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Inspection on 16/12/05 for St George`s House

Also see our care home review for St George`s House for more information

This inspection was carried out on 16th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home`s risk assessments are undertaken with diligence and are robust. The home`s induction and supervision is robust and ensures staff feel confident in providing a competent service and service users feel assured of a good standard of support.

What has improved since the last inspection?

The single requirement made at the last inspection which was very recent was still in time and the home has not had time to respond. The home is generally a good home, well run, well managed with a responsibe staff team and responds well to requirements.

What the care home could do better:

Residents contracts could be clearer, or where the information is not known, a note for the benefit of the resident should be attached to indicate the amount, and method of payment. And whether the resident would have to contribute or not. The home`s quality assurance and auditing needs to be undertaken monthly as required, and the home needs to indicate whether and when they have responded to those audits.

CARE HOME ADULTS 18-65 St George`s House 263 Camden Road Tufnell Park London N7 0HS Lead Inspector Ms Franki Solomon Unannounced Inspection 16th December 2005 10:15 St George`s House DS0000020978.V273549.R02.S.doc Version 5.0 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 House DS0000020978.V273549.R02.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. 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 House DS0000020978.V273549.R02.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service St George`s House Address 263 Camden Road Tufnell Park London N7 0HS 020 7607 7989 0207 371 7519 stg@2-care-rsl.org.uk 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) 2 Care Miss Bettina Jeppesen Care Home 23 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (23) of places St George`s House DS0000020978.V273549.R02.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Home for up to 23 adults (men and women) aged under 65 with needs relating to mental health 7th November 2005 Date of last inspection Brief Description of the Service: St George’s House is registered with the Commission for Social Care Inspection as a care home for 23 adults between the ages of 18 - 65. It is a mental health project owned and managed by2Care, a Charity and Registered Social Landlord. They focus on providing rehabilitation for adults recovering from mental health problems. St George’s has been open since 1989. The Rehabilitation service is designed to enable individuals to acquire or regain the skills necessary to live as indpendently as possible. The home has a registered manager and staff team providing 24 hour / 7 days a week support. The building is purpose built over three floors, most of the accommodation being on the upper two floors. The general office, communal areas, kitchen and single flats are on the ground floor. St George’s is set in its own grounds which include a small garden area and some car parking at the rear of the house. The property is in a residential area off a main road half way between Holloway Road and Camden Overground, and Camden Underground stations and shopping areas. There are good bus routes in each direction. St George`s House DS0000020978.V273549.R02.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the second statutory inspection for the year April 2005 – March 2006. The inspection was unannounced and covered a morning. The date of the inspection was random and not in response to any issues. A single requirement had been made at the last inspection and since the time scale was for january 2006, this requirement was not considered. Most of the key standards had been inspected at the previous inspection. The Person-in-Charge on the day was the deputy manager who was available throughout the inspection. The inspector spoke with residents, staff, examined files and toured the building. The inspector would like to thank residents, staff and management for their hospitality and co-operation. What the service does well: What has improved since the last inspection? The single requirement made at the last inspection which was very recent was still in time and the home has not had time to respond. The home is generally a good home, well run, well managed with a responsibe staff team and responds well to requirements. St George`s House DS0000020978.V273549.R02.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. St George`s House DS0000020978.V273549.R02.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection St George`s House DS0000020978.V273549.R02.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 5. The home’s records for service users are in place but could be improved. EVIDENCE: A sample of files examine had Terms & Conditions and Contract and was signed by the resident. One file had a letter from the authority confirming amount and method of payment. However method of payment and who contributed to the fee was not clearly stated on the contract and could be a source of anxiety to residents. For instance the contract set out: Authority’s contribution ….. … (£blank). The clien’t contribution …… … (£blank). The Third Party’s Contribution ..(if any) ..(£blank). The deputy did state that this information was discussed with the resident verbally, and generally residents did know the fees policy and structure. A requirement has been made. St George`s House DS0000020978.V273549.R02.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9. Risk assessments are suffiently robust to ensure the safety of service users. EVIDENCE: In discussion with the deputy and upon examination of a sample of files, it was evident that the home undertakes robust risk assessments to ensure the safety and well being of residents. St George`s House DS0000020978.V273549.R02.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed on this occasion. EVIDENCE: St George`s House DS0000020978.V273549.R02.S.doc Version 5.0 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed on this occasion. EVIDENCE: St George`s House DS0000020978.V273549.R02.S.doc Version 5.0 Page 12 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed on this occasion. EVIDENCE: St George`s House DS0000020978.V273549.R02.S.doc Version 5.0 Page 13 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed on this occasion. EVIDENCE: St George`s House DS0000020978.V273549.R02.S.doc Version 5.0 Page 14 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 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. Arrangements are in place to ensure staff know their roles and responsibilities. EVIDENCE: A project worker who had started as a permanet full-time employee confirmed that their induction was clear, detailed and robust and included weekly supervision. The staff also confirmed they had received a clear job description. An interim agency worker also confirmed that they also received induction on the day of starting and and on subsequent employment. Staff’s personnel files which would include job desc are not kept at the home but at the organisation’s head office. The deputy produced templates of the organisation’s job description. The inspector spoke with residents who confirmed they felt confident in staff’s knowledge and expertise. St George`s House DS0000020978.V273549.R02.S.doc Version 5.0 Page 15 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39. The home’s self monitoring and quality assurance arrangements are poor. EVIDENCE: Registered homes are required to make monthly visits under regulation 26. The Commission has received 3 monthly reports from St Georges over the past year. These were: • • • 24 January report – received 21st March 2005. 22 February report – received 30 March 2005 27 June 2005 – received 27 October 2005. The last three reports filed at the home were; 25 Mary 2005, 12 July 2005 and 23 September 2005. The manager is therefore unable to act upon any issues raised at these audit inspections. A requirement has been made. St George`s House DS0000020978.V273549.R02.S.doc Version 5.0 Page 16 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X 2 Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X 4 X Standard No 24 25 26 27 28 29 30 STAFFING Score X X 2 X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score 4 X X X X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 St George`s House Score X X X X Standard No 37 38 39 40 41 42 43 Score X X 2 X X X X DS0000020978.V273549.R02.S.doc Version 5.0 Page 17 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA5 Regulation 5 Requirement Timescale for action 30/01/06 2 YA39 26(1) 26(3) 26(4)(c) The Registered Person must ensure the Terms & Conditions and Contract includes a costed contract as to the amount and method of payment of fees. The Registered Person must 30/01/06 ensure the monthly visit reports are sent to the Commission and received at the home so that issues for quality assurance may be acted upon. 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`s House DS0000020978.V273549.R02.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Camden Local Office Centro 4 20-23 Mandela Street London NW1 0DU 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 House DS0000020978.V273549.R02.S.doc Version 5.0 Page 19 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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