Inspection on 10/08/05 for St Dunstan`s

This inspection was carried out on 10th August 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 Dunstan`s 14/03/07

St Dunstan`s 09/03/06

St Dunstan`s 31/01/05

St Dunstan`s 23/07/04

Similar services:

Thorndene

Sutton Lodge Nursing Home

Wingham Court

Heathfield

Red Oaks

Hothfield Manor Centre

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

CARE HOMES FOR OLDER PEOPLE St Dunstans Greenways Ovingdean Brighton East Sussex BN2 7BS Lead Inspector Penny Bailey Merle Blakeley Unannounced 10 August 2005 10.00 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 Dunstans H59-H10 S14041 St Dunstans V229940 100805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service St Dunstans Address Greenways Ovingdean Brighton East Sussex BN2 7BS 01273 307811 01273 302704 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) St Dunstans Mrs Jacqueline Sandra Greer Care home with nursing (N) 77 Category(ies) of Sensory impairment (SI) 77 registration, with number Physical disability (PD) 0 of places St Dunstans H59-H10 S14041 St Dunstans V229940 100805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users in receipt of personal care does not exceed thirty seven (37) within the registered numbers. 2. That the maximum number of service users to be accommodated is seventy-seven (77). Date of last inspection 31 January 2005 Brief Description of the Service: St Dunstan’s is a nursing and care home that provides nursing and social care and accommodation for up to seventy-seven residents with visual or physical impairment. St Dunstan’s is run by a charitable organisation that provides care to ex-servicemen and women who are visually impaired. The home is situated in its own grounds at Ovingdean, near Brighton. St Dunstan’s provides its own transport services and drivers to enable residents to go shopping in Brighton, or participate in day trips. The home provides many facilities to enable service users to participate in activities, including a gym, sports hall, swimming pool and crafts workshop. Facilities are also provided to enable service users to accommodate guide dogs. Accommodation is provided in single, en-suite rooms, with a number of shared rooms available if required. St Dunstan’s has five floors, with service users accommodated on the first, second and third floor. Passenger lifts enable residents to access all areas of the home. A variety of communal space is provided in a large lounge/bar area, dining area and two further lounge areas. There is also a small seating area situated on each floor, and a further small dining area on each unit. There is an enclosed garden that provides a pleasant area for residents to sit, and a gardening club enables residents to participate in landscaping this area. St Dunstans H59-H10 S14041 St Dunstans V229940 100805 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 between 10.00 a.m. and 4.00 p.m., and formed part of the annual inspection plan for this home. A tour of the premises took place and records relating to care and the running of the home were inspected. The Inspectors spoke with five residents and four members of staff. In order that a balanced and thorough view of the home is maintained, this inspection report should to be read in conjunction with the previous inspection reports. The Inspectors would like to thank the residents, staff and management for their hospitality and assistance during the inspection. What the service does well: What has improved since the last inspection? There were no requirements or recommendations made at the last inspection. A programme of redecoration and maintenance has continued, with the foyer of the home having been refurbished to a high standard. St Dunstans H59-H10 S14041 St Dunstans V229940 100805 Stage 4.doc Version 1.40 Page 6 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 Dunstans H59-H10 S14041 St Dunstans V229940 100805 Stage 4.doc Version 1.40 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 Dunstans H59-H10 S14041 St Dunstans V229940 100805 Stage 4.doc Version 1.40 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) 3, 4 & 5 The home makes every effort to ensure that they have sufficient knowledge, and employ staff with enough experience to be able to look after the resident once they arrive at the home. Prospective residents are assessed before they move in, to ensure that the home is able to offer the care needed. EVIDENCE: Welfare Officers visit prospective residents either at home or in hospital to tell them about the home, and make an assessment to ensure that their care needs can be met. Information about their needs is gathered from a variety of sources including the resident, their representatives and health care professionals. The needs assessment then forms the basis of the resident’s plan of care. Prospective residents are able to visit the home prior to admission, and short-term respite stays are available to ensure that the placement is satisfactory. Staff receive training regarding the health and social needs of older people with a visual impairment, and this is updated on a regular basis. The home employs a large number of staff who are skilled and experienced in providing care for residents with a visual impairment, and every St Dunstans H59-H10 S14041 St Dunstans V229940 100805 Stage 4.doc Version 1.40 Page 9 effort is made to enable residents to maintain as much independence as possible. St Dunstans H59-H10 S14041 St Dunstans V229940 100805 Stage 4.doc Version 1.40 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 & 10 The Manager and staff at the home are knowledgeable about the care of the residents and records identify this. Care outcomes for residents were good, and all residents appeared well cared for on the day of the inspection. EVIDENCE: An individual plan of care is in place for each resident, and these provide a comprehensive assessment and plans for meeting each residents physical care needs. Three individual plans of care were inspected. These comprised of many documents including needs assessments, personal information, daily notes and a plan of care, and provided the information necessary to guide staff to meet the needs of residents. Residents’ physical and medical needs are closely monitored, and the home receives regular support from specialist services when necessary. This includes the services of a G.P. surgery twice weekly, a chiropodist, dentist, dietician and visiting physiotherapists. Pressure relieving equipment was in place for those residents assessed as at risk from pressure damage. St Dunstans H59-H10 S14041 St Dunstans V229940 100805 Stage 4.doc Version 1.40 Page 11 All service users spoken with stated that staff treat them with courtesy, and respect their dignity. Care is given in private, with residents accommodated in single, en-suite rooms. A number of treatment rooms are also provided, to ensure that medical care is undertaken in a way that maintains residents privacy. St Dunstans H59-H10 S14041 St Dunstans V229940 100805 Stage 4.doc Version 1.40 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 Flexible routines are part of daily practice at the home. Residents find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests. Links with families are valued and supported by the home. The home is to be commended on the large range of activities that are provided. EVIDENCE: St Dunstan’s employs an Activities Coordinator, who provides a range of activities throughout the week for both individuals and groups. On the day of inspection two groups of residents went on outings to Brighton Marina, or to a local gardens. The home provides residents with many opportunities to undertake activities that include archery, swimming, crafts and gardening. Communion services are held weekly at the home, and residents are supported to attend the local churches of their choice. Residents confirmed that their visitors are made welcome at the home, and that the daily routines are flexible and take into account their personal choices as much as possible. Residents meetings are also held regularly, and minutes are kept, enabling residents to inform the way care and services are provided. Residents are encouraged to remain as independent as possible and maintain control over all aspects of their daily lives. St Dunstans H59-H10 S14041 St Dunstans V229940 100805 Stage 4.doc Version 1.40 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) 18 Staff receive training on the recognition of abuse and Protection of the Vulnerable Adult. EVIDENCE: There are clear policies on adult protection for staff, on how to report suspicions of abuse. Staff attend training on the recognition of abuse and the Protection of the Vulnerable Adult. St Dunstans H59-H10 S14041 St Dunstans V229940 100805 Stage 4.doc Version 1.40 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) 20, 23 & 24 Residents have access to a variety of communal areas. All residents are provided with en-suite single rooms, which are decorated in a homely style. EVIDENCE: Residents have access to a wide variety of communal areas within the home. There is a very large dining area with an adjoining lounge/bar, TV lounge, computer suite, ballroom, several separate quiet sitting rooms, craft workshops, sports hall, gym and swimming pool. Each floor also provides small sitting areas and dining rooms. There is an enclosed garden at the rear of the building, which is accessible to residents. The home is maintained to a very high standard. Each resident is provided with a single room with en-suite facilities and shared rooms are available for couples if required. Bedrooms appeared homely and comfortable and residents are able to individualise their rooms by bringing in their own small possessions. Every room now has a lockable drawer for resident’s possessions. The Manager reported that new bedside cabinets have recently been purchased and each resident has been provided with a key to the lockable drawer unit. A St Dunstans H59-H10 S14041 St Dunstans V229940 100805 Stage 4.doc Version 1.40 Page 15 duplicate key to this facility is kept by security staff at the home in case of loss and it is recommended that consent is obtained from residents in respect of this practice. St Dunstans H59-H10 S14041 St Dunstans V229940 100805 Stage 4.doc Version 1.40 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 & 30 The current staff team provide a good mix of skills. 85 of the staff have attained NVQ training in Levels 2 and 3. Staff have access to an excellent range of training courses. EVIDENCE: The home currently employs seventy staff; twenty are qualified nurses and fifty are care assistants. There appears to be a good mix of male and female staff who are providing a good level of care for residents. To date thirty-eight staff members are either working towards or have gained their National Vocational Qualification (NVQ), which is an excellent percentage. Fifteen of the staff are also NVQ Assessors. The home is committed to the continuing development of its staff and they are offered a very good range of training, which includes core skills training such as infection control, first aid, food hygiene, manual handling, fire training, adult protection, challenging behaviour and sighted guiding. Some of this training is provided in-house by the Practice Development Nurse and each department has its own training plan for staff and will provide external training courses as and when required. All new staff receive induction training and new nurses are required to complete a four-day intensive training course. St Dunstans H59-H10 S14041 St Dunstans V229940 100805 Stage 4.doc Version 1.40 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) 31,35 & 36 The home is run by a competent and qualified manager. Resident’s finances are securely maintained. Staff receive regular supervision. EVIDENCE: The home is managed by a qualified nurse who has many years experience of working in the care field. She has held the post of Registered Manager at St Dunstan’s for approximately nine years and the home appears to be running very efficiently. The home employs a Cashier who is responsible for safeguarding and recording residents finances. Most of the residents have a ‘pocket money’ account, which is used for day trips out and personal items. Each time a resident requires cash it generates a cash transaction form, which has to be signed by the resident to say that they have received that amount of money. Daily cash flow charts are maintained on the computer and can accurately record how much money each resident should have in their account. Several of these accounts were St Dunstans H59-H10 S14041 St Dunstans V229940 100805 Stage 4.doc Version 1.40 Page 18 randomly checked by the inspector and were found to be in order. Residents are supported and encouraged to manage their own finances where possible and many receive assistance from family members and friends. All personal items that are brought into the home by residents are recorded and signed for. All staff receive recorded supervision sessions on a regular basis, which is cascaded down through the line management of the home. The Registered Manager is responsible for supervising the ward managers and they in turn supervise senior staff and nurses. Care staff are supervised by the senior staff members. Staff meetings are held every three months and staff appraisals take place once a year. St Dunstans H59-H10 S14041 St Dunstans V229940 100805 Stage 4.doc Version 1.40 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. 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 x x 3 3 3 N/A 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 4 13 4 14 3 15 x COMPLAINTS AND PROTECTION 3 3 3 3 3 3 x 3 STAFFING Standard No Score 27 3 28 4 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 3 x x x 3 3 x x St Dunstans H59-H10 S14041 St Dunstans V229940 100805 Stage 4.doc Version 1.40 Page 20 No 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 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. 2. Refer to Standard 9 24 Good Practice Recommendations That a second lockable facility is provided to service users who self-administer medication where this is required. That consent is obtained from residents for the home to keep a duplicate key to their personal lockable facility. St Dunstans H59-H10 S14041 St Dunstans V229940 100805 Stage 4.doc Version 1.40 Page 21 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 Dunstans H59-H10 S14041 St Dunstans V229940 100805 Stage 4.doc Version 1.40 Page 22 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!