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

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

This inspection was carried out on 6th October 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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

Care workers at this home say they are knowledgeable about the needs of the service users. Information gathered from the Relatives satisfaction survey showed that relatives rated the attention service users received from care staff as high. They also documented the cleanliness and maintenance of the home as very good. The grounds and gardens were also rated highly. There was unanimous agreement that the home treated their relative as individuals in the relatives` pre inspection questionnaires.

What has improved since the last inspection?

The home has purchased aromatic environmental organic non-toxic deodoriser to use on the carpets throughout the home The home is trying out a new air purifier, which is used during the nights. Three new profile beds have been bought for the use of service users, plus four new vacuum cleaners. A new commercial refrigerator, new pass through dishwasher, a heavy-duty twin fryer and new crockery has been purchased for the kitchen. A new storage shed has been bought. New carpets have been fitted to five bedrooms, and all bedrooms have had new curtains fitted. Some bedrooms have had new armchairs. The three bedpan washers in the home have been refurbished. There is a new reception desk for the front hall reception area. Service users relatives or social services now sign risk assessments and care plans. Care workers employed prior to 2002 now have a recent photograph included in their personal files.

CARE HOMES FOR OLDER PEOPLE St George`s Nursing Home 5 Byfleet Road Cobham Surrey KT11 1DS Lead Inspector Mavis Clahar Announced Inspection 6th October 2005 09:10 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 Nursing Home DS0000017641.V250028.R01.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 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 Nursing Home DS0000017641.V250028.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service St George`s Nursing Home Address 5 Byfleet Road Cobham Surrey KT11 1DS 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) 0113 381 6100 fessere@bupa.com BUPA Care Homes Limited Mr Emilio Fesser Care Home 44 Category(ies) of Dementia - over 65 years of age (44), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (44) St George`s Nursing Home DS0000017641.V250028.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. In this home the 44 Service Users may comprise up to 41 people within category DE(E) or up to 41 people within category MD(E) The age range of service users accommodated within this home is from 60 years in the categories DE(E) or MD(E) Up to 5 service users falling within the category MD may be admitted from the age of 40 years. The age range of service users in the category MD is 40 to 64 years. Day Care may be provided for up to 4 service users from the age of 40 years of age within categories DE(E), DE, MD or MD(E). 6th October 2005. Date of last inspection Brief Description of the Service: St Georges Nursing Home 9one of the BUPA homes), is situated in a rural setting on the outskirts of Cobham, close to the renowned Wisley Gardens. St Georges is a single storey, purpose built home designed specifically to provide a safe and secure environment for service users requiring dementia-nursing care. The carefully planned layout of the home provides a safe environment for service users to walk around freely. St Georges has a number of reception rooms, providing a central meeting place where service users can get together to chat, watch television or read. A feature of the home is the pleasant central secure courtyard garden, where service users can spend strolling or relaxing on the patios. All bedrooms are furnished to a high standard with en-suite facilities, and are equipped with a television and telephone point, allowing each service user to stay in touch with life outside the home. Modern safety features fitted in each bedroom include 24-hour nurse call system, smoke detectors and thermostatically controlled radiators. Meals are prepared daily by the Chef, using fresh produce and are served in the home’s dining room or in the service users bedroom if required. A varied menu provides a nutritious diet, with frequent snacks and light meals served throughout the day. The activity suite is well staffed and service users are encouraged to participate in the programme of activities, which include a varied, and entertaining social calendar. St George`s Nursing Home DS0000017641.V250028.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second inspection to be undertaken in the Commission for Social Care Inspection year April 2005 to March 2006. This inspection was announced and was carried out on the 6th October 2005, by two inspectors and lasted for four hours and twenty minutes. The inspection date was posted around the home, with a request that the inspector would be available to meet and speak with service users relatives. On the day of inspection no relatives were available to speak with the inspector, but the inspector had received a very good response to the relatives questionnaire sent out prior to the inspection. Comments made by the relatives were favourable, praising the staff for the hard work they were doing with their relatives. The first part of the inspection was spent with the newly appointed manager, discussing the format of the inspection, reviewing service users files and care staff files. Only one service user in this home has the ability to speak with the inspectors, therefore the information obtained for this report is sought from documented records found in the service users files, and from information gained from speaking to staff working at the home. The second part of the inspection was spent observing service user and care workers interactions, speaking to service users, and touring the home. This was followed by sharing of information with the manager about the findings of the inspection. The home has made some improvements to its décor, to facilities to enhance the lives of service users and staff since the last inspection. The new addition to the home is now completed and the two bedrooms that were out of use are now functional. The new manager Mrs Carol Purdy has been in post since 12th September 2005. What the service does well: Care workers at this home say they are knowledgeable about the needs of the service users. Information gathered from the Relatives satisfaction survey showed that relatives rated the attention service users received from care staff as high. They also documented the cleanliness and maintenance of the home as very good. The grounds and gardens were also rated highly. There was St George`s Nursing Home DS0000017641.V250028.R01.S.doc Version 5.0 Page 6 unanimous agreement that the home treated their relative as individuals in the relatives’ pre inspection questionnaires. What has improved since the last inspection? What they could do better: The manager informed the inspector that she plans to restart the monthly meetings with service users and their relatives, to improve communication within the home and service users and their relatives by the introduction of a monthly newsletter. Please contact the provider for advice of actions taken in response to this St George`s Nursing Home DS0000017641.V250028.R01.S.doc Version 5.0 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. St George`s Nursing Home DS0000017641.V250028.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection St George`s Nursing Home DS0000017641.V250028.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 Service users and their relatives are given good information about the home, to enable them to make an informed choice. EVIDENCE: The home has an up to date service user guide and statement of purpose, which outlines in plain English the rules and regulations of the home and the rights of the service users. St George`s Nursing Home DS0000017641.V250028.R01.S.doc Version 5.0 Page 10 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): 9 10 The homes policy and procedure on administering medication is followed. Service users are treated with dignity and respect. EVIDENCE: None of the current service users at this home are risked assessed as capable to self-administer their medication. All medication to service users are administered by a Registered nurse under the homes drug administration policy and procedure and the Nursing and Midwifery Council guidelines on administration of medicines. Service users views were not obtained on this standard due to their medical condition. However, in discussion with care workers and from evidence seen in the service users file and responses made by relatives on the pre inspection questionnaires, the inspector formed the opinion that service users are treated with respect, and dignity and their privacy in upheld and maintained. St George`s Nursing Home DS0000017641.V250028.R01.S.doc Version 5.0 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): 14 15 Service users are consulted on a regular basis about choices in their daily lives. Meals are nutritious and are served in a pleasant dining room. EVIDENCE: Making the right choices is sometimes very difficult for the service users at this home. However, the inspector has observed care workers taking time to discuss choices with the service users and encouraging them to make a decision even if the decision is not to comply. The inspector noted that the service user’s decision was accepted. An alternative was offered and the negotiation started all over again. It was good to see how attentive the care workers were to the needs of the service users. A four week menu was reviewed which included two weeks prior to the inspection the week of the inspection and the week following the inspection. It was noted that service users had a choice of hot meals, that appeared nutritious, and that they had three main meals during the day with hot and cold beverages and light snacks in between. On the day of inspection the inspectors sampled the mid-day meal. The presentation was very good, the meat tender and tasty, the vegetables were perfect even for service users without teeth. Service users spoken to about the meal said it was lovely. The St George`s Nursing Home DS0000017641.V250028.R01.S.doc Version 5.0 Page 12 chocolate dessert must have been lovely because one service user was observed helping himself from the plate of another service user. St George`s Nursing Home DS0000017641.V250028.R01.S.doc Version 5.0 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 The home has a satisfactory complaints system with some evidence that service users welfare are taken seriously and acted upon EVIDENCE: The Pre Inspection Questionnaire stated two complaints were received and have been dealt with within the home’s policy timescale. The new manager has been in post since the 12th September 2005 and she has informed the inspector no complaints have been received by the home since her starting date. St George`s Nursing Home DS0000017641.V250028.R01.S.doc Version 5.0 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): 26 Recent investment has improved the appearance of this home maintaining a safe and comfortable environment for those living and visiting the home. EVIDENCE: The home has bought a number of beds, armchairs, fitted new carpets, and curtains for the use and comfort of the service users. The reception area has had a new desk, which enable more information about the home to be more visible to the visitors to the home. During the tour of the home it was noted that discrete white boxes containing non-toxic deodorisers were placed high on the walls in the corridors to help minimise offensive odours. Consequently the home had a pleasant smell of cinnamon. St George`s Nursing Home DS0000017641.V250028.R01.S.doc Version 5.0 Page 15 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): 30 Staff morale is high resulting in an enthusiastic work force that works positively with service users to improve their whole quality of life. EVIDENCE: Discussions with care workers and review of a random sample of their files and the homes training record revealed that care workers are trained to do the work they are asked to perform. Regular updating of information and supervision are also provided and documented. St George`s Nursing Home DS0000017641.V250028.R01.S.doc Version 5.0 Page 16 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 The manager is well supported by the senior staff of the company and the home in providing clear leadership throughput the home. EVIDENCE: The new manager is only recently appointed to this home but has a long record of managing BUPA homes. From observations made by the inspectors and from feedback from care workers, the home continues to operate in the best interests of the service users. The home manages the pocket monies of those service users who requests this. Their relatives, Power of Attorneys, or social services manage Service users main finances. BUPA does not act as appointee for any service user. St George`s Nursing Home DS0000017641.V250028.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X X X X X X X X 3 STAFFING Standard No Score 27 X 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X X St George`s Nursing Home DS0000017641.V250028.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations St George`s Nursing Home DS0000017641.V250028.R01.S.doc Version 5.0 Page 19 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. 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