Inspection on 13/07/05 for St David`s

This inspection was carried out on 13th July 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 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 David`s 15/08/07

St David`s 14/11/06

St David`s 29/12/05

St David`s 23/10/04

St David`s 29/06/04

St David`s 23/10/02

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE St Davids 65 West Hill Road St Leonards-on-sea East Sussex TN38 0NF Lead Inspector Liz Daniels Unannounced 13 July 2005 09:00 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 Davids H59-H10 S14039 St Davids V232665 130705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service St Davids Address 65 West Hill Road St Leonards-on-sea East Sussex TN38 0NF 01424 439266 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) Miss Melvenia Davidson Miss Melvenia Davidson Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (OP) 23 of places St Davids H59-H10 S14039 St Davids V232665 130705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. That a maximum of two service users with physical disabilities requiring nursing care over 65 years of age may be accommodated in single rooms 7 or 22 when vacant 2. That one service user admitted in October 2003 under 65 years of age may continue to reside in the home 3. That only service users aged 65 years or over on admission are admitted into the home Date of last inspection 23 October 2004 Brief Description of the Service: St. Davids Care Home is a large detached property located in a residential area of St. Leonards-On-Sea. It provides nursing and personal care for up to 23 residents of an older age or who have a physical disability. It is owned and managed by an experienced registered nurse. The Home is set out on three floors and a passenger lift provides access to all floors. There is a large lounge area with a sun room attached, providing sea views and some of the upper floor rooms also have spectacular views to the sea. At the front of the building there is a small area providing off road parking facilities. St Davids H59-H10 S14039 St Davids V232665 130705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over a period of almost eight hours, beginning at 10am and finishing at 5.45pm. The Registered Manager was on Annual Leave but the Inspector met with the Registered Nurse in charge, and three other members of staff. The Inspector also had a tour of the Home, and met with three residents and other staff informally before inspecting a range of key records. Some of the residents are frail and the Inspector was not always able to gain their viewpoint. There are therefore a limited number of direct references to the views of the residents in this report. As the Manager was away, some of the supporting documentation for the Inspection was not available for the Inspector to view. The Inspector therefore visited subsequently and met with the Manager. 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 Davids H59-H10 S14039 St Davids V232665 130705 Stage 4.doc Version 1.40 Page 6 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 Davids H59-H10 S14039 St Davids V232665 130705 Stage 4.doc Version 1.40 Page 7 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) 1,2,3 & 5 St. David’s provides good information for prospective residents and their relatives to make an informed choice about its suitability and they are offered the opportunity to be involved as far as is possible in assessments and decisions about admission. Assessments by Health and/or Social Services should be included as part of the pre-admission assessment, prior to admission. Following the Home’s assessment, the Manager should confirm in writing to prospective residents that the Home could meet their needs in respect of health and welfare. EVIDENCE: The Home has a comprehensive Statement of Purpose and Service User guide, which have been updated as discussed at the last Inspection. Prospective residents are assessed prior to being admitted to the Home and told verbally during their assessment whether or not the Home can meet their needs. They are also offered the opportunity to visit for the day or for a meal if practical and the Manager endeavours to involve the prospective resident’s relatives, as much as is possible, prior to admission. Two residents spoken with had not visited themselves prior to their admission, but relatives had been on their behalf. Both are pleased with the Home. St Davids H59-H10 S14039 St Davids V232665 130705 Stage 4.doc Version 1.40 Page 8 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 & 10 The Care Plans reflect the health, personal and social care needs of the residents in general, and are reviewed regularly whereby they remain contemporary. Health care needs appear to be met well. However residents or their representatives should be involved in Care Planning. The Home has good contact with local health services. EVIDENCE: St. David’s provides 24 hour nursing care if required. During the Inspection, three Care Plans were viewed; all contained comprehensive Risk Assessments and a Long Term Care Plan, which had been reviewed monthly. The Care Plans reflect health and personal care needs and the resident’s religious and cultural practices. However, they are not all signed, demonstrating that they may not have been shared with the residents or their relatives. The Care Plans also include an assessment of tissue viability and a nutritional assessment. Body Maps are completed to document any areas where skin is not in tact and its progress in healing. Pressure mattresses are used in the Home when required. Residents are weighed three monthly, but more frequently for those at risk of weight loss or who have a poor dietary intake. Staff confirmed the importance of promoting privacy and respect when residents are undergoing examinations or personal care. The residents that are in double rooms have expressed a wish not to be in a room alone: screens are provided to enable St Davids H59-H10 S14039 St Davids V232665 130705 Stage 4.doc Version 1.40 Page 9 privacy for each resident as needed. Residents can choose to have their own phone line in their room, or staff will ensure the payphone is available in a private area. The Home enables residents to have access to external health professionals including physiotherapists, dentists, chiropodists, and opticians. Staff accompany them to health appointments as needed. St Davids H59-H10 S14039 St Davids V232665 130705 Stage 4.doc Version 1.40 Page 10 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 & 15 The Home recognises the importance of ensuring individual needs are met and endeavours to offer choice and flexibility for the routines of daily living and activities. The menus provided are varied to provide a balanced diet. Specific dietary requests are accommodated. EVIDENCE: The Inspector found that residents were choosing either to spend time in their room or to sit in the lounge. They are encouraged to furnish their own rooms by bringing personal effects with them and are welcome to have visitors at any time, seeing them in private, in the lounge or in the sunroom. A varied programme of activities is organised within the Home, and events are held in the main lounge. Some are pre-planned and some are arranged on a daily basis, dependant on the wishes of the residents. The residents spoken with during the inspection knew what activities were planned and felt welcome to join in as they wished. A varied, nutritious menu is offered, rotated every three weeks. The menu generally includes two choices but residents and staff confirmed that specific individual choices are accommodated when possible. The residents who met with the Inspector described the food as good and varied. The cook confirmed that special diets are prepared and dietary needs are closely monitored. As the Inspection was ongoing during the lunch period, the Inspector was able to see that the food was well presented and assistance was offered as needed. The residents can choose to eat in their rooms or eat St Davids H59-H10 S14039 St Davids V232665 130705 Stage 4.doc Version 1.40 Page 11 together in the lounge area. Food and drinks are available throughout the 24hour period. St Davids H59-H10 S14039 St Davids V232665 130705 Stage 4.doc Version 1.40 Page 12 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 & 18 There is a complaints procedure in the Home which the residents and staff have confidence in. The policy for the protection of Vulnerable Adults needs to be amended to include Social Services as the lead agency for investigation and the contact details for the Commission. EVIDENCE: There have been no complaints forwarded to the Commission, since the last Inspection. The Home has a complaints procedure which staff, when asked, said they were aware of and knew how to access. All complaints and the action taken are recorded and the outcomes fed back to the complainant. Two residents stated that they could discuss any concerns they have with the Nurse-in-charge for the shift, or the Manager. They have confidence that their concerns would be listened to and acted upon. There is a policy for the Protection of Vulnerable Adults. This does not include Social Services as the lead agency for investigations or the contact details for the Commission. However, the Manager has now obtained a copy of the POVA practical guidance issued by the Dept. of Health as discussed at the last inspection. Staff, when asked, could identify when to raise any concerns and what action to take. St Davids H59-H10 S14039 St Davids V232665 130705 Stage 4.doc Version 1.40 Page 13 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) 19,22,24 & 26 St. David’s promotes the importance of enabling residents to personalise their own rooms and provides homely comfortable communal areas. The Home has good facilities and access to all floors, for wheelchair users. Adaptations have been made and equipment is made available, to enable both support and independence. The Home has good fire safety procedures in place and met the Requirement from the last Inspection. EVIDENCE: The Home provides spacious accommodation over three floors, with a passenger lift to each floor. All areas of the Home are accessible for wheelchair users. There is a Lounge on the ground floor with a sunroom attached, which looks out over the sea. This can be used as a dining area or a quiet space where residents can sit, or meet with their visitors. A small patio area can also be accessed off the sun lounge. Some of the bedrooms have spectacular sea views and they all appear homely and comfortable. Residents are encouraged to have their own possessions with them to personalise their rooms. There is a call bell system to ensure assistance as needed. Any resident who prefers to stay in their room, but have the door open at times, has a magnetic door stay fitted to their bedroom door. Cleaning staff are St Davids H59-H10 S14039 St Davids V232665 130705 Stage 4.doc Version 1.40 Page 14 employed at the Home and on the day of Inspection it was found to be free from odours and clean. Within the Home there is a range of equipment and aids to assist those with reduced mobility. A Requirement from the last Inspection was that an Occupational Therapist should visit the Home to assess the environment, equipment and adaptations made. This was undertaken on 20th January 2005 and there were some recommendations made which the Home is aiming to achieve. St Davids H59-H10 S14039 St Davids V232665 130705 Stage 4.doc Version 1.40 Page 15 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) 27,29 & 30 The health and personal needs of residents are met by a team of nurses and care staff. There is a staff rota in place to cover the 24-hour period and the rotas reflect appropriate numbers and skill mix for the needs of the residents. Safe recruitment checks are in place and the Home offers very good training opportunities for the staff. EVIDENCE: A Registered Nurse leads each shift and is supported by care staff. There is a staff rota in place to cover the 24-hour period. The Manager usually works from Monday to Friday, but on the day of Inspection, a senior RN had been rostered to be supernumerary, in the absence of the Manager, whilst she was on Annual Leave. There is currently no deputy Manager in place. The Home accepts nurses from oversees and provides them with an opportunity to undertake an adaptation programme. The Manager mentors them, in association with Manchester University. There was evidence of a comprehensive training programme in place for them and case studies that they have undertaken. Kitchen, domestic and maintenance staff are also employed. The Home has senior carers who have additional responsibilities, which include supervision of new staff and helping with their training. New staff undertake induction training and staff receive specific training to meet the needs of residents. Three staff files were viewed during the Inspection. All files contained references received prior to appointment and a copy of the Terms & Conditions of employment. One file had a CRB disclosure but two files were for adaptation students who had been employed directly from abroad and had brought their own police check with them. However, there was some staff information that the senior RN was unable to access whilst the Manager was on Annual Leave. St Davids H59-H10 S14039 St Davids V232665 130705 Stage 4.doc Version 1.40 Page 16 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) 38 The Registered Manager demonstrates a commitment to promoting the health and safety of residents and staff. The equipment is well maintained and the environment is safe for residents. EVIDENCE: Documentation for safety checks were viewed and found to be in order. The last Environmental Health Inspection was on 29th December 2004 and there are no outstanding recommendations. There is a contract in place for clinical and household waste management, and written assessments have been completed for COSHH (Control of Substances Hazardous to Health). The water-heating test to exclude the risk of legionella was carried out on 29th June 2005. The Emergency Lighting was last tested on 8th June 2005 and the last Fire Alarm inspection was on 10th June 2005. Staff had fire training on 18th June 2005 and the last weekly fire alarm test was on 4th July 2005. There is a Fire Drill every six months, held last on 13th May 2005. A record is now kept of staff involved in fire drills, as recommended at the last Inspection. The Home has now compiled a fire risk assessment of the building, a Requirement from the last Inspection. During the inspection, appropriate equipment for the safe St Davids H59-H10 S14039 St Davids V232665 130705 Stage 4.doc Version 1.40 Page 17 movement and handling of residents was evident. Medical equipment is available and used as needed. The Inspector found that equipment in use had a label of service, which was in date, or documented daily checks by staff. St Davids H59-H10 S14039 St Davids V232665 130705 Stage 4.doc Version 1.40 Page 18 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 2 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x 3 x 3 x 3 STAFFING Standard No Score 27 3 28 x 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 x x x x x x x 3 St Davids H59-H10 S14039 St Davids V232665 130705 Stage 4.doc Version 1.40 Page 19 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 3.2 Regulation 14 (1)(a)(b) (c)(d) Schedule 3(1)(a) Requirement For individuals referred through Care Management arrangements, the Home obtains a copy of their Health and/or Social Services assessment. The Home confirms in writing to the service user that, having regard to the assessment, it is suitable to meet their health and welfare needs. Policy for the Protection of Vulnerable Adults must identify Social Services as the Lead Agency and give the contact details for the Commission. Timescale for action 30 September 05 2. 18.2 21(1)(2) 31 October 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. Refer to Standard Good Practice Recommendations St Davids H59-H10 S14039 St Davids V232665 130705 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection Ivy House 3 Ivy Terrace Eastbourne East Susssex BN21 4QT 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 Davids H59-H10 S14039 St Davids V232665 130705 Stage 4.doc Version 1.40 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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