Inspection on 10/06/05 for St George`s Nursing Home

This inspection was carried out on 10th June 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

St George`s Nursing Home 15/08/07

St George`s Nursing Home 21/07/06

St George`s Nursing Home 07/12/05

St George`s Nursing Home 18/10/04

St George`s Nursing Home 03/06/04

Similar services:

Ashlong House

Spring Lane Care Home

Avenues (The) (Neave Crescent)

Barrington Lodge Nursing Home

Beacon House Nursing Home

St Mary`s Convent & Nursing Home

1-3 Frederick Gardens

The Royal Star and Garter Home

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

CARE HOMES FOR OLDER PEOPLE ST GEORGES NURSING HOME 61 St Georges Square LONDON SW1V 3QR Lead Inspector Wynne Price-Rees Unannounced 10 June 2005 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 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 GEORGES NURSING HOME G60 - G09 S26018 ST GEORGES NH UIV232516 100607 STAGE 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service St Georges Nursing Home Address 61 St Georges Square, London SW1V 3QR Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 7821 9001 020 7821 0707 Mrs Elizabeth Kerins-McManus Mrs Elizabeth Kerins-McManus Care Home 39 Category(ies) of Physical Disability (39) registration, with number of places ST GEORGES NURSING HOME G60 - G09 S26018 ST GEORGES NH UIV232516 100607 STAGE 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 18 october 2004 Brief Description of the Service: This is a care home that provides nursing care for up to thirty-nine residents and is located in the Pimlico area. There are currently thirty-three residents. The home is situated in a square and is a series of inter-connected Georgian mansion blocks that has access to all areas by lift and stairs. It is within easy access of transport links, local shops and other facilities. St Georges has been established for over forty years and many of the senior staff and management team have been in post for a number of years. The Care Manager is also the Proprietor and this is a stand-alone home rather than part of an organisation. Therefore the care provided is very friendly and personalised to the style of the Care Manager. ST GEORGES NURSING HOME G60 - G09 S26018 ST GEORGES NH UIV232516 100607 STAGE 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place during five hours of one day. The inspection was focused on getting the opinions of residents regarding the service they receive, the requirements of the previous visit, care planning, meals and activities provided. During the inspection ten residents’ were interviewed and case tracked. Six entry assessments were also inspected. The time residents had lived at the home varied between two months and many years. A number of staff and one relative were also spoken with. 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 GEORGES NURSING HOME G60 - G09 S26018 ST GEORGES NH UIV232516 100607 STAGE 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection ST GEORGES NURSING HOME G60 - G09 S26018 ST GEORGES NH UIV232516 100607 STAGE 4.doc Version 1.30 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 standard(s) 3 & 6 Standard three was not met. Standard six was met. Care needs are fully assessed to identify if they can be met although the format must be reviewed giving enough space for the information to be recorded clearly. Intermediate care is well catered for with residents supported to prepare to return home when ready. EVIDENCE: Each prospective resident is fully assessed before entering the home and given the opportunity to visit prior to deciding if they wished to move in. A sample of six pre-entry assessments were checked and found to contain all the information required in standard 3.3. although the format used did not contain enough space to record all the information in a clear manner. One assessment looked at had information on the back of the page were it had over run and this was not indicated on the first page meaning the information can be missed. As the initial assessment is the basis of the care plan it is important that all the information contained is clear and easily accessible. Intermediate care is provided although this is not within a dedicated area of the home as these residents receive the same care and support and have the ST GEORGES NURSING HOME G60 - G09 S26018 ST GEORGES NH UIV232516 100607 STAGE 4.doc Version 1.30 Page 8 same access to facilities. They are assessed using the same procedure as that of long-term residents. ST GEORGES NURSING HOME G60 - G09 S26018 ST GEORGES NH UIV232516 100607 STAGE 4.doc Version 1.30 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 standard(s) 7, 8, 9 & 10 Standards seven and nine were not met. Standards eight and ten were met. The care plans and risk assessments were up to date and regularly reviewed although format did not provide adequate recording space. Residents’ rights to privacy, dignity and respect were observed. There were gaps in the recording of medication administered. EVIDENCE: A sample of ten care plans were inspected, found to contain all the required information and were regularly reviewed, although the format used did not provide enough space to clearly and fully record it in an accessible way. The residents interviewed felt their care needs were fully met and this was supported by the documentation provided in the care plans. There were also risk assessments in place that underpinned and enabled the care plans. These included risks to staff. All the residents asked felt they were treated with respect and their right to privacy was adhered to. This was evidenced by observation of the way staff carried out their duties, particularly regarding personal care. The medication administration records were checked for all residents and there were found to be gaps in the recording. ST GEORGES NURSING HOME G60 - G09 S26018 ST GEORGES NH UIV232516 100607 STAGE 4.doc Version 1.30 Page 10 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 standard(s) 12, 13, 14 & 15 Standard thirteen was not met. Standards twelve, fourteen and fifteen were met. The residents interviewed felt the lifestyle they have in the home matched their needs and wishes and they were in control of their lives and made their own decisions. Family and friends are welcome to visit at reasonable times. Everyone felt the food provided was excellent with enough variety and choice. EVIDENCE: The residents spoken with were happy with the way they live their lives, at the home and that they made decisions regarding all aspects of their lives and were supported by staff in a friendly and helpful manner to do whatever they had decided upon. This was evidenced by observation of the support provided by staff and way it was provided. One of the major strands coming out of conversations with the residents was they felt listened to and staff and the management made time to chat with them on a one to one basis. They were confident that if they voiced a need or suggestion that it would be swiftly acted upon. It was the small attention to detail that made the difference. One resident said the Care Manager had bought them a budgie when theirs had past away. Another said sometimes the days were not long enough and they felt it was like being at home. Contact with relatives and friends is actively encouraged and this was evidenced by the number of visitors coming and going during the inspection. A ST GEORGES NURSING HOME G60 - G09 S26018 ST GEORGES NH UIV232516 100607 STAGE 4.doc Version 1.30 Page 11 requirement was made at the last inspection for the practice of requesting visitors to phone first if arriving after nine pm and telling staff when leaving to be included in the written information. This has not been done. All the residents were pleased with the quality of meals provided and the variety. ST GEORGES NURSING HOME G60 - G09 S26018 ST GEORGES NH UIV232516 100607 STAGE 4.doc Version 1.30 Page 12 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 standard(s) 16 & 18 Standards sixteen and eighteen were met. The home has a thorough complaints procedure that residents were aware how to access. Those spoken to felt very safe in the environment in which they lived. EVIDENCE: The residents spoken with said they had no complaints although they always felt listened to. One resident gave an example of not getting on very well with a staff member. They mentioned this to the Care Manager, whom discussed with the staff member and they agreed to be re-rostered. They were also aware of the complaints procedure and complaints are fully documented and responded to within a minimum of twenty-eight days. Staff are fully aware of what constitutes abuse and how to respond to it. The residents felt very safe in the environment in which they live. There is a comprehensive adult protection policy and procedure in place that has been made available to staff. The home has a comprehensive adult protection procedure. ST GEORGES NURSING HOME G60 - G09 S26018 ST GEORGES NH UIV232516 100607 STAGE 4.doc Version 1.30 Page 13 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 standard(s) 19, 25 & 26 All three standards were met. The home is well maintained and the residents felt safe living there. They felt it is a friendly and comfortable place to live. It was clean, pleasant and hygienic. EVIDENCE: On a tour of the premises it was found they were a safe, comfortable and homely environment to live in that met its stated purpose and residents said they enjoyed living there. A resident said it did not have the sanitised environment that they had experienced elsewhere and really felt like their home, as far as that is possible. The home was in a good state of repair, pleasant and odour free. ST GEORGES NURSING HOME G60 - G09 S26018 ST GEORGES NH UIV232516 100607 STAGE 4.doc Version 1.30 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 & 30 All three standards were met. There were suitable numbers of qualified and well-trained staff on duty, which had met the recruitment criteria, to meet residents’ needs. EVIDENCE: There were sufficient numbers of qualified and trained staff on duty to meet residents’ needs and this was reflected in the care practices observed and generally regarding information recorded. The residents spoken with said there were enough staff on duty to meet their needs and they responded quickly when needed. They expressed the opinion that the staff team were excellent and nothing was too much trouble for them. A thorough written recruitment procedure is in place that adheres to current equal opportunities legislation and encompasses all the steps outlined in the standards. All staff have contracts, job descriptions and have been CRB checked. ST GEORGES NURSING HOME G60 - G09 S26018 ST GEORGES NH UIV232516 100607 STAGE 4.doc Version 1.30 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35 & 38 All three standards were met. The residents felt the home is run with their best interestst foremost, financial interests are safeguarded and there are full health and safety risk assessments and checks carried out. EVIDENCE: There is an annual business plan that contains measurable objectives with performance indicators that are regularly reviewed. There are also regular questionnaires sent to residents, relatives and staff that are used to identify areas in which performance and service and support can be improved. Staff also receive annual appraisals as well as structured supervision sessions. The residents have their rights protected by their contracts, legal representatives and placing officers. The Care Manager is not an appointee for any of the residents. Any money or valuables deposited with the home, for safe keeping are kept in a safe and a record and inventory is kept. The Maintenance Officer carries out regular health and safety checks that are recorded and include weekly fire alarm system checks and this is also checked ST GEORGES NURSING HOME G60 - G09 S26018 ST GEORGES NH UIV232516 100607 STAGE 4.doc Version 1.30 Page 16 monthly by the company with the service contract. General and individual risks and health and safety assessments, that include the premises, are carried out by staff, OTs and students as appropriate to their respective areas of responsibility. The students’ carry out assessments as part of their training and these are overseen by staff. Quarterly equipment assessments and others relating to maintenance including COSHH were recorded. The equipment provided met the residents’ needs. ST GEORGES NURSING HOME G60 - G09 S26018 ST GEORGES NH UIV232516 100607 STAGE 4.doc Version 1.30 Page 17 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 2 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x 3 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x 3 x x 3 ST GEORGES NURSING HOME G60 - G09 S26018 ST GEORGES NH UIV232516 100607 STAGE 4.doc Version 1.30 Page 18 yes 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 3&7 Regulation 14 (1), (2) & 15 (1), (2) 13 (2) 16 (2) (m) Requirement Timescale for action 10/08/05 2. 3. 9 13 The assessment and care plan formats must be reviewed to include enough space to contain all the information in a clear, accessible manner. The medication administration 10/06/05 records must not contain gaps. The home must include a 10/07/05 statement that visitors are requested to phone if they intend to visit after 9.00 pm and inform staff when they are leaving in the visiting time information. 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 Good Practice Recommendations ST GEORGES NURSING HOME G60 - G09 S26018 ST GEORGES NH UIV232516 100607 STAGE 4.doc Version 1.30 Page 19 Commission for Social Care Inspection Hammersmith Local Office 11th Floor, West Wing 26/28 Hammersmith Grove London SW1V 3QR 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 GEORGES NURSING HOME G60 - G09 S26018 ST GEORGES NH UIV232516 100607 STAGE 4.doc Version 1.30 Page 20 - 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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