for disabled Service Users. A nurse call system covers all rooms and the gardens. There are well maintained terraced gardens with secluded seating areas and a waterfall accessible to service users. The garden has views over the Devon countryside. The home caters for physically disabled Service Users and has a registered nurse on duty at all times, a range of equipment is available to help meet Service Users needs. St Benets Court DS0000067041.V318393.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 Thursday 1st March 2007. It consisted of speaking with residents, relatives, staff and the provider. Care plans, staff files and other records were inspected. Prior to the inspection, the provider submitted an in depth pre inspection questionnaire. The care, records and feedback of three residents was looked at in detail. This is referred to in the report as ‘Case Tracking’. Resident and relative questionnaires were not sent or received on this visit. Residents, relatives and staff were spoken to in person. This inspection is the fourth inspection performed on the home since April 2006. Two inspections were inspections to investigate complaints. This inspection on the 1st March 2007 took place to monitor the changes and improvements that have occurred since the last inspection in November 2006. What the service does well: St Benets Nursing Home provides a good level of nursing and personal care. A dedicated staff group ensure that residents have all their needs met and ensure residents access a full variety of services. Care planning and delivery of care is very good at the home and links with health care professionals is made when needed. The routines within the home are flexible depending on the choice of the residents. Residents and their families are given information and opportunities to visit the home prior to making a decision to move into the home, and residents and their families confirmed that this good communication continued after admission. Staff communicate well with service users and their families and provide opportunities on a formal and informal basis to ensure their voices are heard and requests acted on. Residents are happy living at the home and feel they are well cared for. Residents say staff are very kind and caring and make sure they have everything they need. St Benets Court DS0000067041.V318393.R01.S.doc Version 5.2 Page 6 Communication between the Commission for Social Care Inspection, provider and staff at the home is good. What has improved since the last inspection? Since the last inspection staff have been regularly reminded about small details of care, which include ensuring residents can reach their drinks or are prompted regularly to drink. Residents are left but now have a call bell within reach. This means residents are kept hydrated and have same control and reassurance when they are left alone. Care Plans have vastly improved. Care is assessed clearly and planned. Residents and relatives are involved in this process and all staff including care staff are encouraged to write, update and write in care plans. Assessments of residents have also been improved by ensuring they are up to date and reviewed and introducing new assessments including nutritional assessments and risk assessments. These changes improve the communication between staff and residents and means that all staff are aware of the needs of each resident. Encouraging care staff to participate in the process helps improve morale and the sense of being part of a team. Other charts have been introduced which show changes and trends in conditions. These are kept in resident’s rooms where necessary. This act as prompts for staff and provide evidence that care has been given to a set standard. The Induction programme for new staff has also been vastly improved with the introduction of a formal booklet, which is completed and based on a national recognised scheme (Skills for care). This then automatically mirrors and leads to NVQ (National Vocational Qualification) training. This means that staff have all the skills and knowledge they need to perform their roles safely and effectively. The medication system management has improved and monitored by the introduction of a company member of staff who visits the home and checks drugs have been correctly ordered, recorded and stored. This acts as a safety net for medications and is to be encouraged. At a previous inspection the provider stated that as an organisation they are aware of the importance for training and produced a plan to show that, over time this would be provided. This plan has been introduced and systems have now been made to ensure the programme of training is ongoing and can spot staff that evade the opportunities to train. St Benets Court DS0000067041.V318393.R01.S.doc Version 5.2 Page 7 Improvements to the environment were seen and were not due to recommendations set but part of the on going programme of maintenance. Fridges and freezers had been replaced and new furniture ordered. The hall and corridor had been recently redecorated and the gardener had been in to tidy the garden. The rear of the house and fire exit doors had been repainted to maintain the high standard of décor at the home. Triple rooms have been used for twin occupancy rather than for three residents. This encourages privacy for residents and the practice should be continued. 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 Benets Court DS0000067041.V318393.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 Benets Court DS0000067041.V318393.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. Residents and their families are given enough information to decide whether St Benets is the right place for them to be. Staff at the home thoroughly assess prospective residents to ensure staff at the home are able to meet their needs. EVIDENCE: Discussion with a relative of a Resident that was being ‘case tracked’ confirmed that the social worker gave them a list of suitable homes with a vacancy. The family then looked at the homes and made the choice to admit to St Benets. Relatives and residents spoken to said that families made this decision as they were too ill at the time. A Statement of Purpose and Service User Guide were available for this inspection and on display in the hall. Both documents included necessary up to St Benets Court DS0000067041.V318393.R01.S.doc Version 5.2 Page 10 date information. This enables Residents to decide whether the home is the right place for them to be. Relatives of residents at the home confirmed that information was given verbally at the time of the tour but paper work was also given to read at home. Case tracking confirmed that, residents sign contracts, or their families even when funding is provided by social services. On the inspection one relative was seen to be returning a signed contract. A sample of these contracts was seen and contained the correct information apart from the reference to the National Care Standards Commission, which is now called the Commission for Social Care Inspection. This was highlighted to the provider and was noted for change. One resident said she had chosen St Benets because of its reputation. One resident said the staff had been fantastic in her short time at the home, even though the decision to move in was very scary. The resident said staff had been patient and very accommodating. St Benets Court DS0000067041.V318393.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,elements of 9,and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The improved clear and consistent care planning system means that the health and social needs of Residents are fully planned. Staff communicate well with the multi disciplinary team, which safeguards Residents. The recent staff training reminds staff of the promotion of the welfare, privacy and dignity of residents at all times. EVIDENCE: All residents seen on the day of inspection appeared well cared for. Residents being cared for in bed appeared warm, pain free and had call bells within reach. Residents who were up and in the lounge or in their bedrooms were seen to have clean eyes, teeth, and were dressed in their own clothes. Residents who wore glasses had them on and footwear appeared appropriate. Residents stated that they felt very well cared for. One resident said ‘you could not ask for better staff and even when they are short staffed they are kind and St Benets Court DS0000067041.V318393.R01.S.doc Version 5.2 Page 12 caring’. Those residents still in bed stated that this was their choice. One resident who was not happy about being in bed said she wanted to be in her chair. Inspection of care plans clearly showed the reason for bed rest and showed a plan of care that had been agreed with family. Discussion with the relative of this resident confirmed that staff had explained why the resident was nursed in bed and that staff had explained to the resident why she could not be sitting out for the majority of the day. Thank you cards and letters from grateful relatives were seen in the home. A letter from a health care professional was seen which praised the level of care given to a resident. Three residents were case tracked. This is where three newly admitted resident care plans were inspected and care followed to ensure care needs had been assessed, met, reviewed and changed. The Care Plans inspected on this occasion clearly demonstrated vast improvements in the quality and frequency of care assessment, review and planning. This system of Care Plans was being introduced at the last inspection. The newly changed care plans were inspected and were written to a high standard that was easy to read and follow. All care plans were up to date, well written and complete. Risk assessments for moving and handling, pressure area care, nutrition and the environment were seen in all care plans and had been regularly reviewed. Weight and bowel records were written separately and done so in a way, which would be able to be used to monitor trends. Photographs taken not only showed what residents looked like but also captured the character of the residents. Care staff spoken to had also been given an opportunity to participate in the writing of care plans and assessments. The Provider had produced a guideline which staff were using when writing the plans. The improvements in the standard and quality of care planning are to be commended at the home. Care Plans showed that staff access a range of health care services for the residents. These services included out patient appointments, visits by the GP, speech and language therapist, and physiotherapist. Continence nurse specialists and other nurse practitioners are also consulted when needed. All residents spoken to said staff were very kind and caring. All residents spoken to said they wear their own clothes, staff knock before entering their room and that they receive their post unopened. Some residents chose to have a telephone in their room. Rooms where residents share have screening, which was used by staff. Residents said staff had been able to move their room upon request and where a spare room became available. St Benets Court DS0000067041.V318393.R01.S.doc Version 5.2 Page 13 The registered nurses manage the homes medication administration system. During the inspection, a company member of staff was present to perform an audit on the ordering, administration and recording of medications. The MAR (Medicine administration records) were briefly inspected and appeared to be correctly completed with no gaps or omissions. The storage area of the medicines were, clean, tidy and secure and the systems for the collection and disposal of medicines were well managed. Residents spoken with confirmed that they were happy with the care and felt safe. All residents spoken to said staff knock at the door before entering and are covered when personal care is given. Residents said they receive their medications on time and bells are answered as quickly as staff could manage. Relatives spoken to confirmed that they had been involved in reviewing care where their relatives are not able or have been too unwell. One relative said she is kept up to date with changes in care and consulted about any changes. One resident said she thought the staff were fantastic and worked very hard. Another resident said staff do their best and were kind. Residents and relatives alike said the standard of care at St Benets appears to have improved considerably in the last few months. One relative said that some staff had left when the new owners had taken over and this has now settled with some lovely new staff joining the team. Another resident said ‘things had taken a dip but were back up now but staff had always been lovely’ One relative said ‘the staff are cheerful well mannered and helpful. I, as a visitor feel welcome and staff endeavour to help me as best they can. All the patients I see appear well cared for.’ St Benets Court DS0000067041.V318393.R01.S.doc Version 5.2 Page 14 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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The improved social activities programme means that residents have access to creative, well-managed and varied activities. Residents have more choice and control over their lives whilst living at the home and generally enjoy the meals that are provided. EVIDENCE: Observation of the visitor’s book confirmed that friends and family have access to the home at any reasonable time. Discussion with relatives confirmed they are invited to join their families for lunch with minimal notice to the home. A tour of the home confirmed that Residents rooms are personalised by bringing in personal possessions with them to the home. Residents spoken to said they are able to go out for lunch or trips with family and friends. Residents spoken to say they always receive post unopened and are able to make and receive telephone calls in private. Discussion with staff confirmed that those residents who are unable or too unwell to read are asked if they St Benets Court DS0000067041.V318393.R01.S.doc Version 5.2 Page 15 would like the letter opened and read or will wait for family to visit for this to happen. Discussion with residents and observation confirmed that the home use a new activity co coordinator who visits the home once a week to organise the activities programme. Residents said she visits once a week and another member of staff does activities on another day. Residents spoken to said they were able to join in with these activities if they chose. Residents said the activities were ‘a bit of a giggle’ and were ‘not demeaning’ On the day of inspection another visitor was in the lounge with a ‘toddler’ who was playing with a balloon. All the other residents appeared to enjoy watching this. Other residents were in the other lounge and were either reading newspapers or watching the TV. Residents said that activities include bingo, cards, and crafts, touch and feel, arm chair skittles and armchair basketball. Residents said they decided which activities they joined in and could opt to go to the quiet lounge or their room if they wanted to. Posters advertised a forthcoming mothers day celebration. Photographs displayed photographs of events and trips out. One resident said she was waiting for some better weather so they could sit in the garden a bit more often. Residents spoken to said they have some degree of choice over their lives. One resident said as well as the weekly bath, she has asked for showers more often too, which staff have given. All residents and relatives spoken to said the food was excellent. Residents said there was enough to eat. A rota of menus was produced pre inspection but this may vary depending on seasonal produce. During the inspection the inspector sampled the meal. The food was colourful, appetising and full of flavour. Food for those with swallowing difficulties was pureed separately, was hot and tasted full of flavour without loosing the texture. On the day of inspection residents were served sausage and mash and coconut sponge and custard. Residents spoken to said they never knew what was for lunch but that it was a surprise. Another resident said this was not a problem as if the food served was not to their choice an alternative was always found. Staff have also introduced a nutritional screening tool, which identifies those residents of being at risk of loosing or gaining weight. Residents spoken to said the food was good at the home and had never been a problem. Another resident said she enjoyed the food and the quality of the meat had improved and on the whole was good. St Benets Court DS0000067041.V318393.R01.S.doc Version 5.2 Page 16 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents feel able to complain knowing the provider and staff will act on them appropriately. The recent training has further protected residents in adult Protection awareness. EVIDENCE: St Benets has a complaints procedure that meets the National Minimum Standards and Regulations. The complaints procedure is available within the Home, Statement of Purpose and Service User Guide, which are on display in the entrance hall. Four relatives/visitors were asked about complaints. All said that they knew who to complain to but had not needed to make a complaint in recent months. One relative said she had to complain about a small thing but the nurse in charge had sorted it out straight away. Five residents were asked about complaints. They said they would speak with the care staff. One resident said she would be reluctant to complain but would probably say something to her family. One resident said complaint is too strong but ‘niggles’ are usually sorted out straight away. The Commission for Social Care Inspection have received no complaints since the last inspection. Prior to this inspection, information received from an anonymous source and an additional complaint prompted a spot check/unannounced inspection. Although some issues were unsubstantiated, areas of concern were noted at the time of inspection. These concerns included St Benets Court DS0000067041.V318393.R01.S.doc Version 5.2 Page 17 access to drinks and staff forgetting to ensure the drinks were within reach of some residents. Also some residents were left without access to call bells. At the previous inspection some residents were still in bed in the late morning. These shortfalls were formally told to the provider. Since this time the provider has organised additional staff training and made changes in work practices which have improved life for the residents. Staff spoken to said staff were reminded regularly about the drinks and call bells in report sessions and that it was a good reminder. On the day of this inspection, there were residents still in bed in the late morning (11.30). All but one of these residents had either requested a lie in, or were too poorly to sit out in a chair. The one resident that was unhappy about being in bed was nursed in bed for a reason, which was explained by staff and was recorded clearly in the care plan. Relatives for this resident were contacted following the inspection. The inspector was informed that the staff at the home had informed her why her relative had to be nursed in bed and that the resident had been explained this reason too. The relative said staff had been very good. On the day of inspection all residents were within reach of the call bell and had a drink within reach. The home have new policies and procedures regarding protection of residents. Within the policy it is clear when incidents need external input and who to refer the incident to. Discussion with staff confirmed that they would speak with on of the directors if an allegation of abuse was made. All staff spoken to knew how to contact them. Discussion with staff and records confirmed that staff had received training in POVA (Protection of vulnerable adults) issues. Staff said they had been told what the different types of abuse were, how to prevent it and how to report it. One member of staff said she had also covered this in her NVQ training. All residents spoken to said they felt safe at the home and that all staff were kind, gentle and caring. St Benets Court DS0000067041.V318393.R01.S.doc Version 5.2 Page 18 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): 19,24,25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment is well maintained, safe and hygienic and provides a homely place for residents to live. EVIDENCE: Improvements to the environment were seen and were not due to recommendations set but part of the on going programme of maintenance. Fridges and freezers had been replaced and new furniture ordered. Residents said the hall and corridors had been recently redecorated and that the gardener had been in to tidy the garden. One resident said she was St Benets Court DS0000067041.V318393.R01.S.doc Version 5.2 Page 19 pleased about this as in the past residents had enjoyed sitting outside and were now waiting for the fine weather to arrive. A tour of the building showed that the three-bedded rooms were being used as twin occupancy at present. Discussion with the provider said they tried to keep this arrangement where possible. All areas of the home appeared very clean. Residents and relatives said the home was always clean. One resident said there was always a cleaner cleaning somewhere in the home. One resident said her room was always tidy. One relative said she visits the home regularly and has never noticed the home smelling. On the day of inspection the only smell noted was tat of lunch being prepared. Maintenance safety records for electric, waste, Environmental health, nurse call system, boiler, gas, hoists, lift and stair lift were seen to be up to date. The Provider also explained that the rear of house and fire escapes had been painted and that new carpet, curtains and a dresser were on order for the dining area. Discussion with residents confirmed that residents have the choice to bring small personal items of furniture into the home. The shared areas provide a choice of communal space with opportunities to meet relatives and friends in privacy or in their own rooms. Residents spoken to said there is a choice of bathing facilities, which included showers and baths and there are a number of toilets strategically placed around the home. Although there is sufficient number of bath and shower rooms but not all are regularly used. Residents spoken to said they have set bath days where they enjoy the larger assisted bathrooms. One resident said she requests additional showers, which staff organise for her. A Tour of the building confirmed that the home is generally clean and tidy, and there have been no outbreaks of infection. Hygiene equipment is available with evidence that staff wear gloves and aprons when providing personal care. The Laundry is well equipped with sluice cycle washing machines, which reduce the risk of infection. Residents say that the clothes are washed well and returned promptly. St Benets Court DS0000067041.V318393.R01.S.doc Version 5.2 Page 20 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. The change in work patterns and a more formal induction process means residents are more likely to have their needs met EVIDENCE: At a previous inspection the provider stated that as an organisation they are aware of the importance for training and produced a plan to show that, over time this will be provided. This plan has been introduced and systems have been made to ensure the programme of training is ongoing and can spot staff that evade the opportunities to train. The spreadsheet used and discussion with staff confirmed that training for moving and handling, POVA, fire safety and food hygiene. Dates have been booked for further training. Discussion with a member of the trained staff team revealed that the importance of updating knowledge and skills is sometimes neglected due to time pressures, cost of training and in some cases apathy. The Nursing and Midwifery Council is the regulatory body for nurses in the UK and nurses have to be on this register in order to practice. All registered nurses have to be on St Benets Court DS0000067041.V318393.R01.S.doc Version 5.2 Page 21 the Nursing and Midwifery Council register and declare each year that they have updated their knowledge. A Registered nurse spoken to on the day of inspection could not recall what learning or education had taken place in the last year. This should be addressed as a matter or importance. Discussion with care staff confirmed that induction has improved at the home and a formal booklet is completed which is based on a national recognised scheme (Skills for care). This then automatically mirrors and leads to NVQ (National Vocational Qualification) training. Staff spoken to said that the providers have supported them in accessing NVQ training. Posters displayed in the office confirmed that English language courses have been sourced at a local college. The provider stated that overseas staff are expected to attend. Inspection of off duty confirmed that staffing levels have been stable recently. Discussion with care staff confirmed that staff are sent to work in different areas of the home and are expected to assist other areas when their residents have been given the care they need. Staff spoken to were clear regarding their roles and what is expected of them. One member of staff said morale continues to improve. The atmosphere appeared more relaxed at the home. Staff were seen smiling and rapport between residents and staff was relaxed courteous and caring. Three newly recruited staff files were inspected on this occasion. These confirmed that all information required had been obtained and Criminal Records Bureau/POVA (Protection of Vulnerable Adults) checks performed. No concerns regarding this process were identified. St Benets Court DS0000067041.V318393.R01.S.doc Version 5.2 Page 22 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): 32,35,36,37 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Despite no manager being at the home the daily presence of the provider has given stability and improved the running of the home. EVIDENCE: The Provider has the necessary experience to run St Benets and has a clear understanding of the National Minimum Standards. She and the staff at the home have worked hard to introduce changes at the home, which has ensured the standards are met, and the quality and safety of life has improved for residents and staff alike. St Benets Court DS0000067041.V318393.R01.S.doc Version 5.2 Page 23 The change of ownership a year ago caused distress to residents, relatives and staff. Some staff left and the number of complaints rose. This has now settled with no complaints being made since November 2006, more staff training introduced and the activities programme recommenced. Residents and relatives spoken to said that some staff had left when the new owners had taken over and this has now settled with some lovely new staff joining the team. Another resident said ‘things had taken a dip but were back up now but staff had always been lovely’ The providers had met requirements and Recommendations in a timely way. Communication regarding the recent departure of the Manager has been prompt by the providers. Residents and relatives spoken to said the Providers were always at the home and often checked to see if things were OK. The organisation of the home continues to be good at the home, with many services being on a routine maintenance contract. Records were seen for gas and electric safety, lift and hoist maintenance, fire safety, waste management. Environmental Health reports were seen and recommendations being considered. Residents spoken to either said they manage their own finances or relatives do this for them. One relative was seen to come in an give money for extras such as hairdressing. The personal monies were not inspected on this occasion. During the inspection residents and relatives were seen to come and go to the office to speak with staff and the provider. One resident was just informing staff she was going out with her family. Staff spoken to said communication was good at the home. Regular report sessions were held for all staff where changes were communicated and ideas shared. Staff said these “reports are really useful especially when you have had a few days off”. Discussion with the provider confirmed that the home have a new Manager who will be starting at the home in the near future. The Majority of records were well maintained and secure. Staff files were stored in locked facilities and resident care plans stored within the office. At a previous inspection the provider stated that as an organisation they are aware of the importance for training and produced a plan to show that, over time this will be provided. This plan has been introduced and systems have been made to ensure the programme of training is ongoing and can spot staff that evade the opportunities to train. St Benets Court DS0000067041.V318393.R01.S.doc Version 5.2 Page 24 The spreadsheet used and discussion with staff confirmed that training for moving and handling, POVA, fire safety and food hygiene. The Provider information questionnaire provided contained statements that training in medication, challenging behaviour, safer food, better business and continence training. Dates have been booked for further training. St Benets Court DS0000067041.V318393.R01.S.doc Version 5.2 Page 25 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 x HEALTH AND PERSONAL CARE Standard No Score 7 4 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 3 3 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x 3 x x 3 3 3 3 St Benets Court DS0000067041.V318393.R01.S.doc Version 5.2 Page 26 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 2 Refer to Standard OP23 OP28 Good Practice Recommendations Continue to use the triple rooms for twin occupancy and consider making this arrangement permanent Continue to improve the skills and knowledge of staff by: • Continuing with the mandatory training programme • Ensuring overseas staff attend the English Language courses where needed • Ensuring registered nurses are up to date with their PREP (post registration education and practice) requirements so they can re register with the Nursing and Midwifery Council St Benets Court DS0000067041.V318393.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton 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. 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