CARE HOMES FOR OLDER PEOPLE
St Edmunds 3-5 Marine Parade Gorleston Great Yarmouth Norfolk NR31 6DP Lead Inspector
Hilda Stephenson Unannounced Inspection 6th October 2005 10:00 X10015.doc Version 1.40 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 Edmunds DS0000027497.V255827.R01.S.doc Version 5.0 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 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 Edmunds DS0000027497.V255827.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service St Edmunds Address 3-5 Marine Parade Gorleston Great Yarmouth Norfolk NR31 6DP 01493 662119 01493 651282 RICKPENTINTERNET.COM 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) Richard James Pendle Mrs Penelope Pendle, Mr Anthony Barfield Ms Susan Jayne Harvey Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32) of places St Edmunds DS0000027497.V255827.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Thirty-two (32) persons maybe accommodated in the category Older People. Service Users who are accommodated on the second floor must be independently mobile. 17th May 2005 Date of last inspection Brief Description of the Service: St Edmunds is a residential home located on the sea-front in Gorleston. It provides twenty-four hour care for up to thirty-two older people. The Home offers easy access to local shops and amenities and there is a local bus to Great Yarmouth on a regular basis. People in the home are encouraged to make use of all the local amenities and staff can support people when required. All the rooms are tastefully decorated with many communal areas; many of the Service Users rooms have views of the sea. St Edmunds DS0000027497.V255827.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was undertaken as an unannounced inspection commencing at 10.00am during Thursday 6th October 2005 lasting three hours. The majority of the visit was spent speaking to several of the 30 residents who live at the home, some in private and some within small groups and two members of staff. A short tour of the home was undertaken with this finding the home continuing to maintain a high standard of cleanliness and decoration. The building is on three floors with the second floor not used for either residents or staff. Bedrooms are situated on both floors with access by the new shaft lift. There are three communal lounges, one large dining room, and two smaller areas within the front conservatory, and a small seating area within the reception area. The home is surrounded by well-maintained gardens containing a mixture of flowers and shrubs. The home offers a hotel style environment for low dependency residents with a condition that residents who live on the first floor are independently mobile. What the service does well:
The home offers a hotel style service to residents who are accommodated with the majority having views over the sea at Gorleston. The home offers a comfortable environment with plenty of communal space. The home has a consistent loyal staff team who were observed to treat both residents and their relatives with dignity and respect. Residents who are entertaining visitors are offered tea facilities to enable residents to continue to entertain the same as if they were in there own home. Meals and mealtimes continue along the same hotel style line with several choices for each meal on the menu, with lunch and tea maintained at set times and breakfast and supper more flexible to accommodate residents individual times for getting up and going to bed. St Edmunds DS0000027497.V255827.R01.S.doc Version 5.0 Page 6 Social activities are arranged with visiting outside entertainers, with staff encouraging individual interests. Several residents were out walking along the seafront at Gorleston, others were reading library books or newspapers, and several residents were entertaining visitors. 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 Edmunds DS0000027497.V255827.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection St Edmunds DS0000027497.V255827.R01.S.doc Version 5.0 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 the following standard(s): 3 The home has a clear admission procedure. Written details are available to inform prospective residents about the service. EVIDENCE: The most recent resident who was admitted to the home was spoken to during this visit. The procedure in this case followed a telephone call from a member of the resident’s family to enquire if a vacant room was available. The manager arranged an appointment with the resident to visit and introduce herself and chat about her personal, health needs, concerns and expectations about moving into a home. The assessment records after this initial visit makes up part of the care plan to enable staff to gain an insight of the prospective residents care preferences. The resident stated ‘I was really worried about making my mind up to move into a home, all I could think about was that the meals would be like school dinners, but I have been made to feel really welcome, the meals are lovely, the staff are very friendly and helpful, and I have made my mind up that I am going to stay’.
St Edmunds DS0000027497.V255827.R01.S.doc Version 5.0 Page 9 The resident also stated that she was invited to visit the home beforehand and stayed for a whole day. She also received written details about the home, terms and conditions and is aware that if she becomes more highly dependent that she may need to move into a nursing home and St Edmunds does not offer nursing care. This information is included within the service user guide. The residents assessment records were clear and precise including all the required information for staff to care for her. St Edmunds DS0000027497.V255827.R01.S.doc Version 5.0 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 the following standard(s): 7,8,9,10 Residents are aware that written information about them is kept in care plans and they are regularly consulted regarding any changes in their personal and health needs. EVIDENCE: Several care plans were seen. The residents that spoke to the Inspector were aware of and consulted when their care plans were devised and reviewed. The care plans contained details of the resident’s personal care, health care and a good range of social interests. The plans were easy to follow and provided the staff with the information to allow them to care for the residents and gain a good overall background of the residents past life. Each of the residents has a key worker who reviews the care plans. Occasionally, a district nurse visits residents when they require nursing input, with the information being transferred to the care records. All personal care and visits by other professionals are carried out in resident’s rooms to enable them the privacy that the home promises within the service user guide. This was observed when a nurse visited residents during this inspection.
St Edmunds DS0000027497.V255827.R01.S.doc Version 5.0 Page 11 Residents confirmed that they were fully involved when organising hospital appointments, or requesting to see a GP, dentist or optician. The medication records were seen during this visit. A requirement issued at the previous inspection has not been met because one MAR chart was found to contain gaps. The medication charts are legal documents and must be signed and dated at every administration. The manager must monitor this through audit and staff training, and the requirement has been issued for a second time with immediate effect. The service user guide states the intention at St Edmunds is to provide the best possible standards of care together with a free and easy lifestyle allowing residents to live their lives to the full’. Residents confirmed that they continue to maintain their own choices, interests and staff assist when they are requested. St Edmunds DS0000027497.V255827.R01.S.doc Version 5.0 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 the following standard(s): 12,13 & 15 Residents are offered sociable activities for both group and individual interests. Meal times are included as a social event. EVIDENCE: Social activities are organised by care staff during the week including both group activities such as bingo or cards and more personal activities such as manicures, crosswords, reading and going out for a walk along the sea front. Some residents organise and hold their own quiz. A musician is invited once a month to entertain residents either for an afternoon or evening session. Several residents were seen continuing their own daily activity such as reading the library books, newspapers, walking outside or speaking with each other in small groups. The majority of residents tend to congregate within the lounges during the morning, with several taking a rest after lunch or going to their own rooms. Several visitors were seen during the inspection and were offered tea facilities. St Edmunds DS0000027497.V255827.R01.S.doc Version 5.0 Page 13 The home has a large dining room that can seat four to a table, the meals are served in the manner of a restaurant where residents can help themselves or be served their food by the staff. Several residents enjoy an aperitif before lunch. The meals are rotated over a two-week menu and the chef includes resident’s favourite dishes. The menu contains a good choice of wholesome meals changed every two weeks. One resident stated ‘the meals are very good, much better than I could ever do at home, and its so nice that staff serve it out in front of me’. St Edmunds DS0000027497.V255827.R01.S.doc Version 5.0 Page 14 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 the following standard(s): 16 & 18 Residents’ views and concerns are listened to and acted upon. EVIDENCE: Procedures are in place for responding to allegations of abuse; staff receive tuition on basic awareness of adult protection. Some staff are booked to attend an awareness of adult protection course later this month. The home has a complaints procedure in place, a copy is displayed in reception and is now included in the written service users guide. The home appears to encourage residents to put their points of view to the management with regular discussion groups. No complaints were received during this visit. St Edmunds DS0000027497.V255827.R01.S.doc Version 5.0 Page 15 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 the following standard(s): 19 Residents can be accommodated in a clean, tidy and well-maintained environment. EVIDENCE: St Edmunds has been developed from a hotel, situated on Gorleston seafront. There are well-maintained gardens surrounding the premises. It consists of three floors, where the bedrooms are situated on the ground and first floor. There are large comfortable lounges, a dining room, conservatory and a sun lounge with extra dining facilities. There are also smaller areas containing seats throughout the floors. The bedrooms vary in size with more than half overlooking the sea. One of the proprietors carries out the regular maintenance and decoration of the building. Two bedrooms have been redecorated since the last inspection.
St Edmunds DS0000027497.V255827.R01.S.doc Version 5.0 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 Residents are cared for by sufficient numbers of staff. EVIDENCE: A senior care staff was managing the morning shift with three care staff, one member of staff was employed as a waitress who was preparing the dining room for lunch, two domestic staff, one housekeeper, one chef and a kitchen assistant being on duty. This ensures the care staff are not taken up with other domestic duties during the day and can spend their time caring for the residents. A senior carer is in charge during every shift. The manager was not on duty during this visit. Both proprietors who live next door to the home visit and support staff most days and continue to be ‘on call’ when the manager is away. Since the last inspection the care staff have been issued with new uniforms. One resident stated ‘the staff look lovely in their new uniforms and it is easier to distinguish the senior staff’. St Edmunds DS0000027497.V255827.R01.S.doc Version 5.0 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were inspected during this inspection. EVIDENCE: St Edmunds DS0000027497.V255827.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x x STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x x x x x St Edmunds DS0000027497.V255827.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? Yes 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 OP9 Regulation 13 & 17 Requirement The MAR charts must have no gaps within the records. Timescale for action 06/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations St Edmunds DS0000027497.V255827.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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