Inspection on 08/07/08 for St George Residential Home

This inspection was carried out on 8th July 2008.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 24/07/06

St George Residential Home 17/01/06

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 28/09/2008.

CARE HOMES FOR OLDER PEOPLE St George Residential Home 42-43 West Cliff Whitstable Kent CT5 1DJ Lead Inspector Chris Woolf Key Unannounced Inspection 8th July 2008 09:15 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.V367705.R01.S.doc Version 5.2 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.V367705.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St George Residential Home Address 42-43 West Cliff Whitstable Kent CT5 1DJ 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 ian@stgeorgecarehome.co.uk Darbyshire Care Ltd Mr David Gilbert 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.V367705.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th July 2006 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 to provide access to the first floor. However, this does not give completely step free access because there are two sub-landings on the first floor. The home has 10 single and 4 double rooms, nine of which have en-suite toilet facilities. The property is located on a quiet residential road. There are extensive views across a golf course and out to sea from the front and an enclosed garden at the rear of the property. Whitstable town centre is about one quarter of a mile away. The current fees for the service at the time of the visit range from £312.81 to £540.00 per week. Information on the Home’s services and the CSCI reports for prospective service users will be detailed in the Statement of Purpose and Service User Guide. The e-mail address of the home is care@stgeorgecarehome.co.uk St George Residential Home DS0000062884.V367705.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 star. This means the people who use this service experience excellent, quality outcomes. Key Lines of Regulatory Assessment (KLORA) have informed the judgements made based on records viewed, observations made and written and verbal responses received. KLORA are guidelines that enable The Commission for Social Care Inspection (CSCI) to make an informed decision about each outcome area. The information for this report has been gained from an Annual Quality Assurance Assessment (AQAA) completed by the service; notifications of significant events submitted by the home since the last inspection; comment cards received from 10 residents or their representatives; and a site visit to the service that lasted 7 hours and 20 minutes. The site visit was unannounced. This means that neither the staff nor the residents knew that we (the Commission) were going to visit. During the site visit we spoke with the majority of the residents, 4 in more depth; 2 visitors to the service; and staff on duty including the activities organiser, the handyman, care assistants, the head of care, and the Registered manager. Observations were made of residents enjoying taking part in activities: the lunchtime meal being served; and the way that the staff interacted with the residents. We had a tour of the building and observed its cleanliness, maintenance, and infection control procedures. Medication was looked at including policies, storage, and records. A variety of other records were in inspected including care plans, complaints information, records of monies held for residents, staff recruitment files, staffing rotas, staff training matrix, activities records, menus, quality assurance records, and some health and safety records. The people who use this service prefer to be called ‘residents’ and this is the term used to describe them throughout this report. What the service does well: The home is clean and fresh and has a relaxed and welcoming atmosphere. Care in the home is good. A visitor commented, “They are well looked after, the care is very good” St George Residential Home DS0000062884.V367705.R01.S.doc Version 5.2 Page 6 Residents in the home benefit from a well structured activities programme. A resident said, “The activities help to keep our minds occupied”. The residents receive a balanced and nutritious diet with choices for all meals. A resident said, “We can’t fault the food”. Staff at the home are helpful, kind and considerate and respect the dignity and privacy of the residents. A resident commented, “The staff are wonderful, so helpful, patience personified”. The homes manager supports both residents and staff and the home is managed in the best interests of the residents. A resident said, “We don’t want to go anywhere else, we are perfectly happy here, we could not be better looked after”. A comment card completed by a relative of one of the residents at the time of the Annual Service Review stated, ‘The staff are a band of very caring people, knowing the needs of each of its clients. The manager always finds time to deal with the smallest of upsets and is one of the most dedicated people I know, and in my opinion, he deserves a medal for the devotion given and the time spent in ensuring that all the people under his care receive the very best attention’. A comment observed on the homes own quality assurance questionnaire said, ‘Mum has settled in well and is happy here. The staff are always welcoming and it is a pleasure to meet them when visiting. Since being here, knowing mum is being so well cared for, it has given the family great peace of mind’. What has improved since the last inspection? The residents’ contract has been improved and now shows the fees payable and the room number of the resident. Care plans are now prepared electronically and are printed out to make them easier for residents to read The activities coordinator now works additional hours. Menus have been changed to reflect the wishes expressed by the residents. St George Residential Home DS0000062884.V367705.R01.S.doc Version 5.2 Page 7 There have been a number of environmental improvements made since the last inspection including the provision of a second stair lift, and ongoing decorating and refurbishment of communal rooms and bedrooms. The home now ensures that when they need to employ agency staff they keep to the same people to maintain consistency for the residents. Following requests from residents and their families the home now looks after some monies for residents. 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. The summary of this inspection report can be made available in other formats on request. St George Residential Home DS0000062884.V367705.R01.S.doc Version 5.2 Page 8 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.V367705.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, & 4. Standard 6 is not applicable in this home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents needs are assessed and they and their representatives have the information needed to ensure the home will meet their needs EVIDENCE: There was a requirement on the last report that the resident’s contracts should be updated to include the fee payable and by whom and the room number of each resident. New contracts have been introduced which now fully meet the standards. The home has also updated its brochure since the last inspection. Resident comment cards confirmed that they had received enough information about the home before moving in to decide if it was the right place for them, St George Residential Home DS0000062884.V367705.R01.S.doc Version 5.2 Page 10 and that they had received a contract. One commented, ‘‘This was the best home around’. The Registered Manager and the Head of Care visit all prospective residents together, either at home or in hospital, to carry out an in-depth assessment of their needs. Having both the Registered Manager and the Head of Care present gives the prospective resident the opportunity to relate to a person of whichever gender they feel most comfortable with, at a time which can be quite stressful and worrying for them. The assessment takes into account physical, psychological, spiritual, and social needs. A detailed assessment enables the home to be confident that they will be able to meet the needs of the prospective resident. If the Registered Manager and the Head of Care consider that the home would not be able to meet the person’s individual needs, admission will not be progressed. Comment cards received from residents confirmed that they receive the care and support they need. Prospective residents or the representatives are welcome to visit the home prior to admission. These visits give the prospective resident the opportunity to meet and talk with existing residents to gain a first hand impression of what it is like to live in the home. This home does not offer the facility of intermediate care. This is a specialised service with dedicated accommodation and specialised facilities, equipment, and staff, designed to deliver short-term intensive rehabilitation and enable service users to return home. St George Residential Home DS0000062884.V367705.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, & 10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The health and personal care that residents receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: A comprehensive, person centred care plan is formulated with each resident based on information gained during the pre-admission assessment. Care plans are regularly reviewed and updated to reflect any change in need. Information in the care plan includes details of physical and mental health, history, social interests past and present, cultural and religious needs, diversity needs, and details of contact with any health care professionals. St George Residential Home DS0000062884.V367705.R01.S.doc Version 5.2 Page 12 Individual risk assessments include moving and handling, tissue viability, and nutrition. Where appropriate charts are maintained for behaviour monitoring and for fluid intake. The home has improved its care planning in the last year by now holding them on computer and printing them out, enabling users and clients to read them more easily than the previous hand written plans. The residents’ health care needs are supported by the home and access to health care services is organised to meet these needs. Comment cards confirmed that residents receive the care and support and the medical support that they need. Residents said, “If you are not well they are on the spot, they are kindness in themselves”, and “the care is good”. A visitor said, “Residents are well looked after, the care is very good”. The home is proactive in preventing pressure areas from breaking down. The AQAA says ‘The home has Spenco mattresses and cushions for clients where there is any risk of pressure sores’. If a resident shows signs of developing pressure sores the district nurses are consulted and they visit to provide treatment, advice, and any additional equipment that may be needed. Residents’ nutritional needs are assessed and weights are regularly monitored. Any significant variation is reported to the G.P. Residents are encouraged to be active and to take appropriate exercise. Residents said, “My friend and I go for walks, we often go up to the seat overlooking the golf course and wave to people we know”, and “I like to go for a walk after lunch”. The home organises a monthly exercise session and photographs were seen of residents obviously enjoying the exercises and using a variety of equipment such as balls and stretchy bands. The home has robust policies and procedures for the receipt, storage, administration, recording, and disposal of medication. All residents sign to indicate whether they wish to administer their own medication or if they would prefer the staff to take on this responsibility. Where a resident wishes to selfmedicate a risk assessment is completed and this is reviewed on a 3 monthly basis or more frequently if considered necessary. All residents have a lockable facility in their own bedroom in which medication can be safely stored. On the day of the site visit it was identified that the home did not have the appropriate storage facility for controlled drugs to comply with the recently changed legislation of the Royal Pharmaceutical Society. This was discussed with the registered manager an appropriate controlled drugs cabinet to fully comply with the regulations is now on order. Staff confirmed that upholding the privacy and dignity of residents is a priority at St. Georges. Staff knock on doors before entering. Personal care and health care treatments are carried out in private. All clothes are clearly marked with the name of the resident. A member of staff was observed sewing on labels whilst the residents were having their lunch. Where residents share a room appropriate screening is available. If residents have diversity needs these are respected. Residents are provided with personal phone points when requested, and the home phones are now ‘walkabout’ to ensures that St George Residential Home DS0000062884.V367705.R01.S.doc Version 5.2 Page 13 residents without a phone point can take calls in private. A resident said, “We always get our clothes washed, they change them every day”. All residents who completed comment cards answered ‘always’ to the question ‘Do the staff listen and act on what you say’. St George Residential Home DS0000062884.V367705.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, & 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are able to make choices about their life style. Social, cultural and recreational activities meet individual’s expectations. Residents receive a balanced and nutritious diet. EVIDENCE: The home has a dedicated activities coordinator who works 5 days a week on a regular basis and additional hours around special periods e.g. Christmas, Easter, birthdays and wedding anniversaries. The hours of work of the activities coordinator have been increased since the last inspection giving residents even more opportunities to participate in activities or 1:1’s. The activities coordinator is supported in her work by the care staff. Individual records are maintained to evidence the different activities that each resident takes part in. Activity charts are kept for ‘extras’ and special events. The St George Residential Home DS0000062884.V367705.R01.S.doc Version 5.2 Page 15 home has introduced the games of ‘Triominoes’ (triangular dominoes) and ‘Hoy’ (a card game) into the regular repertoire and on the day of the site visit 10 residents were observed thoroughly enjoying Triominoes. Residents said, “This helps to keep our minds working”, “It’s a very good game”, and “We had Bingo yesterday, today its Triominoes, we are well entertained”. Regular craft afternoons take place and the residents often make cards or make games for use in group activities. At Christmas almost 100 of the cards made by residents were sold to family and friends with the proceeds going back into purchasing more materials. Other regular activities include Bingo, cards, hairdressing and manicures. Residents said, “We have games”, “I love making the cards”, “I made the calendar on my wall”, “I never thought I would play Bingo, but I enjoy it and we win lovely prizes”, “We had manicures yesterday”, “We have plenty to do”, and “We play Hoy, its good”. Staff said, “We all join in, I love the craft”, and “I do the Bingo when the activities coordinator is on holiday”. The activity organiser also has 1:1 sessions and chats, particularly with residents who do not wish to join in with group activities. Larger events include a horse racing game, with horses coloured by the residents during craft sessions, visiting entertainers and sing along duos, monthly exercise session, Easter bonnet making and parade, St. Georges day celebrations, and a visiting clothing provider. Residents said, “The activities are very good, very helpful”, and “We had a musician recently with all the old songs, it was very good”. Trips out are organised and the residents have visited Minnis Bay, Manston airfield and Tankerton for lunch, and the garden centre for afternoon tea. A trip to the Marlow Theatre is planned for August. A resident commented, “I am going to the theatre”. The religious and cultural needs of residents are supported by the home. A monthly holy communion is held for those who wish to participate, and the Catholic Priest visits fortnightly. Contact with other faiths would be organised at the request of the resident or their family. A staff member said, “Their religious needs are met”. Residents are encouraged to maintain contact with their family and friends and also with the wider community. There is no restriction on visiting in the home. A visitor said, “I am made welcome”. Residents who wish are supported to go to clubs or to go out to meet friends. The home is currently introducing a free monthly luncheon club for other pensioners in the area. This will include transport, lunch and entertainment from 11:30 - 3:30. It is taking a while to get a good take up for this club but once up and running it will benefit the residents, by giving them additional community contact, and also benefit those who choose to come for the day. The concept of the luncheon club was discussed with and agreed with the residents before it was advertised. Residents have choices in all aspects of their daily lives including time of getting up and going to bed, what to wear, whether to join in activities or not, where to sit, whether they want to go out for walks, what they want to eat and drink, and who they wish to spend their time with. Staff said, “They have St George Residential Home DS0000062884.V367705.R01.S.doc Version 5.2 Page 16 choices in everything they do”, and “Its always what they prefer”. The home has its own small shop for the residents to purchase personal items of their choice and the activities organiser also shops for other more specialist items at the request of the residents. A resident said, “We have a shop here, its very handy” A nutritious and balanced diet is provided for the residents with choices at all meals. The menu has been changed since the last inspection to reflect requests from residents. Residents said, “The food is excellent”, “The food is very good, I am ashamed to say I don’t eat all I should”, “We fill in the menus each week”, “Today I had chicken in sauce. We could have either mashed potatoes or rice with it, and some nice veg. I had peach sponge and custard for pudding, it was lovely, very light”, and “Sometimes we have jacket potatoes and prawns for tea -I love it”. Staff said, “The food is good”, and “The food is good, even I eat it”. St George Residential Home DS0000062884.V367705.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to express their concerns, and have access to a robust, effective complaints procedure. Residents are protected from abuse. EVIDENCE: The home has a robust complaints procedure and a copy is on display in the hallway. Resident comment cards confirmed that residents know who to speak to if they are not happy and how to make a complaint. There have been no official complaints made to the home since the last inspection. A concern raised by a resident which the resident did not wish to be treated as an official complaint, was taken seriously, investigated, and the outcome was recorded. Residents said, “I can’t complain about anything”, and “I can’t fault it in any way”. Residents are protected from abuse. No new member of staff is employed until a satisfactory check of the Protection of Vulnerable Adults register has been received. All staff are given a basic knowledge of abuse and whistleblowing, and know the procedures they should follow if they suspect or St George Residential Home DS0000062884.V367705.R01.S.doc Version 5.2 Page 18 witness abuse. However at present not all staff have attended formal Protection of Vulnerable Adults training. The Registered Manager explained, and showed evidence, that staff had been booked for this training but that the training provider had cancelled the last two courses, both at short notice. Further courses have since been booked and all staff should complete this training in the near future. St George Residential Home DS0000062884.V367705.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 24, & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a clean, safe, well-maintained and comfortable environment with rooms that are personalised to meet their needs and wishes. EVIDENCE: St. Georges is situated at the end of a no through road adjacent to open space and footpaths. Many of the rooms have views over the Golf Club and the bay. There is a very pleasant garden at the rear of the property where residents, their visitors, and staff enjoy the fresh air and sunshine. On the afternoon of the site visit a number of residents were enjoying sitting in the garden until St George Residential Home DS0000062884.V367705.R01.S.doc Version 5.2 Page 20 ‘rain stopped play’. A visitor commented, “There is a nice garden here for them”. The home is well maintained with an ongoing programme of maintenance and improvement. The AQAA states, ‘As part of the internal audit there is an inspection of rooms and communal areas against a set of key criteria’, and ‘We employ a handy man who works a minimum of 2 days a week’. On the day of the site visit one room was in the process of being decorated and the Registered Manager commented that once this room is finished it would mean that all of the rooms in the home have been decorated since he became manager. In addition to decorating internally and externally, improvements since the last key inspection include the re-carpeting of all communal areas; all sinks and hot water outlets have had thermostatic mixer valves fitted; ozonizers have been bought to provide cleaner air; all bathroom areas have had non slip flooring fitted; the food store area has been redecorated and refitted; the fire door has been alarmed; a new secure gate has been fitted; handrails have been fitted where required; the handrail to the gardens has been replaced; and the tumble drier, washing machine and fridge have all been replaced. The home already had a stair lift on one side of the building to assist with access to the first floor. Since the last inspection a second stair lift has been installed on the other side of the building. There are still 4 steps to negotiate to reach the rooms on the first floor but there are grab rails available to assist. Residents using the rooms on the first floor need to have a certain amount of mobility to climb these few steps. A resident said, “I always use the stair lift, its very good, and there is a handrail to help me up the few steps at the top”. The home has a pleasant garden room/conservatory and a separate dining room, which is also used for activities. Furnishings and fittings in these rooms are homely and suitable for the needs of the residents. Resident’s bedrooms are personalised to meet their needs and wishes. A resident was pleased to show us her room, which had recently been decorated. She told us, “That is my mirror, the handyman has just put it up for me”. The AQAA tells us that ‘All rooms have been assessed for health and safety as well as mobility to ensure the resident can move around their room easily’. All clients have individual personalised buzzers to ensure they can call for assistance at any time. Lockable doors with keys are fitted when requested, although some residents have specifically requested not to have locks fitted. Each room has a lockable drawer facility. Individual phone call points are fitted on request. Residents comments included, “I share my room, it is very nice, we have a lovely view, and we get on very well”, “It’s a very nice room”, and “I love my room”. A visitor said, “She is in the best room in the house, what a lovely view”. Where rooms are shared privacy curtains are fitted unless the residents request not to have these in which case a portable screen is available in case of need. A resident said, “They were going to put up curtains between us but we told them we did St George Residential Home DS0000062884.V367705.R01.S.doc Version 5.2 Page 21 not want them, the way the room is set out we are quite private from each other anyway, and we have a separate toilet”. The home is clean and odour free throughout. Residents comment cards confirmed that the home is always fresh and clean. Residents said, “My room is always kept clean for me”, and “The cleaner works very hard”. A staff member said, “It’s kept clean”. The home has robust procedures for infection control. Liquid soap and paper towels are available where needed. Sufficient personal protective clothing is available. The laundry has the correct equipment to maintain infection control. St George Residential Home DS0000062884.V367705.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to support the residents. EVIDENCE: Sufficient staff are employed to meet the needs of the residents. Staff comment cards confirmed that staff are always or usually available when they are needed. The AQAA says ‘We ensure that at all times there is sufficient numbers (or more) of staff members on duty at any one time and increase these numbers when the need arises’. One of the improvements made since the last inspection is that the home now ensures that when agency staff are needed they keep to the same two people to maintain consistency for the residents. The home has a good track record of training staff in NVQ (National Vocational Qualifications). Currently the head of care has just completed her NVQ 4 and St George Residential Home DS0000062884.V367705.R01.S.doc Version 5.2 Page 23 is waiting for this to be verified. Other staff are trained to NVQ Level 2 or 3. A member of staff said, “I have got NVQ 3”. The home has robust recruitment procedures. No new member of staff is employed until 2 satisfactory references have been obtained; an enhanced disclosure has been submitted to the Criminal Records Bureau; and a satisfactory check of the Protection of Vulnerable Adults register has been received. The homes AQAA states, ‘All new members of staff go through a probationary period (day or night) which could last up to 3 months where they shadow other members of staff’. The Registered Manager or the Head of Care train and assess the competency of all new staff, including night staff, when they first start work at the home. The home has had some difficulties recently in employing night staff of a suitable calibre to meet the needs of the residents and the requirements and standards of the home. The Registered Manager and Head of Care have been covering some of the night shifts in the interim period when other staff or the regular agency staff have not been available. All new staff have induction training. Staff are trained in the mandatory subjects and these are all either up to date or courses have been booked. Currently all staff are three quarters of the way through a 12-week distance learning course in dementia. This training includes an independent assessment at the end of each month. Half of the staff have attended Challenging Behaviour training and the other half are booked to attend this training. All staff that administer medication have been trained. A member of staff, “Only staff who have been trained give out medication”. The home has also introduced a range of in-house training using DVD’s and questionnaires. Resident comment about the staff included, “You can have a laugh and a joke with them”, “The staff on the whole are very good”, “The staff are very pleasant”, “They all do their best for us”, and “The activities lady is excellent, I can always talk to her.” General comments from staff included, “I don’t look at it as a job”, and “Its like home from home”. St George Residential Home DS0000062884.V367705.R01.S.doc Version 5.2 Page 24 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, & 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect, and has effective quality assurance systems developed by a qualified and competent manager. The health, safety and welfare of residents and staff are promoted and protected. EVIDENCE: St George Residential Home DS0000062884.V367705.R01.S.doc Version 5.2 Page 25 The Registered Manager holds an RMA (Registered Managers Award) and since the last inspection has completed his NVQ 4 in care. He is now waiting for this to be externally verified. A Head of Care who has also just completed her NVQ 4 in care supports the Registered Manager. There are clear lines of accountability within the service from the provider down. The AQAA sent to us by the manager was comprehensive and included all of the information we required. The manager is committed to ensuring that good equality and diversity practices are promoted throughout the home. The Staff we spoke to confirm that the Registered Manager is very supportive, they said, “I can always talk to Dave” and “Dave regularly works with us on the floor”. Residents said, “David is a martyr”, “David is very good”, and “The cook is on holiday this week so Dave is cooking, he is good”. The Registered Managers style is relaxed but efficient and the atmosphere throughout the home is reflective of this style. The home has good quality assurance systems in place. Questionnaires are sent out to residents, families, staff, and visiting professionals. A very clear analysis is produced of the results including visual bar graphs. Comments viewed on returned questionnaires included, ‘The living areas are always clean and fresh’, ‘There are more than sufficient meal choices’, ‘Staff are very obliging and discrete when dealing with personal problems’, ‘All the staff are wonderful, and ‘It couldn’t be better’. Bi monthly residents meetings are held in the home. The AQAA says, ‘A few days prior to residents meetings all the residents are asked if there any topics or areas they would like to be covered. This gives us the chance to set a focussed agenda and cover topics for people who may not be able to attend’. The home has a comments/complaints box, where anyone can deposit comments anonymously or otherwise. The proprietor deals with any comments from this box. The AQAA tells us that the following improvements have been made as a result of listening to residents. ‘From the internal quality audit: Laundry – a new steam press has been bought and a new system put in place for sorting and putting away clothes. From the residents meetings: Menu changes – more fruit, a more seasonal menu, Changes and additions to the selection in the in house shop, Residents decided as to where they went on outings, Every room now has a proper TV aerial point fitted’. As well as the questionnaires regular audits are also undertaken examples include, a monthly medication audit, and inspection of rooms and communal areas against a set of key criteria. The home looks after small amount of money for residents when requested by the resident or their representative. This is administered in a well-documented manner. This is a change since the last inspection when no resident’s monies were handled. The introduction of this service has been made specifically to meet the needs and request of some residents and their families. The home protects the health, safety and welfare of residents and staff. All staff are wither up to date or booked on mandatory training courses. Accident St George Residential Home DS0000062884.V367705.R01.S.doc Version 5.2 Page 26 records are properly completed, securely stored and analysed by the Registered Manager. Risk assessments are carried out and documented for all safe working practices. The home has a current fire risk assessment and all fire checks are up to date. The service records of maintenance of equipment which we saw were all up to date. St George Residential Home DS0000062884.V367705.R01.S.doc Version 5.2 Page 27 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 3 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 3 X X X 3 X 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 4 X 3 X 3 X X 3 St George Residential Home DS0000062884.V367705.R01.S.doc Version 5.2 Page 28 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. 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. Refer to Standard Good Practice Recommendations St George Residential Home DS0000062884.V367705.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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.V367705.R01.S.doc Version 5.2 Page 30 - 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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