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Inspection on 19/05/08 for St Bridget`s Residential Home

Also see our care home review for St Bridget`s Residential Home for more information

This inspection was carried out on 19th May 2008.

CSCI found this care home to be providing an Good service.

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

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

What the care home does well

The home understands the importance of ensuring they have all the information necessary concerning a persons health and welfare prior to them moving in and of the persons rights to know all about the service before they make the decision to move. Based on assessment information a care plan is devised detailing how care needs are to be met; care needs are reviewed and updated regularly to ensure care can be delivered satisfactorily and that all care needs are addressed in the daily routines. Residents at St Bridget`s have access to healthcare services from the local surgeries and are supported in meeting appointments with other health care professionals. Medication is well managed in the home. Social and recreational activity is limited to that which the residents wish to participate in, some organised activities are arranged and visitors from family and friends and other members of the community keep residents stimulated and involved. Meals provided are nutritious and varied and residents spoken with confirmed there is sufficient with good quantities of fresh fruit and vegetablesResidents living at the home are protected by the home`s policies regarding safeguarding and complaints and can be assured that any concerns will be taken seriously and acted upon. St Bridget`s provides residents with a comfortable environment in which to live where they are safe, warm and have suitable facilities to meet their needs. Good progress has been made in upgrading the building to ensure it complies with regulations Residents confirmed that staff are always available to meet their needs and to provide assistance when needed, it has been recommended however that a dedicated cook is appointed. St Bridget`s is well managed and Mrs Simpson has a good understanding of the principles and focus of the service and of processes needed to ensure the home continues to meet the National Minimum Standards

What has improved since the last inspection?

Five requirements were made as a result of the last inspection, this inspection evidenced that all these have been met. A controlled drugs cabinet has been installed, radiators and hot surfaces have been guarded, suitable equipment has been purchased to support safe moving and handling processes, the upgrading of the premises ensures it now complies with the requirements of the fire authority and a photograph of each resident is held.

CARE HOMES FOR OLDER PEOPLE St Bridget`s Residential Home 42 Stirling Road Talbot Woods Bournemouth Dorset BH3 7JH Lead Inspector Jo Palmer Unannounced Inspection 19th May 2008 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 Bridget`s Residential Home DS0000003985.V362244.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 Bridget`s Residential Home DS0000003985.V362244.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Bridget`s Residential Home Address 42 Stirling Road Talbot Woods Bournemouth Dorset BH3 7JH 01202 515969 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) Mr Anthony Howell Mrs Denise Simpson Care Home 10 Category(ies) of Old age, not falling within any other category registration, with number (10) of places St Bridget`s Residential Home DS0000003985.V362244.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: 2. Old age, not falling within any other category (Code OP) The maximum number of service users who can be accommodated is 10 17th December 2007 Date of last inspection Brief Description of the Service: St Bridgets Residential Home has the capacity to care for ten older people all enjoying single rooms. The home is set in a large 1930s converted house, in a quiet residential area of Bournemouth - Talbot Park - close to shops and other local amenities. The home is over two floors - ground and first - and there is a passenger lift. There are a variety of aids around the building to allow residents to move about more independently. One bedroom has an ensuite. There are four communal toilets and two baths - the more popular one has a mechanical bath seat. The weekly charge currently ranges between £388 and £452. St Bridget`s Residential Home DS0000003985.V362244.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The inspection took place on 19th May 2008 between 10.00 and 13.00. Denise Simpson is the Registered Manager who takes responsibility for the day-to-day management of the home; Mrs Simpson was present to assist with the inspection process. Mr Anthony Howell came in briefly during the inspection, Mr Howell is the Registered Provider and owner of St Bridget’s. The main purpose of this key inspection was to check that the residents living in the home were safe and properly cared for and to review the homes performance against the key National Minimum Standards and in meeting requirements of the last inspection St Bridget’s is registered for 10 places, there were no vacancies, three residents, the manager and two members of staff were spoken with, relevant records were examined and a tour of the premises also informed this inspection visit. What the service does well: The home understands the importance of ensuring they have all the information necessary concerning a persons health and welfare prior to them moving in and of the persons rights to know all about the service before they make the decision to move. Based on assessment information a care plan is devised detailing how care needs are to be met; care needs are reviewed and updated regularly to ensure care can be delivered satisfactorily and that all care needs are addressed in the daily routines. Residents at St Bridget’s have access to healthcare services from the local surgeries and are supported in meeting appointments with other health care professionals. Medication is well managed in the home. Social and recreational activity is limited to that which the residents wish to participate in, some organised activities are arranged and visitors from family and friends and other members of the community keep residents stimulated and involved. Meals provided are nutritious and varied and residents spoken with confirmed there is sufficient with good quantities of fresh fruit and vegetables St Bridget`s Residential Home DS0000003985.V362244.R01.S.doc Version 5.2 Page 6 Residents living at the home are protected by the home’s policies regarding safeguarding and complaints and can be assured that any concerns will be taken seriously and acted upon. St Bridget’s provides residents with a comfortable environment in which to live where they are safe, warm and have suitable facilities to meet their needs. Good progress has been made in upgrading the building to ensure it complies with regulations Residents confirmed that staff are always available to meet their needs and to provide assistance when needed, it has been recommended however that a dedicated cook is appointed. St Bridget’s is well managed and Mrs Simpson has a good understanding of the principles and focus of the service and of processes needed to ensure the home continues to meet the National Minimum Standards 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. The summary of this inspection report can be made available in other formats on request. St Bridget`s Residential Home DS0000003985.V362244.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 Bridget`s Residential Home DS0000003985.V362244.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A pre admission procedure is in place and assessments are routinely undertaken to ensure that only residents whose needs can be met by the home are offered places there EVIDENCE: Pre admission assessments were seen for two resident’s who have moved to the home since the last inspection; the needs of the residents were assessed prior to them agreeing to move into the home using a set format that has been developed to take into consideration their health and welfare needs. The records indicated that the needs and circumstances of the people had been properly taken into account. It was evident where appropriate that the resident or their representative had been consulted regarding the pre-admission assessment. Where the resident is assisted with funding arrangements by a St Bridget`s Residential Home DS0000003985.V362244.R01.S.doc Version 5.2 Page 9 local authority, that authorities assessment of need in respect of the what the care home is to provide, is held for staff reference. St Bridget`s Residential Home DS0000003985.V362244.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems are in place to provide staff with the information they need to meet the health, personal care and social needs of residents. The principles of respect, dignity and privacy are put into practice. EVIDENCE: Information gathered through assessments is used to help compile a plan of care for each resident. Care plans provide succinct information about the needs of the resident and how these needs are to be met in a manner that is respectful of the resident’s own choices and individual needs and it was clear that reviews were being undertaken and plans updated with changes. Care plans for three residents were reviewed, these were noted to provide staff at St Bridget’s of the care they need to provide to support and maintain the health and welfare of the residents. St Bridget`s Residential Home DS0000003985.V362244.R01.S.doc Version 5.2 Page 11 A daily record of care provided is written by staff following each shift, of those reviewed, it was evident that each record provided a good account of the care received by the resident and any other significant event. Medication records are well kept and evidenced that residents are in receipt of any medication as prescribed by their GP, storage of medicines in the home was safe and in order. A monitored dosage system is in place administered by the dispensing pharmacist, the system provides medication administration records (MAR) for completion by the home. Most medicines are issued from the supplying pharmacist in blister packs (MDS), those that are not suitable for this type of dispensing are issued in their original containers, stocks of medicines held audited with recorded information. The last inspection made the requirement that a cabinet was provided in which to store controlled drugs; this requirement has now been met. Recommendations of the previous inspection have also been addressed in respect of a sample signature sheet, regular audits, counter signatures for hand written entries and methods of administration. Residents spoken with said that they were treated well and that staff were kind and friendly; one resident said that they ‘couldn’t wish for better’ and another stated that the ‘staff are lovely and are very supportive’. Staff were seen to treat residents with extreme courtesy, patience, kindness and respect. St Bridget`s Residential Home DS0000003985.V362244.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The level of activities provided are tailored to individual residents needs and people are encouraged to make choices about their life style and to maintain contact with their family and friends. The meals in the home are wholesome and varied and are served in a pleasant environment EVIDENCE: Assessments of residents social, cultural and psychological welfare are in place under headings of ‘independence’, ‘safety’, ‘communication’ and ‘social’ to ensure staff have a basic understanding of individual need. Care plans, produced from assessment provided staff with instruction on how needs are to be met and were noted to reference individual time with residence and reminded staff of their roles in psychological support, respect and maintaining dignity. Daily records indicated the level of activity participated in including individual, independent activity, family and friends visits and outings and any group or organised activity. Residents spoken with confirmed they are at liberty to ‘do their own thing’ including getting up and going to bed when they St Bridget`s Residential Home DS0000003985.V362244.R01.S.doc Version 5.2 Page 13 pleased, going out, taking their meals in either the ir rooms or the dining room and some groups they enjoyed such as the weekly exercise session. The main meal of the day is served at lunch time, this was observed during the inspection and noted to be a social affair with residents sitting at pleasantly laid dining tables with staff in attendance for assistance and waiting as appropriate, residents spoken with confirmed that they enjoyed the meals in the home. Care staff or the manager do the home’s cooking from a set menu, a review of this showed there to be a varied diet provided including a range of home cooked and pre-prepared dishes. All staff have appropriate Food Hygiene training certificates. This inspection has recommended that a dedicated cook is employed to enable care staff to devote their time on duty to resident care. St Bridget`s Residential Home DS0000003985.V362244.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Policies, procedures and staff training programmes are in place to protect the residents living at the home; residents can be assured that they can express any concerns they may have and that any incidents will be managed appropriately. EVIDENCE: The last inspection reported that a complaints procedure is available to residents and visitors to the home; this was not reviewed as Mrs Simpson confirmed that it has not changed and also confirmed that no complaints have been received. Adult protection procedures are in place detailing the correct action to be taken should any concerns or allegations be made. The home holds a copy of local authority and Department of Health guidance on adult protection matters and all care staff have received training in adult protection and recognising abuse; no referrals have been made. St Bridget`s Residential Home DS0000003985.V362244.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22, 25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. St Bridget’s provides residents with a comfortable environment in which to live where they are safe, warm and have suitable facilities to meet their needs. Good progress has been made in upgrading the building to ensure it complies with regulations. EVIDENCE: Residents spoken with confirmed that they are comfortable in their rooms and are able to bring personal effects to make their space more homely and that the communal areas provided comfortable living space; a tour of the premises viewing some rooms evidenced that they were clean, well maintained and homely. The home was clean and well maintained at the time of inspection; infection control procedures are in place with suitable hand washing facilities for staff in St Bridget`s Residential Home DS0000003985.V362244.R01.S.doc Version 5.2 Page 16 respect of infection control procedures. Residents spoken with confirmed that the laundry systems in the home work well and that their clothing, bedding etc is returned promptly, clean and in good condition; the laundry area was seen to be satisfactory. Issues raised at the last inspection have been, or are in the process of being addressed. Equipment has been purchased to support the safe moving and handling of residents should the need arise and the installation of new fire doors, automatic closures and radiator guards was near completion. Work being carried out at the time of inspection was seen to be unobtrusive with minimal impact on residents living at the home. Mrs Simpson confirmed however that the premises have not been assessed by an occupational therapist or other qualified person in respect of access around the home, the recommendation is repeated. St Bridget`s Residential Home DS0000003985.V362244.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sufficient numbers of staff are on duty to meet resident’s needs. Training is provided to staff in order that they have the skills and are competent to do their jobs. Safe staff recruitment practice is used. EVIDENCE: Rota’s seen demonstrated that there are two care staff on duty daily supported by a senior carer, additionally the owner/manager is present in the home at various times throughout the week. Day shifts are worked between 8am and 2pm, and 2pm and 8pm. The night shift is between 8pm and 8am where there is one member of care staff with a second sleeping in/on call. Residents spoken with confirmed that staff are available when they need them. Care staff also have the role of preparing the meals in the home, whilst this has worked sufficiently while residents accommodated do not have high dependency care needs, it is recommended that Mr Howell consider appointing a dedicated cook in order that care staff can devote their time to resident care. (See also standard 15) One member of care staff have attained NVQ level 2 and several of the staff have nursing qualifications obtained overseas and although not registered to practice nursing in the UK, Mrs Simpson is advised to verify that their qualifications are NVQ level 3 equivalent. St Bridget`s Residential Home DS0000003985.V362244.R01.S.doc Version 5.2 Page 18 All staff have attended training in the following and updates and refresher courses are booked where necessary: • Moving and handling • First Aid • Health and Safety • Food Hygiene • Fire safety • Infection control • Adult protection • Induction training Recruitment files were not examined, Mrs Simpson confirmed that no new staff have been appointed since the last inspection which reported that safe practices were used in recruitment. St Bridget`s Residential Home DS0000003985.V362244.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Mr Howell is the registered provider for St Bridgets, Mrs Simpson, the registered manager takes responsibility for the day to day management of the service and is aware of the basic processes set out in the National Minimum Standards and of the need to keep up to date with practice and to develop the service. Quality assurance systems are being developed. People are supported to manage their own money where possible and health and safety policies and procedures are in place for the protection of residents. EVIDENCE: St Bridget`s Residential Home DS0000003985.V362244.R01.S.doc Version 5.2 Page 20 Mrs Simpson has been managing St Bridget’s for 17 years, she has a City and Guilds managers award. Standard 33 was not assessed during this inspection, the Commission for Social Care Inspection sent the home an annual quality assurance assessment (AQAA) in 2007 which was completed and returned providing necessary information to assist with the Annual Service Review (ASR) undertaken by the Commission in August 2007. The report of the ASR is available to interested parties via the Commission’s web site inform the last inspection. Mrs Simpson confirmed that residents views were sought via questionnaires which when returned showed positive comments about the care and services received. Questionnaires were sent to other stakeholders although Mrs Simpson said that these had not been returned. In order to protect residents, it is the policy of the home not to have any involvement with their personal finances. Therefore, any resident unable or not wishing to handle their own affairs has a relative or other representative to deal with their personal affairs and finances. A Fire Risk Assessment is being updated with respect to the upgrading of the homes fire precautions, regular testing and maintenance of fire fighting equipment, alarms and emergency lighting systems takes place and all staff receive fire safety and awareness training regularly. St Bridget`s Residential Home DS0000003985.V362244.R01.S.doc Version 5.2 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 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 St Bridget`s Residential Home DS0000003985.V362244.R01.S.doc Version 5.2 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. 1. 2. Refer to Standard OP15 OP22 OP28 Good Practice Recommendations It is recommended that a cook is employed to enable care staff to dedicate their time on duty to resident care. It is recommended that an assessment of the premises is undertaken by an occupational therapist or another suitably qualified person. It is recommended that the home ensures that 50 of care staff have NVQ training and that any overseas qualifications are verified as equivalent. St Bridget`s Residential Home DS0000003985.V362244.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI St Bridget`s Residential Home DS0000003985.V362244.R01.S.doc Version 5.2 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. 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