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Inspection on 06/04/05 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 6th April 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

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 manager and staff at St Bridgets have created a very homely environment for the residents to live in. The manager has worked there for 14 years and she has a core group of staff who have also worked at the home for a long time. This means that they are used to working together as a team to look after residents. Staff said they liked working at the home as it was small and friendly. Residents, who have lived at the home for a long time, benefit from having the same people looking after them

What has improved since the last inspection?

Care plans have been written for all residents and daily notes are made of the care given and other things that happen. Having good care plans in place ensures that staff have all the information they need to fully meet residents` needs. Some radiators have been guarded and others will be. This will protect residents from the risk of burning themselves on potentially hot surfaces.

What the care home could do better:

After prospective residents have been assessed and the home is sure that they can meet their needs the home is going to confirm this in writing to the resident. Recommendations made by other authorities such as the fire and rescue service, in respect of upgrading the building for fire safety, and environmentalhealth, in respect of updating the kitchen, need to be addressed. On an individual basis the home staff must be constantly aware of the safety of residents e.g. by them always having their emergency call bells to hand. Some paperwork needs amendment, such as the adult protection policy. Other policies need to be put into practice, such as the self medication policy, where a written risk assessment is needed. Comment cards are going to be made available to relatives and visitors to get more feedback about the home and how residents are cared for there to help the home management make the home even better. In future the manager is going to make sure that every member of staff gets their fire training when it is due.

CARE HOMES FOR OLDER PEOPLE St Bridgets Residential Home 42 Stirling Road Talbot Woods Bournemouth BH3 7JH Lead Inspector Debra Jones Unannounced 06 April 2005 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 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 Bridgets Residential Home Version 1.10 Page 3 SERVICE INFORMATION Name of service St Bridgets Residential Home Address 42 Stirling Road Talbot Woods Bournemouth BH3 7JH 01202 515969 01202 291347 Telephone number Fax number Email 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 CRH – Care Home 14 Category(ies) of OP - Old Age (14) registration, with number of places St Bridgets Residential Home Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection 22nd September 2004 Brief Description of the Service: St Bridget’s Residential Home has the capacity to care for fourteen older people but in practice has no more than ten people living there, 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. All 10 rooms are currently used as single rooms. One of them has an ensuite. There are four communal toilets and two baths the more popular one has an mechanical bathseat St Bridgets Residential Home Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 3.5 hours and was one of the two anticipated inspections of the year. The recommendations and requirements made at the last inspection were followed up to see if the home had made any progress towards meeting them. The Inspector looked around some of the building and a number of records were inspected. The 3 morning staff and 5 of the nine residents were spoken to as well as the manager. What the service does well: What has improved since the last inspection? What they could do better: After prospective residents have been assessed and the home is sure that they can meet their needs the home is going to confirm this in writing to the resident. Recommendations made by other authorities such as the fire and rescue service, in respect of upgrading the building for fire safety, and environmental St Bridgets Residential Home Version 1.10 Page 6 health, in respect of updating the kitchen, need to be addressed. On an individual basis the home staff must be constantly aware of the safety of residents e.g. by them always having their emergency call bells to hand. Some paperwork needs amendment, such as the adult protection policy. Other policies need to be put into practice, such as the self medication policy, where a written risk assessment is needed. Comment cards are going to be made available to relatives and visitors to get more feedback about the home and how residents are cared for there to help the home management make the home even better. In future the manager is going to make sure that every member of staff gets their fire training when it is due. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. St Bridgets Residential Home Version 1.10 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 Standards Statutory Requirements Identified During the Inspection St Bridgets Residential Home Version 1.10 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 standard(s) 1,3,4 and 5 Progress has been made in the preparation and distribution of key information for new residents so that they can make an informed decision about moving into the home. Prospective residents and / or their representatives are welcome to visit the home to decide if the home suits them. Assessments are being carried out prior to people moving into the service to ensure that care needs can be met. The home does not assure prospective residents in writing that their needs can be met. EVIDENCE: Information for residents is all in rooms and a copy of the most recent inspection report available in the main hallway. A new resident talked of how her son had been to see the home before she moved in. She had moved from another part of the country and so the home had had to rely on information about her care needs from her family and from the hospital she had been in. St Bridgets Residential Home Version 1.10 Page 9 The home encourages people to come and visit and spend time at the home, where possible, before making decisions about moving there. At present nothing is put is writing confirming that the home is able to meet the needs of the prospective resident. St Bridgets Residential Home Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 and 10 There is a clear care planning system in place to provide staff with the information they need to meet service users needs. The health needs of residents are also well met with evidence of good support from community professionals. Residents confirmed that they felt treated with respect and that their right to privacy upheld. EVIDENCE: Care plans were well written and reflected the care needs that service users said they had and the actions that needed to be taken to meet these needs. Community health professionals and emergency services had been contacted appropriately and promptly. Risk assessments have also been developed that take into account people’s environment. Staff confirmed that communication systems in place at the home kept them up to date with the care needs of residents. Medication administration procedures in the home were discussed and a visit by the Commission’s pharmacy Inspector will be arranged. One resident is self medicating but no written risk assessment was in place. A policy for risk assessing residents to self medicate has been developed in the home. No St Bridgets Residential Home Version 1.10 Page 11 residents are taking controlled drugs at present. A facility for storing controlled drugs is not currently available. The manager described some of the residents as being ‘private’ people and their privacy was clearly respected. Residents confirmed this. St Bridgets Residential Home Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14 and 15 Residents’ lives are enriched by the social opportunities afforded by their visitors and are encouraged to exercise choice and control over their lives by staff at the home. Social activities suit current residents. Food is wholesome and plentiful. EVIDENCE: Residents talked about their families and how they visited them at the home. The visitors’ book confirmed the number and range of visitors to the home. Residents also talked of how they were able to do what they liked and how they could spend their days as they chose. No one that the Inspector spoke to was interested in group activities. Some residents like to spend their days in the lounge, others in their rooms – reading or watching TV. That days lunch was well presented and portions were generous. The majority of residents came down to the dining area to eat their lunch, others stated a preference to eat in their rooms. Views about the food were mixed but residents were clear that they were encouraged to tell staff if they did not like any meal that they were served and an alternative would be provided. St Bridgets Residential Home Version 1.10 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 standard(s) 16 and 18 A system is in place to deal with any complaints that might be made by residents to make sure that any concerns raised by them are taken seriously and where possible resolved. The home’s adult protection policy demonstrates an understanding of abuse and of how residents are protected. EVIDENCE: The home has a satisfactory complaints policy and system for dealing with complaints. No complaints have been received by the home or by the Commission in the last 12 months. An adult protection policy dated March 2004 is in place. The requirement made at the last inspection about adding information about the Protection of Vulnerable Adults list has not been acted upon yet. St Bridgets Residential Home Version 1.10 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,22,23,24,25 and 26 The standard of the environment within the home is good providing residents with an attractive and homely place to live. All necessary facilities are available in the home. Progress is being made to ensure the safety of residents at all times and the manager has a good understanding of what needs to be done e.g. cover radiators, ensure accessibility of emergency call bells. EVIDENCE: The home is registered for 14 people and has 10 bedrooms. The home usually only has 10 people living there at any time so that they can all have single rooms. One room has an ensuite. Communal bathrooms and toilets are readily accessible in the home, along with commodes. Residents are able to have their personal possessions and some furniture in their rooms. St Bridgets Residential Home Version 1.10 Page 15 All rooms have emergency call bells in them for residents to summon help if they need it. The manager needs to check all rooms to make sure that residents can reach the bells from where they usually lie or sit as this was not the case on the day of inspection. The manager is also to encourage all staff to make sure that call bells are placed next to residents when they go into their rooms. Residents confirmed that their rooms were cleaned every day and their laundry was done as they like it to be. The laundry area was clean and tidy with clothes and bedding neatly put away. Some radiators in the home are guarded. Others identified as posing a potential risk to residents are yet to be covered. In the meantime furniture is being placed in front of them or other methods employed to minimise the risk of burns. In the last year the lounge and main hallway at the home have been redecorated and bedrooms are decorated when they are vacant. No major works are planned at the home but the manager is hopeful that this year will see the refurbishment of one of the communal bathrooms and of the kitchen. When the kitchen is updated the recommendations made by the Environmental Health Officer can be addressed i.e. putting diffusers on the fluorescent strip lighting and creating a rack to store the chopping boards. An assessment of the whole premises has not yet been undertaken by suitably qualified persons, as recommended in previous reports. St Bridgets Residential Home Version 1.10 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29 and 30 The procedures for the recruitment of staff are robust and therefore provide the necessary safeguards to offer protection to people at the home from unsuitable workers. Sufficient staff are on duty at all times to meet the needs of the residents. It is not clear who is in charge at the home when the manager is not on duty potentially compromising the safety of residents. EVIDENCE: The well ordered staff files indicated that the home undertakes all the necessary recruitment checks to ensure the protection of residents. Staff are not issued with contracts. Staff rosters showed the number of staff on duty and what jobs they do. It was not clear from the rosters who was in charge of the home when the manager was not on the premises. The manager agreed to make this clear on the roster in future and to make sure that person knew what this meant e.g. taking the lead role in case of a fire. Residents at the home said that the staff were kind and caring and performed care tasks in a gentle manner. One member of staff out of 9 care staff employed at the home has a NVQ at level 2. St Bridgets Residential Home Version 1.10 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,33,36, 37 and 38 The management of the home is generally good and the manager is open to reflecting on the way things are done in the home to improve on practice to make the home even better for the people who live there. Plans are in place to expand the quality assurance system in involved other interested parties. Progress is being made towards improving the overall safety of the building for residents in developing an action plan with the local fire service. EVIDENCE: Staff were clear about their duties in the home and talked of recent training that they had had. This included fire safety, food hygiene and moving and handling. Staff also confirmed they had supervision. A quality assurance system is in place and a suggestions box has recently been introduced. Residents have expressed satisfaction with the home. St Bridgets Residential Home Version 1.10 Page 18 Comment cards are to be made available to other stakeholders e.g. relatives and other visitors including health and social care professionals to gain their views about the home. All records asked for at the inspection were made available. The home documents all accidents and analyses these records regularly, looking for any trends that can help them prevent future accidents. Fire records are well kept. One member of staff who works both nights and days was slightly overdue for fire training, this was clearly an oversight in an otherwise robust system for ensuring that staff are trained at appropriate intervals. The Proprietor is having meetings with the Local Fire and Rescue service about progressing the recommendations that they have made about improving fire safety at the home. See the environment section above in respect of Environmental Health Authority recommendations. St Bridgets Residential Home Version 1.10 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 2 3 3 2 3 STAFFING Standard No Score 27 2 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 3 x 2 x x 3 3 2 St Bridgets Residential Home Version 1.10 Page 20 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 4 Regulation 14 Requirement Timescale for action 1.6.05 2. 9 13 3. 18 13 4. 22 13 5. 25 13 The home must confirm in writing to prospective residents that having regard to their assessment the home is suitable to meet their health and welfare needs. A written risk assessment must 1.6.05 be undertaken with the resident who is self medicating and with any others who express this preference. (Timescale of 22/9/04 not met) The adult protection policy must 1.6.05 be updated to include details of procedures for referring staff to POVA (Protection of Vulnerable Adults) list when required. (Timescale of 22/9/04 not met) The manager must to check all 1.5.05 rooms to make sure that residents can reach the emergency call bells from where they usually lie or sit and to make sure that staff know to place call bells next to residents when they go into their rooms. The programme of covering / 1.8.05 guarding or replacing with low temperature surfaces, all radiators and pipework, assessed as posing a risk to residents is to Version 1.10 St Bridgets Residential Home Page 21 be completed. 6. 33 24 Comment cards must be made available to relatives, visitors and professionals to give feedback to the home as part of the quality assurance system. Adequate arrangements must be in place to comply with the recommendations of the Fire and Rescue Service. (Timescale of 31/12/04 not met) All night staff are to have fire training every 3 months. 1.8.05 7. 38 23 1.8.05 8. 38 23 1.5.05 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 22 27 Good Practice Recommendations 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 manager make it clear on the roster who is in charge of the home in her absence and what their responsibilities are e.g. taking the lead role in case of a fire. It is recommended that all staff employed at the home have contracts of employment. It is recommended that the home ensures that 50 of care staff attain NVQ level 2 by the end of 2005. It is recommended that the recommendations made by the Environmental Health Authority are carried out. 3. 4. 5. 27 28 38 St Bridgets Residential Home Version 1.10 Page 22 Commission for Social Care Inspection Unit 4 New Fields Business Park Stinsford Road Poole Dorset, BH17 0NF 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 Bridgets Residential Home Version 1.10 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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