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Inspection on 07/12/05 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 7th December 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

The home provides a high standard of care within a warm, friendly, caring and professional environment.

What has improved since the last inspection?

The home continues to maintain its` high professional standards and provides a lifestyle in which residents feel safe, thrive and follow pursuits of their choice within a risk assessed environment.

What the care home could do better:

Although the medication administration records are accurate and well maintained, the tablet count was erratic on occasions and a recommendation has been made regarding this.

CARE HOMES FOR OLDER PEOPLE St George`s Nursing Home 61 St George`s Square London SW1V 3QR Lead Inspector Wynne Price-Rees Unannounced Inspection 7th December 2005 10:30 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 Nursing Home DS0000026018.V257927.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 DS0000026018.V257927.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service St George`s Nursing Home Address 61 St George`s Square London SW1V 3QR 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) 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 George`s Nursing Home DS0000026018.V257927.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th June 2005 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 is a current full occupancy. 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 George`s Nursing Home DS0000026018.V257927.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over four hours with the focus being on collating the views of residents and relations regarding the standard of service received. A total of twelve residents and relations were spoken with during the inspection and five care plans case tracked. The care plans were taken from each floor. A tour of the building was also conducted. The requirements from the previous visit were checked and found to be met. No new requirements were made at this visit although there is one recommendation. What the service does well: What has improved since the last inspection? What they could do better: St George`s Nursing Home DS0000026018.V257927.R01.S.doc Version 5.0 Page 6 Although the medication administration records are accurate and well maintained, the tablet count was erratic on occasions and a recommendation has been made regarding this. 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 Nursing Home DS0000026018.V257927.R01.S.doc Version 5.0 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 Nursing Home DS0000026018.V257927.R01.S.doc Version 5.0 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): 3&6 Residents do not move in without first being fully assessed including those receiving intermediate care. EVIDENCE: A sample of the assessment information was inspected and found to be comprehensive and covered all areas required to make a judgement whether the needs of the individual can be met. The process incorporates as many visits to the home, by prospective residents and their relations, as needed to help determine if they wish to move in. A visit was arranged for the inspection day that was unfortunately cancelled by the prospective resident’s relative. One resident that has recently moved in was formally a GP servicing the home. Residents receiving intermediate care receive the same support as those living at the home permanently. They are also supported to maintain and increase their independence in readiness for when they return home. St George`s Nursing Home DS0000026018.V257927.R01.S.doc Version 5.0 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, 9 & 10 The residents have individual care plans, medication is appropriately administered and recorded and they are treated with dignity and respect. EVIDENCE: A sample of five care plans were case tracked and the information contained was comprehensive covering all required aspects of care with goals identified that were underpinned by risk assessments and regularly reviewed at monthly intervals. The medication administration records were checked for each resident and found to be complete and up to date. The staff that administer medication are trained to do so and there is a written procedure to follow. The only area for improvement was regarding tablet counts that were intermittent and a recommendation has been made regarding this. The residents and relatives spoken with felt they are treated with respect and their dignity and privacy observed. St George`s Nursing Home DS0000026018.V257927.R01.S.doc Version 5.0 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 the following standard(s): 12 Residents’ pursue a lifestyle in accordance with their interests and cultural and religious needs. EVIDENCE: A number of activities are taking place over the Christmas period including residents going to a restaurant of their choice, a carol service with mince pies and champagne and a series of Christmas lunches that are cooked and served by the management team. Mass is celebrated everyday and other arrangements are made for residents to accommodate their religious needs. A number of residents make use of local amenities, in particular theatres, art galleries and exhibitions such as that at Buckingham Palace and the Canalletto Venice collection. Regular in-house bingo, crossword and domino sessions take place that residents said they enjoy and there is also a visiting musician. The residents said they partake in the entertainment and visits as little or as much as they wish. St George`s Nursing Home DS0000026018.V257927.R01.S.doc Version 5.0 Page 11 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 Residents and relatives are confident that complaints are listened to and acted upon. EVIDENCE: The residents and relatives spoken with felt that they did not have any complaints to make about the home and any suggestions or comments they made were listened to and taken seriously. One relative felt that communication with the home’s management could be improved although they felt the standard of the home was generally good. There is a thorough written complaints procedure that residents have access to and staff know how to follow and implement. Any complaint made is addressed within twenty-eight days and generally as soon as staff are made aware of it. St George`s Nursing Home DS0000026018.V257927.R01.S.doc Version 5.0 Page 12 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 & 26 Residents live in a safe well-maintained environment that is clean, pleasant and hygienic. EVIDENCE: A tour of the building showed that it is suitable for the stated purpose, well maintained, safe, clean and hygienic. Each resident has their own room or suite of rooms and there are adequate communal areas that are served by toilets readily accessible to residents. St George`s Nursing Home DS0000026018.V257927.R01.S.doc Version 5.0 Page 13 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, 29 & 30 Residents are supported and protected by the recruitment procedure, their needs are met by the staff numbers and mix and they are trained and competent to do their jobs. EVIDENCE: 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. 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 regarding information recorded. 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 George`s Nursing Home DS0000026018.V257927.R01.S.doc Version 5.0 Page 14 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 The residents’ benefit from living in a home that is well run and managed. EVIDENCE: The Care Manager is a qualified SRN, RGN, has a Diploma in Gerontology and forty years Care Management experience. They have also obtained an NVQ level 4-verifier certificate. There is a highly experienced and competent management team in place. The calibre of the home’s management is reflected in the high level of support and caring, professional manner in which staff observed went about their duties during the inspection. St George`s Nursing Home DS0000026018.V257927.R01.S.doc Version 5.0 Page 15 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 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X X X X X X 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 3 X X X X X X X St George`s Nursing Home DS0000026018.V257927.R01.S.doc Version 5.0 Page 16 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. 1 Refer to Standard OP9 Good Practice Recommendations The tablet counts must be continuous. St George`s Nursing Home DS0000026018.V257927.R01.S.doc Version 5.0 Page 17 Commission for Social Care Inspection Hammersmith Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE 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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