Inspection on 27/01/06 for St George`s Ltd

This inspection was carried out on 27th 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`s Ltd 09/08/07

St George`s Ltd 03/08/06

St George`s Ltd 03/03/05

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE St George`s Ltd Croxteth Avenue Liscard Wallasey Wirral CH44 5UL Lead Inspector Lynn Sharples Unannounced Inspection 27th 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`s Ltd DS0000060055.V279882.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`s Ltd DS0000060055.V279882.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service St George`s Ltd Address Croxteth Avenue Liscard Wallasey Wirral CH44 5UL 0151 630 6754 0151 638 8721 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) St George`s (Liverpool) Ltd Colin John Moore Care Home 60 Category(ies) of Old age, not falling within any other category registration, with number (60) of places St George`s Ltd DS0000060055.V279882.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 60 nursing beds, with up to 18 OP/E PC within the total number. Accommodate six (6) named service users under the age of 65 years, within the total number of 60. 30/06/05 Date of last inspection Brief Description of the Service: St Georges is a two storey converted building located in the Liscard area of Wallasey and close to local amenities. The home is registered to provide nursing care for 60 older persons and 18 of the beds may accommodate clients who require personal care only. The large reception area is welcoming and the reception desk is staffed during office hours. A large lounge, a dining room and a visitors room are provided on the ground floor and a second lounge/dining room on the first floor. There are also various quiet sitting areas in various parts of the building. Televisions, videos, music centres and an in house library are provided. Both single and shared accommodation is available and most of the rooms have recently been redecorated and refurbished. A selection of bathrooms and toilets are provided and assisted bathing facilities are available however, en suite facilities are not available. A large lift serves both floors. There is parking for some cars at the front of the building and a car park at the rear. St George`s Ltd DS0000060055.V279882.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home did not know about the visit, which took seven hours. The inspector spent time with residents, the registered manager and several members of staff. The inspector also spoke some guests who were visiting on the day. The inspector read six care files and examined documentation kept at the home. What the service does well: 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`s Ltd DS0000060055.V279882.R01.S.doc Version 5.1 Page 6 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 Ltd DS0000060055.V279882.R01.S.doc Version 5.1 Page 7 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): 1,2,3,5,6 The homes Statement of Purpose is good and the Service User Guide is excellent providing residents and prospective residents with details of the home and the services provided enabling an informed decision about admission to the home. To ensure that all residents are informed these documents should be available in other languages. EVIDENCE: The home’s Statement of Purpose and Service User Guide are well written documents that provide detailed information about the home. The home has residents whose first language is not English and the documents should be produced in a written format that residents can understand. Residents in the home are provided with a statement of terms and conditions, plus a contact when they move in to the home on a permanent basis. The homes senior nurses undertake a nursing pre admission assessment on residents before they are admitted to the home, to ensure care needs are identified. Multidisciplinary healthcare team members such as the resident’s St George`s Ltd DS0000060055.V279882.R01.S.doc Version 5.1 Page 8 social worker, physiotherapist plus members of their family are part of this process. Residents are able to visit the home or have an overnight stay before they move in on a permanent basis. Relatives are encouraged to visit the home. The home does not provide intermediate care. St George`s Ltd DS0000060055.V279882.R01.S.doc Version 5.1 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): 7,8,9,10 There is very clear, consistent care planning system in place to provide staff with the information they need to meet service users needs. The health needs of service users are very well met with evidence of very good multidisciplinary working taking place on a regular basis. The medication at this home is very well managed promoting good health. EVIDENCE: The residents in the home have an individual care plan, which is formulated on admission to the home and reviewed by the senior nurses on a monthly basis. Daily health records are documented daily for each resident, this includes any critical incidences plus any visits from GPs, specialist nurses etc. The daily record sheets on some of the files examined were not completed everyday. On the day of the inspection, no pressures sores on residents were reported to the inspector, most of the care staff has undertaken training on tissue viability. The Primary Care Trust (PCT) tissue viability nurse will visit the home at any time if needs arise. St George`s Ltd DS0000060055.V279882.R01.S.doc Version 5.1 Page 10 No resident in the home currently self medicates, all medications for residents are administered by the nurses in the home. The protocols for the receipt, storage, disposal, and documentation of medications in the home are in accordance with the National Minimum Standards (NMS). All residents in the home can access their NHS entitlements. The residents spoken to were happy that they were treated with respect and their privacy was respected. On each residents bedroom door there is a notice asking all people to knock before entering. St George`s Ltd DS0000060055.V279882.R01.S.doc Version 5.1 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): 12,13,14,15. Service users have limited opportunity to participate in leisure and social activities. Visitors are welcomed at the home and people do call in at the home. Dietary needs of residents are well catered for with a balanced and varied selection of food available. EVIDENCE: The home does not have an activities co-ordinator and is seeking to employ one soon. There are planned trips out throughout the year and various daily activities. On the day of the inspection, no activities were taking place. The staff spent their time addressing personal care needs and did not spend time talking with the residents. The residents whose first language is not English do not have their cultural needs met. The home has tried to involve some local communities in the home. Visitors are allowed in the home at any reasonable time for day, residents may entertain their visitors, in the communal lounges, or in their own bedroom. The gardens appear to be safe and well-kept, and have a patio area, flowers borders. St George`s Ltd DS0000060055.V279882.R01.S.doc Version 5.1 Page 12 By direct and indirect unobtrusive observations of staff on the day of the inspection, residents were observed to be treated with respect and courtesy at all times. The inspector spent time talking with residents who felt well respected. One resident felt that they were treated well by the staff but the “girls are too busy to talk with us.” In the residents bedroom is an individual preference record, that details resident’s preference in terms of personal grooming, dental care etc. The kitchen and store areas were examined and found to be well kept, with required records up to date. The food was well presented, nutritious and took into account any specialist dietary needs of the individual residents. The home is to change their menus next week and have a four weekly menu planner. The inspector ate lunch with the residents, which was served in a relaxed manner. St George`s Ltd DS0000060055.V279882.R01.S.doc Version 5.1 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): 16,18. Staff are provided with good information regarding Adult Protection issues, which protects service users from abuse. EVIDENCE: There is a robust complaints procedure in the home, which is contained in the statement of purpose, and in the service guide. This procedure includes information on ‘whistle-blowing’, in accordance with the Department of Health ‘No Secrets’ guidelines. Complaints are logged and action taken by the homes management is recorded, as evidenced on the day of the inspection. The Whistle blowing policy is in place in the home, this information is communicated to all newly appointed employees in the home on their induction course. The CSCI has received no complaints about this service since the previous inspection last June. Most of the staff have now completed training in adult protection. Staff do receive basic training in the protection of vulnerable adults during induction. The residents all spoke highly of the staff team and said they “have no complaints about how I’m treated, the girls are lovely.” St George`s Ltd DS0000060055.V279882.R01.S.doc Version 5.1 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): 19,20,23,26 The domestic arrangements have improved the appearance of the home creating more comfortable environment for those living there and visiting. The overall quality of some of the furnishings and fittings is good. EVIDENCE: The two large lounges are spacious and well decorated, as is the dining room and the dining area adjoining the main lounge. Some residents choose to have meals in their own rooms, especially at breakfast time. The garden area is well maintained and accessible by wheelchair; the home benefits from trees providing privacy. The overall fabric of the building is of a good standard, with most resident’s rooms being highly personalized. The home is currently experiencing problems with young people congregating near the boiler at the back of the home. The local police have been informed. St George`s Ltd DS0000060055.V279882.R01.S.doc Version 5.1 Page 15 The home was generally clean and odour free on the day of the inspection. The manager has devised a cleaning roster for various items to be cleaned and this has proved to be successful. There has been an improvement in keeping the home clean since the last inspection. St George`s Ltd DS0000060055.V279882.R01.S.doc Version 5.1 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): 27,28,29,30. The permanent staff members offer consistency of care within the home. A staff team that has benefited from training supports residents, specialist training would enhance this. EVIDENCE: There is always at least one first level nurse on duty at all times who is assisted by care staff and ancillary staff. The manager is committed to ensuring all the care staff have NVQ level 2 and by February this year this will be achieved. There is a programme to register the next candidates onto the NVQ training. The home recruitment policy is robust and in accordance with the NMS, all staff in the home has an up to date CRB/POVA enhanced certificate, so ensuring the safety of the residents. All staff receive induction and three paid training days a year. The care staff would benefit from some specialist training; for example: - dementia, epilepsy, challenging behaviour. St George`s Ltd DS0000060055.V279882.R01.S.doc Version 5.1 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36,38 The home does review aspects of its performance through a programme of self-review and consultation, which include seeking the views of service users, staff and relative. EVIDENCE: The manager is experienced and well qualified for the post. He has set up a programme for individual staff supervision and is personally appraising all staff before putting that programme in to action. The manager is about to complete his NVQ 4. The owner visits monthly and these visits are recorded and forwarded to the CSCI office. The home also, has a residents and visitors questionnaire form and they hold relatives and residents meeting. St George`s Ltd DS0000060055.V279882.R01.S.doc Version 5.1 Page 18 The inspector read a letter from the bank that demonstrated that residents have their own bank accounts. All the staff at the home receive formal supervision on a regular basis and this is well documented. Not all the staff team have participated in fire drills last year. It is important that all day staff have two fire drills per year and night staff have three fire drills per year. When a member of staff receives an injury, whether that is from furniture or a resident, this must be recorded in the RIDDOR book. (Reporting of Injuries, Diseases and Dangerous Occurrences Regulations). St George`s Ltd DS0000060055.V279882.R01.S.doc Version 5.1 Page 19 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 2 3 3 X 3 N/A 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 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X 3 X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 2 St George`s Ltd DS0000060055.V279882.R01.S.doc Version 5.1 Page 20 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 OP1 Regulation 4,5 Requirement The registered person must ensure that the Statement of Purpose and Service User Guide are made available in other languages, so that all residents can read them. The registered person must ensure that daily activities take place and these are recorded in the resident’s files. The registered person must ensure that resident’s cultural needs are met. Timescale for action 24/04/06 2 OP12 12 27/02/06 3 OP12 12 27/02/06 4 OP38 23 The registered person must 26/03/06 ensure that all staff participate in the required number of fire drills each year. A record of all staff that attended must be kept. The registered person must ensure that all incidents involving residents and staff are recorded in the appropriate documents. 27/02/06 5 OP38 17 St George`s Ltd DS0000060055.V279882.R01.S.doc Version 5.1 Page 21 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 OP30 Good Practice Recommendations It is recommended that care staff receive specialist training. This training could include:- dementia, epilepsy, challenging behaviour, diversity. St George`s Ltd DS0000060055.V279882.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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. 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