Inspection on 15/06/06 for St George`s (Banstead)

This inspection was carried out on 15th June 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`s (Banstead) 10/12/07

St George`s (Banstead) 14/11/05

St George`s (Banstead) 15/08/05

St George`s (Banstead) 24/01/05

St George`s (Banstead) 09/08/04

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Thorndene

Southfields

Insight - Eastchurch

Magenta

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Dovedale Court

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

CARE HOMES FOR OLDER PEOPLE St George`s (Banstead) 58 Fir Tree Road Banstead Surrey SM7 1NQ Lead Inspector Megan McHugh Key Unannounced Inspection 15th June 2006 09:30 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`s (Banstead) DS0000013800.V297096.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`s (Banstead) DS0000013800.V297096.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St George`s (Banstead) Address 58 Fir Tree Road Banstead Surrey SM7 1NQ 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) 01737 370224 Prospect Housing and Support Services To be confirmed Care Home 8 Category(ies) of Learning disability (1), Learning disability over registration, with number 65 years of age (7) of places St George`s (Banstead) DS0000013800.V297096.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The age/age range of the persons to be accommodated will be: 2 PERSONS 58-65 YEARS AND 6 OVER 65 YEARS OF AGE 14th November 2005 Date of last inspection Brief Description of the Service: St. Georges, Fir Tree Road, is registered to provide accommodation, support and care to up to eight people who have a learning disability. The home is a large detached property that is on a main road, with limited car parking on the front drive. There are eight individual bedrooms on the ground and first floors. All bedrooms on the upper floor and one bedroom on the ground floor have their own shower rooms. A bathroom is available on the ground floor that is fitted with an easy access bath. A spacious lounge is divided into two areas, with a television available in both areas. An air conditioned conservatory is used as the dining room. The rear garden is well maintained, is mostly level and access is provided from the house by steps. Fees range from £ to £ per week. St George`s (Banstead) DS0000013800.V297096.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first inspection for the year 2006/07 and was the home’s key inspection. Mrs Meg McHugh, Regulation Inspector carried out the inspection, with Mrs Sue Luray, deputy manager and Ms. Diane Czako, Head of Learning Disability Services present. A tour of the home was undertaken and a number of records and documents were examined, including individual plans, staff files and service user finance records. Six of the seven service users were spoken with and two members of staff were spoken with. Information about the service was also provided in the completed pre-inspection questionnaire, which was returned to CSCI. The Commission would like to thanks the service users and staff for their hospitality during the inspection process. What the service does well: What has improved since the last inspection? Individual care plans and assessments of risks have been updated to guide staff to the current needs of the service users. Specific details of any special dietary requirements are included in service user’s individual plans to ensure all staff are aware of these. Where they are able, service users have signed their care plans to show that they have been involved in the drawing up of the document. Contracts have been reviewed and revised to ensure they contain all the required information. St George`s (Banstead) DS0000013800.V297096.R01.S.doc Version 5.2 Page 6 The manager has applied for registration with CSCI and is awaiting a return of a document so that the registration process can be completed. The container for disposing of sharp items, which was stored in the ground floor toilet, has been moved and is no longer kept in an area that service users have access to. 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`s (Banstead) DS0000013800.V297096.R01.S.doc Version 5.2 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`s (Banstead) DS0000013800.V297096.R01.S.doc Version 5.2 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): 2,3,and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Statements of terms and conditions are provided to service users. All service users have their needs assessed prior to moving into the home. The home does not offer intermediate care. EVIDENCE: Each service user is provided with a statement of the terms and conditions of living at the home and these are known as tenancy agreements. These are signed by the service users if they are able and list the individual room to be occupied by the service user and detail the shared space available. The tenancy agreements seen state the weekly rent and the weekly service charges. The deputy manager discussed the admission process and a copy of the pre admission assessment was seen. This incorporated all aspects of the individual’s life and care needs. St George`s (Banstead) DS0000013800.V297096.R01.S.doc Version 5.2 Page 9 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans were well written, detailed service user’s personal, social and health needs. These plans were not reviewed on a monthly basis. Health care needs were well met and service users were treated with respect and their privacy was upheld. Medication was administered in accordance with policy and procedure and one minor amendment was required on handwritten medications on the medication administration records. EVIDENCE: All the care plans were rewritten in January 2006. These are comprehensive and contain details about the individuals care needs, physical needs, emotional needs, mental needs and social needs. It was pleasing to see comprehensive and holistic care planning in place. The plans also contain risk assessments and action plans on how to minimise the identified risk. Service users have signed their care plans wherever possible and there was evidence in the plans of their involvement and their family’s input into creating these documents. The plans have not been reviewed on a monthly basis. It is important to update the care plans on a monthly basis to ensure that they reflect the service user’s needs. St George`s (Banstead) DS0000013800.V297096.R01.S.doc Version 5.2 Page 10 Records showed that service users have access to a range of health care needs including referrals to specialists, such as speech and language therapists, diabetic nurses and more. The home is supported by the local GP practice. The home has commenced using blister packs for their medication and stated that this is a good system and they have adapted well to using it. The deputy manager explained the process to the inspector and records were sampled. There were no gaps noted on the medication administration records and all medications were signed in on the charts. Some medication has been handwritten onto the administration records and this was not done in a satisfactory manner. It is strongly recommended as good practice that when it is necessary to handwrite on a medication administration record chart in the home that the member of staff writing the chart signs and dates the chart and that a second carer checks the entry for accuracy and then initials the chart. In addition the entry should include a reference to where this information was sourced, such as the prescriber’s name. Service users talked to the inspector about their bedrooms and that people cannot come in when they want to but only if they have said they can. Staff were heard talking to service users and calling them by their preferred name. St George`s (Banstead) DS0000013800.V297096.R01.S.doc Version 5.2 Page 11 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 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users lifestyle experiences matched and satisfied their social, cultural, religious and recreational interests and needs. Contact with family, friends and the community is maintained and promoted. Service users have choice and control over their lives. Meals provided are of a good standard, quality and quantity. EVIDENCE: Service users have many activities available to them. Most days of the week they are out attending activities at day centres and in the community. Service users discussed the places they go during the week and stated that on Thursdays a lady comes into the home to provide activities there. Six of the seven service users were taking part in the activity and showed the inspector their knitting and discussed what they were making. One service user was not knitting but taking part in another activity with input from the activities person. Service users talked about their favourite activity and why this was so. Many service users discussed their family and who visits them in the home and where they go to visit people. There is an active relationship between the home, service users and their relatives. Some service users go out to stay with relatives for the day or overnight and this was an enjoyable activity that was discussed at length. Service users talked about the church service in the home St George`s (Banstead) DS0000013800.V297096.R01.S.doc Version 5.2 Page 12 on a Sunday and evidence of other religions being taken into account and service users being given the opportunity to attend their specific place of worship was seen. Service users talked to the inspector about days out, trips out to the local playhouse, to the seaside and to parties at other houses and at their friends’ houses. The staff informed the inspector about a family reunion that had taken place recently and the party that they had at the home. Staff prepare the meals and service users have input into what meals are to be served. Service users stated that they like and dislike certain foods and staff were prepared to offer alternatives to the main meal whenever required. On the day of the inspection one service user chose another meal and there was a choice of dessert offered. Service users discussed how they chose what they want to do, what to wear and who they are friends with. Staff were heard asking service users what they wanted to eat and if they would like dessert. Service users were aware of their rights and informed the inspector of these. St George`s (Banstead) DS0000013800.V297096.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service The home has a clear complaint procedure and service users are confident that their complaints will be listened to and taken seriously. Service users are protected from abuse. EVIDENCE: The complaints log showed no complaints have been made to the home since the last inspection. The procedure was in place in the care office. Service users stated that if they had a worry or concern they would talk to staff like their key worker or the manager. One service user stated that she would talk to the regional manager if it were a serious concern. The deputy manager stated that the staff have developed good relationships with the relatives of the service users and that any concerns are brought to their attention early to prevent them turning into complaints. POVA training forms part of the staff s induction and all staff have had inhouse training. However this was last made available in 2003/04. Discussions with staff members showed that staff are aware of the procedures to follow and who to contact in safeguarding vulnerable adults. Therefore only a recommendation was made that all staff are given a training update in safeguarding vulnerable adults. St George`s (Banstead) DS0000013800.V297096.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Environment was clean, homely and well maintained. All areas of the home were safe and accessible to all service users and meets their individual and collective needs. EVIDENCE: The home is a large detached property that is well maintained. On the day of the inspection new curtain rails were put up in the lounge and the maintenance man was attending to the homes bus. The deputy manager stated that the response time to a maintenance request was exceptionally fast. All areas of the home were safe for service users and well maintained. Some of the service users invited the inspector into their bedrooms and these were decorated to their individual tastes with pictures, photographs, stuffed animals, certificates of their achievements, televisions and radio. A service user stated that they like living here as it is home. The communal areas provided plenty of space for St George`s (Banstead) DS0000013800.V297096.R01.S.doc Version 5.2 Page 15 all service users to be together and to provide areas where they could have some quiet time too. The garden was a good size, well maintained and had chairs, tables and parasols out for service users use. The home has a cleaning roster in place and this was satisfactory. Staff were observed to wash their hands after tasks and adhering to infection control practices. Policies and procedures were in place for COSHH (Control Of Substances Hazardous to Health) and infection control. St George`s (Banstead) DS0000013800.V297096.R01.S.doc Version 5.2 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, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staffing levels met the service users needs and staff were competent to do their job. Training was satisfactory and the home is anticipating training needs and providing the training for staff. The recruitment practices were satisfactory. EVIDENCE: The staff rota was correct at the time of the inspection as the staff on duty were due to be on duty. Observation during the day indicated that there were sufficient staff on duty throughout the waking day. The deputy manager stated that there is a waking night staff and a sleeping-in staff member. The levels were sufficient to meet service users collective and individual needs. The home has provided the Commission with their completed Pre Inspection Questionnaire and this contained information about the training provided and due to be provided for staff. Staff are due to have some training in care of people with dementia in preparation of dealing with the aging of the service user group as a whole. LDAF (specialist training for staff working with people with learning disabilities) training is given to all staff on commencing the job; this is to be completed in their first 6 months of work. Some of the LADF training has been accredited to the NVQ (National Vocational Qualification) St George`s (Banstead) DS0000013800.V297096.R01.S.doc Version 5.2 Page 17 award. All staff have up to date mandatory training certificates and the home operates a good system of recording training needs. A recommendation was made under Standard 18 to provide a refresher course for all staff in safeguarding vulnerable adults. The deputy stated that two staff have nursing qualifications, two staff have National Vocational Qualification (NVQ) level 2, three staff are on the NVQ level 2 course and one is due to start. A staff member interviewed stated that they are about to complete their NVQ level 2 and are looking forward to starting NVQ level 3. The regional manager stated that all staff must complete induction within the first month of working. No records of induction were seen at the time of the inspection. Four staff files were sampled and all contained the required information. The home’s policy and procedure of recruitment and vetting of staff was satisfactory. St George`s (Banstead) DS0000013800.V297096.R01.S.doc Version 5.2 Page 18 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements for management and administration were good and service users safety and welfare is promoted and protected. EVIDENCE: The manager has returned from a period of sick leave but was not on duty on the day of the inspection. The regional manager stated that the manager has 1 unit left to complete her Registered Managers Award. The manager has applied to become the Registered manager of the home and is awaiting the outcome of this process. A copy of the homes quality audit was provided to the Link inspector following the previous inspection and this was satisfactory. The deputy manager stated St George`s (Banstead) DS0000013800.V297096.R01.S.doc Version 5.2 Page 19 that they hold service user meetings 3 monthly and also have a chat after mealtimes to see how everyone is and any issues are discussed then too. Records confirmed that service user meetings are held and issues discussed included what activities service users would like to have over the next few months, menus, parties to be held and any input to planned decorating of the home. Another home manager has audited the home as part of the organisations audit and this included feedback from service users, staff and relatives as well as looking at paperwork. Service users are very vocal about what goes on in the home and are happy to talk about what they like and dislike in the home. They are very much involved in the running of the home. Two service users finances were checked against the records and these were seen to be satisfactory. The petty cash system was explained and records were seen but the money was not checked. No issues with finances were noted. The finance department audits the service users finances on a regular basis and evidence of these audits was seen. The home and organisation has clear policies and procedures for dealing with finances and clear audit trails can be seen and followed. No issues relating to health and safety or welfare of service users were noted in the environment. St George`s (Banstead) DS0000013800.V297096.R01.S.doc Version 5.2 Page 20 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X 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 3 X 3 X 3 X X 3 St George`s (Banstead) DS0000013800.V297096.R01.S.doc Version 5.2 Page 21 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 OP7 Regulation 15(2)(b) Requirement The service user’s plan of care must be kept under review. Timescale for action 29/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP9 Good Practice Recommendations Any medication that is handwritten must contain full information about dosage, frequency and medication. This should then be checked and signed by a second member of staff to stop any mistakes from happening. This was rectified at the time of the inspection and a requirement was made. All staff should receive a refresher course in safeguarding vulnerable adults. 2. OP18 St George`s (Banstead) DS0000013800.V297096.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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`s (Banstead) DS0000013800.V297096.R01.S.doc Version 5.2 Page 23 - 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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