Inspection on 17/01/06 for St George Residential Home

This inspection was carried out on 17th January 2006.

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 George Residential Home 08/07/08

St George Residential Home 24/07/06

St George Residential Home 18/04/05

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 George Residential Home 42-43 West Cliff Whitstable Kent CT5 4PP Lead Inspector Mark Hemmings Unannounced Inspection 17th January 2006 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 George Residential Home DS0000062884.V264015.R01.S.doc Version 5.1 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 George Residential Home DS0000062884.V264015.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service St George Residential Home Address 42-43 West Cliff Whitstable Kent CT5 4PP 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) 01227 280599 Darbyshire Care Ltd Vacant Care Home 18 Category(ies) of Dementia - over 65 years of age (1), Learning registration, with number disability over 65 years of age (1), Old age, not of places falling within any other category (16) St George Residential Home DS0000062884.V264015.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th April 2005 Brief Description of the Service: The premises are a two storey detached older property which as been adapted for its present use. The accommodation for service users is provided on the ground and the first floors. There is a stair-lift which traverses the main flight of stairs between the lower floors. However, this does not give completely step free access because there are two sub-landings on the first floor. When full, there is provision for 10 service users to have their own bedroom. There are four bedrooms which can be shared by two people each. All of the bedrooms have a private wash hand basin and nine of them also have a private toilet. The property is located on a quiet residential road. To the front there are extensive views across a golf course and out to sea. To the rear, there is an enclosed garden. Whitstable town centre is about one quarter of a mile away. The Registered Provider is a private limited company. The Directors of the Company are Mr and Mrs Darbyshire. Mrs H Darbyshire is the Responsible Individual. This means that she is responsible for supervising the operation of the Home. The day to day administration of the Home is undertaken by the Acting Manager. St George Residential Home DS0000062884.V264015.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit was unannounced and it took about three hours to complete. During this time, the Inspector spoke with or spent time with five service users. He spoke with the Acting Manager and with the Head of Care. Also, he spoke with two of the care workers and with the cook. The Inspector looked at various parts of the accommodation. This included (by invitation) two of the service users’ bedrooms. The Home continues to provide the service users in residence with the support and assistance they need within a comfortable setting. There are two Required Developments at the end of this Inspection Report. The Inspector did not examine all of the Standards on this occasion. The reader is asked to read this Inspection Report in conjunction with the previous Inspection Report in order to obtain a comprehensive account of the Inspector’s current evaluation of the facilities and services available in St George. What the service does well: The Home provides service users with a pleasant and comfortable setting within which to make their home. The assistance each service user receives is provided in consultation with them. There is an organised system in the Home which enables the service users to comment upon the adequacy of the facilities and services which are made available to them. The Home’s catering service is well organised and service users consider the food served to be enjoyable and sufficient. St George Residential Home DS0000062884.V264015.R01.S.doc Version 5.1 Page 6 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 George Residential Home DS0000062884.V264015.R01.S.doc Version 5.1 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 George Residential Home DS0000062884.V264015.R01.S.doc Version 5.1 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): 1, 2, 3, 4 and 5. Prospective service users are given the information they need to make an informed decision about living in the Home. Each service user receives a written statement of the terms and conditions of their residency. Service users’ needs for assistance are assessed before admission. Service users are confident that their needs for personal care will be met when they enter the Home. Prospective service users and their representatives are encouraged to visit the Home before a decision is made about moving in. EVIDENCE: There is a Service Users’ Guide. This is a brochure which prospective service users are given and which outlines the facilities and services provided in the Home. In addition to this, the Acting Manager speaks with prospective service users in order to answer any remaining questions they may have. St George Residential Home DS0000062884.V264015.R01.S.doc Version 5.1 Page 9 Each service user receives a written statement of the terms and conditions in accordance with which the Registered Provider delivers accommodation and personal care services in the Home. The document is suitably detailed and it is clearly laid out. Previously, the Inspector has been informed that all new service users and their representatives are given an opportunity to talk through the document with the Acting Manager. This is done so that any necessary clarification can be given. The Inspector spoke with one of the service users about her recent experience of moving into the Home. She said that she had been confident at the point of admission to the Home, that her needs for support could be met reliably and consistently. The Registered Provider is aware of the responsibility placed upon it to ensure that only people whose needs for assistance can be met reliably, are admitted to the Home. St George Residential Home DS0000062884.V264015.R01.S.doc Version 5.1 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 and 10. Service users are confident that their present and future needs for personal care will be met in a reliable and consistent manner. They are suitably consulted about the assistance they receive. Service users’ health care needs are met fully. Suitable arrangements are in place with respect to the administration of service users’ medication. Service users consider that members of staff are respectful and that they appreciate their needs for privacy. EVIDENCE: There is a service user plan for each service user. These documents should reflect a clear understanding between service users and care workers about the personal care support to be provided. The Inspector sample checked one of the documents in this system. He found it to be detailed suitably. Service users say or indicate that they are consulted about the personal care they receive. This is done in order to make sure that it acknowledges their St George Residential Home DS0000062884.V264015.R01.S.doc Version 5.1 Page 11 preferences. Service users consider that they receive all the assistance they need. The Inspector observed examples of care workers assisting service users in a manner consistent with that described in the Acting Manager’s assessment of their individual needs. Service users say or indicate that care workers assist them to maintain their health. There is evidence which shows that service users’ doctors are called promptly when there is a concern about someone’s health. The Commission has not received from any of the members of the local primary health care team, any expressions of concern about their working relationships with the Home. The Acting Manager said that when appropriate service users are assisted to administer their own medication. The Inspector understands that suitable arrangements are in place to support this practice. Also noted, were the appropriate systems used by the Acting Manager to administer and to dispense the other service users’ medicines. Service users say or indicate that care workers are cordial in their manner towards them, while at the same time being respectful of their individual preferences. The Inspector noted several occasions on which care workers varied their approach according to what they know to be service users’ different expectations of them. For example, one person wanted to sit quietly on his own while others wanted to enjoy the company of others in the main lounge. St George Residential Home DS0000062884.V264015.R01.S.doc Version 5.1 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, 14 and 15. Service users have access to a suitably varied range of social activities. Service users are assisted to maintain normal contacts with family and friends. Service users are enabled to exercise suitable choice in their everyday lives. Service users are offered a suitably healthy diet. EVIDENCE: Various social activities are convened in the Home. These are organised by the recently appointed Activities Coordinator. The small number of service users who commented upon the matter, said both that they are occupied suitably and that they welcome the time spent with them by the Coordinator. Previously, service users have said that they are assisted to maintain contacts with members of their families and with friends who do not live in the Home. The Inspector has not received any expressions of concern about this matter from members of service users’ families. Service users say or indicate that the pace of daily life in the Home is relaxed and unhurried. There is evidence of service users exercising choice. For St George Residential Home DS0000062884.V264015.R01.S.doc Version 5.1 Page 13 example, people observed that they decide for themselves when to get up and when to go to bed and how to spend their day. Service users say that they receive good quality meals and they always have enough to eat. On this occasion, the Inspector did not have the opportunity to join service users for a meal. However when he last did so, he noted the food to have been well prepared and that the portions were of an adequate size. Also noted previously, was the written menu which indicated that service users are offered a normally balanced diet. The cook said that always there are sufficient provisions in the Home to enable all the meals listed on the menu to be prepared. St George Residential Home DS0000062884.V264015.R01.S.doc Version 5.1 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 and 18. Service users consider that their views are listened to and that as necessary they are acted upon. Arrangements are in place which are designed to protect service users from abuse, neglect and self harm. EVIDENCE: There is a complaints procedure which explains how service users and other stakeholders can make a complaint about any aspect of the facilities and services provided in the Home. Previously, service users have said or have indicated, that they are confident that any matter they raise will receive serious attention and if possible will be addressed. Previously, the Inspector has established that the care workers have a sound understanding of what constitutes good care practice. As part of this, they are aware of the need to be alert to instances which might jeopardise the wellbeing of a service user. Also, that they are aware of the various agencies external to the Home to which reference can be made should they become concerned about a service user’s wellbeing. Service users say or indicate that they feel safe living in St George. St George Residential Home DS0000062884.V264015.R01.S.doc Version 5.1 Page 15 St George Residential Home DS0000062884.V264015.R01.S.doc Version 5.1 Page 16 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, 20, 21, 22, 23, 24, 25 and 26. Service users are provided with a suitably homely environment. There are adequate shared use facilities. The arrangements used to facilitate service users’ mobility are sufficient. Service users’ bedrooms are generally suitably equipped. There is an omission in one aspect of the arrangements used to promote service users’ safety. The accommodation is presented to a normal domestic standard of cleanliness. EVIDENCE: Service users say that they are comfortable living in St George and that they consider the accommodation to be homely and welcoming. Until recently, there has in practice been only one bathroom in use in the Home, when really a minimum of two should be provided. The second St George Residential Home DS0000062884.V264015.R01.S.doc Version 5.1 Page 17 bathroom was rarely used, because of significant problems with access due to the way the room is laid out. The Registered Provider has now installed a special walk in shower in this room and is so doing it has returned to everyday use this second bathroom. Naturally, this development is a welcome example of the Registered Provider’s commitment to implementing improvements which have been recommended by the Commission. There are various items of equipment in the Home which are designed to assist care workers when helping those service users who experience a measure of reduced mobility. This includes a hoist in the main bathroom. This is designed to help people use the bath in safety and comfort. Previously, the care workers have said that this provision is adequate to enable them to complete safely this aspect of their work. Service users say that they like their bedrooms and that they have been invited to arrange them as they wish. The Inspector noted that service users have been encouraged to personalise their bedrooms with small items of their own furniture and with various ornaments of their choice. The Inspector noted the Home to be pleasantly warm and the service users said that this always is the case. The Inspector understands that the Registered Provider continues to take suitable precautions against the risk of someone being burnt by accidental contact with a heated surface. Previously, the care workers have said that always there is an adequate supply of hot water in the Home. The Inspector noted that some of the hot water taps accessible to service users are not temperature controlled to help reduce the likelihood that someone could be scalded accidentally. The Acting Manager said that he will now complete an assessment of the need to fit temperature control valves to the taps in question. Also, he said that any tap considered to constitute a significant hazard will be fitted with the necessary valve. The timescale agreed for the completion of this exercise is as stated in the relevant Required Development listed at the end of this Report. On the days of the inspection visit, the main areas of the accommodation were clean and orderly. The kitchen was presented to a suitable standard of hygiene. The cook was noted to have a sound knowledge of good practice in relation to food handling and to food preparation. The Inspector understands that the local Department of Environmental Health has not required the completion of any improvements with respect to catering and hygiene which remain outstanding. St George Residential Home DS0000062884.V264015.R01.S.doc Version 5.1 Page 18 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, 28, 29 and 30. There are enough members of staff on duty in the Home to enable service users’ current needs for assistance to be met. Suitable arrangements are in place to ensure that only trustworthy people are allowed to have unsupervised access to service users. The care workers have the competencies they need in order to work effectively with the present service users. EVIDENCE: There is a sufficient number of care workers and housekeeping staff on duty to ensure that service users’ needs for personal care and other resources are met reliably. The Inspector understands that the staff complement is sufficient to ensure that all of the rostered shifts are filled reliably. Service users say that they receive all the assistance they need from care workers and that this is provided in a timely manner. The Inspector observed care workers when they were assisting a number of the service users. He noted this help to be delivered in an appropriate manner, with the care workers being kind and considerate in their approach. St George Residential Home DS0000062884.V264015.R01.S.doc Version 5.1 Page 19 The Registered Provider is required to complete various security checks in relation to each member of staff. This is done to ensure that only suitable people are entrusted to have unsupervised access to service users who may be vulnerable. The Inspector understands that the Registered provider has continued to complete the specified checks in the manner required by the Regulations. The Registered Provider ensures that all new care workers receive introductory training. This is designed to ensure that they have the competencies necessary to enable them to support service users effectively. Previously, the Inspector has noted that a strengthened system has been introduced to determine the need for new care workers to receive introductory training, before working on their own. In addition to this, the Acting Manager partly has completed a review exercise which should validate the adequacy of the competencies possessed by all of the existing care workers. As noted already, the Inspector observed the care workers in a number of situations in which they provided assistance for service users. He noted them to have the competencies which the Acting Manager claimed for them. St George Residential Home DS0000062884.V264015.R01.S.doc Version 5.1 Page 20 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): 31, 32, 33, 36 and 38. There is a suitable management system in place to support the delivery of care and accommodation services in the Home. Service users’ preferences and wishes are reflected in the operation of the Home. The work completed by members of staff is supervised. There is an omission in one of the systems used to promote the health and safety of the service users and of members of staff. EVIDENCE: The Acting Manager has applied to the Commission to become the Registered Manager. Given that this application has not yet been determined, the Inspector has scored this Standard accordingly. However, the Inspector can St George Residential Home DS0000062884.V264015.R01.S.doc Version 5.1 Page 21 note that the Acting Manager has a detailed understanding of how the Home operates in practice. Also to be noted, are the various arrangements in place to promote effective team-work in the Home. These include handover meetings at the end of each shift and the completion of diary records in relation to each service user. These and other measures are designed to help ensure that each service user receives a consistent response to their needs for assistance. Periodic staff meetings are convened in the Home. These are held to enable staff to meet and to discuss how their work is proceeding. The Acting Manager has begun a course of study which should enable him to acquire both of the formal management qualifications which are required by the Standards. These Awards are designed to confirm and to extend managers’ abilities to promote and to ensure the provision of good quality residential care for service users. The Acting Manager said that he meets with each member of staff on a periodic basis to review their work and to resolve any difficulties. Service users say or indicate that the Home is run without there being any intrusive rules or routines. This means that they can continue to experience a normal home life of their choosing. Previously, the Inspector has established that the Registered Provider operates a system by means of which service users are invited to comment about their home. The Acting Manager said that all items of equipment in use in the Home remain in good working order. The Registered Provider continues to check periodically both the continued operability of the fire alarm bells and that of the various other items of fire safety equipment used in the Home. The Registered Provider is responsible for ensuring that all members of staff are aware of how best to avoid the occurrence of a fire safety emergency and how to respond effectively to one should the need arise. The Inspector noted that the validation exercise in question has become overdue. The Acting Manager said that the oversight will be corrected within the timescale established in the relevant Required Development at the end of this Report. The Inspector understands that the Kent Fire and Rescue Service has not recommended the introduction of any fire safety equipment additional to that which already is in operation in the Home. The Acting Manager said that he has completed a general review of the premises in order to identify any potential hazards which might compromise the health and safety of both the service users and members of staff. He reported that no such hazards were found. The Inspector examined various parts of the premises and he did not notice any obvious hazards which required attention. St George Residential Home DS0000062884.V264015.R01.S.doc Version 5.1 Page 22 St George Residential Home DS0000062884.V264015.R01.S.doc Version 5.1 Page 23 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 3 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 2 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 3 X X 3 X 2 St George Residential Home DS0000062884.V264015.R01.S.doc Version 5.1 Page 24 Are there any outstanding requirements from the last inspection? No 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 25 Regulation 23 Requirement The Registered Provider should take suitable precautions against the risk of a service user being scalded accidentally by hot water. The Registered Provider should ensure that a suitable system of fire safety competency appraisal is re-established. Timescale for action 01/04/06 2 38 23 01/04/06 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 George Residential Home DS0000062884.V264015.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 George Residential Home DS0000062884.V264015.R01.S.doc Version 5.1 Page 26 - 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. 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