Inspection on 16/04/07 for St David`s Nursing Home For Disabled Ex-servicemen and Women
Also see our care home review for St David`s Nursing Home For Disabled Ex-servicemen and Women for more information
This inspection was carried out on 16th April 2007.
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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.
Other inspections for this house
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
People living at the home are cared for in a gentle and professional manner, thus respecting their privacy and dignity. On the general nursing unit preadmission assessments are thorough and clearly reflect the needs of people wishing to live at the home. End of life care is planned in accordance with the wishes of each individual. Individuals` religious and cultural needs are catered for by the home. The home has an open visiting policy and visiting is encouraged. Visitors spoken with said that they are made welcome at the home. The food provision is good, offering variety and choice. Policies and procedures are in place for the management of complaints and safeguarding adults, and these are adhered to. People spoken with said that any concerns raised are promptly addressed and representatives are kept up to date with any issues. The accommodation provision on both units is of a good standard, with the adaptations and equipment necessary to meet peoples individual needs. Bedrooms are bright and airy and personalised. The home was clean and tidy and smelled fresh throughout. Although some issues arose with the laundry facilities on the first day of inspection, these were promptly addressed and the laundry provision is appropriate for the size of the home, with personal items of laundry being well cared for. Any monies being held on behalf of people living at the home are well managed and securely stored.
What has improved since the last inspection?
There had been an improvement in several areas since the last inspection. Progress has been made with the intermediate care unit to manage the individual rehabilitation programme for each person more effectively. Work is continuing in this area. Some progress has been made to access training or experiential learning for staff working on the intermediate care unit, plus increasing the hours for healthcare professionals working on the unit. More work is still needed in these areas to provide a full, informed, proactive service. There has been an overall improvement in the service user plans, which were up to date and overall contained the information required. Shortfalls in this area should be easy to address. Progress has been made with the ascertaining of peoples individual social and leisure interest information, with more work to be done to ensure the care plans reflect these individual interests. Also, thought has been given to the different types of activity provision required for the each unit. The Registered Manager has made headway regarding obtaining advocacy services information. An up to date redecoration and refurbishment plan is in place, and the home was tidier with no issues regarding storage noted. The staffing provision has been reviewed since the last inspection in line with the needs of the people living at the home, and this is to be kept under review. There has been an improvement in the level of completed and planned training for staff, and more work is required to ensure all staff are kept up to date with the knowledge and skills to provide an ongoing high standard of care. There had been an improvement in the overall management of the home, with a substantial number of management supernumerary hours being provided, the result of which is a steady improvement in areas where shortfalls were identified at the last inspection. Work is ongoing and robust systems must be followed so that once the home has improved further, the quality is then maintained. There has been an improvement in the implementation of monitoring systems for quality assurance such as auditing processes, and as a result, with the exception of medications, a noticeable improvement has been made in the areas being audited.
What the care home could do better:
The pre-admission assessments viewed were thorough and gave a good picture of each persons needs. However for one person on the intermediate care unit the homes assessment could not be located and the Social Services assessment was out of date. The home must ensure they have up to date information and store records securely. Some progress has been made to gain comment from the people living at the home and their representatives about the care provision, and more work is required in respect of involving them in the formulation and review of the service user plans. Despite regular auditing there continues to be concerning shortfalls in the management of medications and the registered nurses must take responsibility for ensuring they complete documentation fully and are up to date with medication policy and guidance. An issue was identified with subcontractors carrying out building works at the home and having unsupervised access to areas where people at the home live. Appropriate action must be taken promptly to address this and prevent further occurrence. The Registered Manager needs to undertake current training in topics relevant to his management role, so that his knowledge and skills are kept up to date. Regulation 26 visits on behalf of the Registered Person to monitor the home have recently been announced visits, and although the reasoning for this is understandable, in that it allows people to plan to meet with and speak with the person carrying out the visits and express their views,the Care Home Regulations 2001 require that these visits are unannounced, so a plan to address this is needed. Some fire safety training issues were identified and the need to ensure everyone undergoes fire safety training as part of their induction was discussed. Lack of assessment and minimising of any risks in an area where work is being carried out gave the Inspectors cause for concern. This has since been addressed, however the shortfalls should have been identified promptly by the home, and not left for an Inspector to identify. Proactive processes to prevent further occurrences of this nature must be put in place.