Inspection on 18/07/06 for St Claire`s Home

This inspection was carried out on 18th July 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

St Claire`s Home 31/05/07

St Claire`s Home 25/01/06

St Claire`s Home 16/08/04

St Claire`s Home 19/04/04

Similar services:

Chesham House

Argyll House

Oliver Court

Dalmeny House

Omnia

Dorset Lodge

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

CARE HOME ADULTS 18-65 St Claire`s Home 38 - 40 Church Crescent St Albans Hertfordshire AL3 5JE Lead Inspector Marian Byrne Key Unannounced Inspection 28th July 2006 10:00 St Claire`s Home DS0000019540.V304426.R01.S.doc Version 5.2 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 Claire`s Home DS0000019540.V304426.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 Adults 18-65. 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 Claire`s Home DS0000019540.V304426.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Claire`s Home Address 38 - 40 Church Crescent St Albans Hertfordshire AL3 5JE 01727 762386 01727 761561 stclaires@nildram.co.uk 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) Hightown Praetorian & Churches Housing Association Jeanette Collins Care Home 10 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (10), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (10) St Claire`s Home DS0000019540.V304426.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home may accommodate 10 people with mental disorder who require personal care. 25th January 2006 Date of last inspection Brief Description of the Service: St Claires in a large, two storey, period property, based in the residential area of the city centre of St Albans. The home provides personal care and support to ten mixed service users with enduring and complex mental health needs. St Claires has a car park to the rear of the property with a small patio garden available. It is ideally located for the town centre and all local amenities. The fees are £861.92 per week. St Claire`s Home DS0000019540.V304426.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out by one inspector, in the main it was a positive inspection. Service users spoken with were generally happy with the care given. Staff spoken with reported that they enjoyed working at St Claires and felt that they were trained to carry out their duties. On the day of the inspection there were six service users living there. The service was no longer able to care for one of their service users and they were waiting for a suitable home to be available for them. The environment must be better maintained and running repairs be carried out in a timely fashion. The furniture in the communal areas is shabby and unsuitable for the age group in the home as it is too low. The dining room - which is in the conservatory - must have a temperature control measure to enable service users to enjoy their food in comfortable surroundings. The home had six service users living there on the day of the inspection. One service users was due to move to a home where their needs could be better met. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. St Claire`s Home DS0000019540.V304426.R01.S.doc Version 5.2 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection St Claire`s Home DS0000019540.V304426.R01.S.doc Version 5.2 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 EVIDENCE: No new service users had been admitted since the last inspection. St Claire`s Home DS0000019540.V304426.R01.S.doc Version 5.2 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 & 9. Quality in this outcome is adequate; this would have been good had the documentation been up to date, this judgement has been made using available evidence including a visit to this service. Service users are facilitated in living a full life. Care plans were not up to date. EVIDENCE: Two care plans were inspected, one being the service users whose needs could no longer be met at St Claires, this was up to date. The other care plan had not been reviewed. Service users spoken with and documentation inspected showed that they had a full social life and had structured activities that they enjoyed. They are assisted to make decisions and are supported to take part in activities. On the day of the inspection one service user was assisting a staff member to shop for food for the home. There was one service user whose needs could not be met by the home and a more suitable home is being found for this service user. St Claire`s Home DS0000019540.V304426.R01.S.doc Version 5.2 Page 9 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 & 17 Quality in this outcome is good; this judgement has been made using available evidence including a visit to this service. The service users have access to the local community, visitors are welcome to the home and residents rights are respected. The food was of good quality. EVIDENCE: The home is very close to the centre of St Albans which allows easy access to the shops. All service users have a full social life and all attend day centres. Visitors and families are welcome. On the day of the inspection there was a constant stream of visitors to the home. The inspector was not present for a meal but all the food stored was of good quality and variety. Service users spoken with were happy with the food. St Claire`s Home DS0000019540.V304426.R01.S.doc Version 5.2 Page 10 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20 Quality in this outcome is good; this judgement has been made using available evidence including a visit to this service. Service users were happy with the support they get. Medication was appropriately administered and recorded. EVIDENCE: The home is aware of when they can no longer meet a service users needs. Recently they have identified three service users whose needs they can no longer meet and have found or are in the process of finding alternative homes for them. The remainder who are living there have their needs met. The home is clear that it caters for semi-independent service users only. The medication was administered and recorded appropriately. St Claire`s Home DS0000019540.V304426.R01.S.doc Version 5.2 Page 11 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome is good; this judgement has been made using available evidence including a visit to this service. Service users had their views listened to and they are protected from abuse. EVIDENCE: Service users spoken with stated that they find talking to staff easy. The home has procedures in place to ensure service users are protected from abuse, neglect and self-harm. The home is aware of when they can no longer meet service users needs. St Claire`s Home DS0000019540.V304426.R01.S.doc Version 5.2 Page 12 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome is poor; this judgement has been made using available evidence including a visit to this service. Overall the communal living areas of the home were shabby, care must be taken with individual rooms. EVIDENCE: Some parts of the home are shabby and neglected. More care must be taken to ensure that the toilets are clean and safe. In the downstairs toilet the seat was broken and dangerous, the floor covering was stained and dirty. The shower curtain in the downstairs shower was old and discoloured this must be replaced. The furniture in the communal areas was too low for the service users and was shabby and discoloured. Meals are eaten in the conservatory but there are no measures in place to control the temperature. On the day of the inspection the conservatory was very hot and this was not one of the hottest days experienced in July. This must be addressed. Room six had an odour that could be associated with incontinence and the curtains were falling down. A requirement was left at the last inspection to replace the furniture in the sitting room by 01/05/06 this had not been done. The Registered Manager did not have a maintenance plan for the home. There is very little garden St Claire`s Home DS0000019540.V304426.R01.S.doc Version 5.2 Page 13 available other than a patio which was furnished with outdoor furniture. The garden is used as a staff car park. It is recommended that this is turned into a facility for the service users. The area of the garden by the bins is messy with rubbish beside the bins. St Claire`s Home DS0000019540.V304426.R01.S.doc Version 5.2 Page 14 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 & 35 Quality in this outcome is adequate; this judgement has been made using available evidence including a visit to this service. There was not enough clarity of roles and responsibilities in the home. The home has a robust recruitment policy. Staff were well trained. EVIDENCE: Staffing levels were adequate. Staffing roles appeared to be confused (see standard 38). There was a high turnover of staff due to maternity leave. One staff member who had recently returned from sick leave was no longer line managed by the Registered Manager. Training records showed that staff received the appropriate training. Recruitment policies were followed and files inspected contained the appropriate documentation or identity and Criminal Records Bureau checks had been carried out. St Claire`s Home DS0000019540.V304426.R01.S.doc Version 5.2 Page 15 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39 & 42 Quality in this outcome is poor; this judgement could have been adequate had sufficient information been available to make a judgement; this judgement has been made using available evidence including a visit to this service. It is not possible to say if the home is well managed in the best interests if the service users as the Registered Manager was not line managing one member of staff. The impact of this on the service user was not considered. EVIDENCE: The Registered Manager of the service does not line manage one of members of staff. There was conflict with this staff member, this member of staff was due to work waking nights at the home unsupervised for three consecutive nights. No risk assessments had been completed on how this situation was to be managed. There is conflict in the home which has to be managed therefore it is not possible to make an informed judgement on the management of the home. St Claire`s Home DS0000019540.V304426.R01.S.doc Version 5.2 Page 16 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 X 3 X 4 X 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 2 2 3 X X 2 x St Claire`s Home DS0000019540.V304426.R01.S.doc Version 5.2 Page 17 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 YA20 Regulation 13 (2) Requirement The registered manager must ensure that; Gaps are not present on MAR sheets. Auditing systems must show effective and clear follow up’s. Controlled drugs book is purchased. This requirement was met 2. YA24 23 (2) (b & d) A planned maintenance and renewal plan must be in place. This requirement was not met. Failure to comply with this requirement could result in legal action being taken. 3. YA29 23 (2) (n) All furniture must meet the needs of the service users. New appropriate seating must be provided. This requirement was not met. 01/10/06 01/09/06 Timescale for action 28/07/06 St Claire`s Home DS0000019540.V304426.R01.S.doc Version 5.2 Page 18 Failure to comply with this requirement could result in legal action being taken. 4. YA35 18 (1) (c) All staff must receive medication refresher training. This requirement was met. 5. YA39 24 Effective quality assurance systems must be in place that actively seeks the views of the service users. This requirement was met. 6. YA42 23 (4) Individual smoking risk 28/07/06 assessments must be completed. This requirement has been carried forward from the last report; failure to comply may result in enforcement action being taken. This requirement was met. 7 YA24 16 (2) (k) The Registered Manager must ensure that the home is kept well maintained and odour free throughout, and that issues identified in this report as addressed. The Registered Manager must ensure that a risk assessment is completed on the staff member who is working unsupervised on the 29th,30th and 31st July 2006. This must be submitted to the offices of this commission by 17.00 hours today 29th July 2006. 31/08/06 28/07/06 28/07/06 8 YA42 23 29/07/07 St Claire`s Home DS0000019540.V304426.R01.S.doc Version 5.2 Page 19 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA20 Good Practice Recommendations It is recommended that a sample signature sheet be implemented for auditing of medicines. St Claire`s Home DS0000019540.V304426.R01.S.doc Version 5.2 Page 20 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 Claire`s Home DS0000019540.V304426.R01.S.doc Version 5.2 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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