Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 20/03/06 for St Georges Care Home

Also see our care home review for St Georges Care Home for more information

This inspection was carried out on 20th March 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.

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 standard of personal care provided to residents at St. George is good. This ensures that residents` are treated with respect and that their right to privacy is up held. Staff were observed as being respectful, warm in manner and sensitive towards the residents` within a relaxed environment. St. George continues to provide residents with the opportunity to experience a stimulating and varied life where various informal and formal activities are made available throughout the day. Visitors are made very welcome and meals are well managed and provide daily variation, good nutrition and social contact for people. The home has a satisfactory complaints system with evidence that service users feel that their views are listened to and acted upon.A comfortable, clean, safe standard of accommodation is provided internally for residents of St. George. The residents and staff team continue to benefit from a manager who encourages an open style management approach. The system for accessing records that must be available for an inspection is good and the records were found to be up to date and accurate. This protects residents` rights and best interests.

What has improved since the last inspection?

In general care plans have improved since the last inspection ensuring all staff providing care are clear both about the care needed and how that care is to be given. Staff have an awareness of what abuse is and their role in reporting suspected or actual abuse and protecting the resident, this awareness has been consolidated by in-house and external training.

What the care home could do better:

There needs to be careful review of information provided by agencies in the assessment stage. This would safeguard the potential service users that their choice to live at St. George is suitable for their care needs. Some medication records were not clear enough to demonstrate that medication had been administered as prescribed. Improvements are needed to ensure that residents are not put at risk.

CARE HOMES FOR OLDER PEOPLE St Georges Care Home Kenn Road St George Bristol BS5 7PD Lead Inspector Jill Cornelius Announced Inspection 20th March 2006 09:30 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 Georges Care Home DS0000020254.V284656.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 Georges Care Home DS0000020254.V284656.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service St Georges Care Home Address Kenn Road St George Bristol BS5 7PD 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) 0117 9541234 0117 9542233 St Georges Care Home Ltd Ms Alexandra Crew Care Home 66 Category(ies) of Old age, not falling within any other category registration, with number (66) of places St Georges Care Home DS0000020254.V284656.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. May accommodate up to 66 persons aged 50 years and over requiring nursing care. May accommodate up to 3 persons aged 65 years and over requiring personal care. Staffing Notice dated 22/06/2001 applies Manager must be a RN on parts 1 or 12 of the NMC register. May accommodate one named person aged 34 years and over with severe multiple sclerosis. Home will revert when named person leaves. May accommodate one named service user aged 47 years requiring nursing care. Condition of registration will lapse when service user leaves the home 11th July 2005 Date of last inspection Brief Description of the Service: St. George is registered as a Care Home for a maximum of 66 service users requiring nursing care. The home is situated in a residential area of St. George, with easy access to local community facilities and is less than 3 miles to the city centre. It can be accessed by car or bus, with a short walk. The home is purpose built, providing a mix of double and single en-suite rooms. Care is provided over two floors, the first being for the more dependent service users. Each floor offers bedrooms, communal lounge and dining room as well as bathroom facilities. There are also pleasant gardens to the rear and side of the property. There is a passenger lift providing access to all service users areas. All parts of the home are accessible to the able-bodied as well as wheelchair users. St Georges Care Home DS0000020254.V284656.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection conduced as part of the annual inspection process. The inspection lasted for two days. A Pharmacist inspection was undertaken during the same period. During the inspection the inspector spent time in discussions with the manager, senior care staff and examined a number of records, including nine residents care plans, and records relating to the day to day running and management of the home. Care plans have improved since the last inspection ensuring all staff providing care are clear both about the care needed and how that care is to be given. The inspector spent time observing the residents in the home throughout the course of the visit and spoke at length with five at length and three visitors. Members of staff were observed on duty and four were consulted individually. As at previous inspections the feedback from residents suggests the home remains a friendly, happy and comfortable place to live. Seventeen ”Comment cards” were received from relatives two of these highlighted; “I would have no hesitation in recommending the home to anyone considering such a place”. “Domestic cleaners excellent – always a cheerful word for the resident”. What the service does well: The standard of personal care provided to residents at St. George is good. This ensures that residents’ are treated with respect and that their right to privacy is up held. Staff were observed as being respectful, warm in manner and sensitive towards the residents’ within a relaxed environment. St. George continues to provide residents with the opportunity to experience a stimulating and varied life where various informal and formal activities are made available throughout the day. Visitors are made very welcome and meals are well managed and provide daily variation, good nutrition and social contact for people. The home has a satisfactory complaints system with evidence that service users feel that their views are listened to and acted upon. St Georges Care Home DS0000020254.V284656.R01.S.doc Version 5.1 Page 6 A comfortable, clean, safe standard of accommodation is provided internally for residents of St. George. The residents and staff team continue to benefit from a manager who encourages an open style management approach. The system for accessing records that must be available for an inspection is good and the records were found to be up to date and accurate. This protects residents’ rights and best interests. 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 St Georges Care Home DS0000020254.V284656.R01.S.doc Version 5.1 Page 7 contacting your local CSCI office. St Georges Care Home DS0000020254.V284656.R01.S.doc Version 5.1 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 Georges Care Home DS0000020254.V284656.R01.S.doc Version 5.1 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): 1,3,4 Prospective residents are given clear details of the services the home provides enabling them to make an informed decision about admission. The admission procedure ensures that there is an assessment prior to people moving into the service. The home’s ability to meet the assessed care needs of the residents relies on the information given and obtained at point of assessment. EVIDENCE: The home’s Statement of Purpose and Resident Guide give residents and prospective residents details of the services the home provides in accordance with legal requirements and the expectations of the National Minimum Standards. Individual records are kept for each resident. The records for rapid response residents were viewed and evidenced a full assessment with care plans and risk assessments. These are now held for care staff to met individual needs in St Georges Care Home DS0000020254.V284656.R01.S.doc Version 5.1 Page 10 residents’ rooms. Evidence of the Rapid response team visiting their clients was observed. Evidence of shortfalls in information supplied from Social Services and hospitals; has lead to a number of difficult placements at St. Georges’. There is evidence however that the manager and her teamwork hard to support these service users’ with a multidisciplinary support group. Prospective service users are invited to visit the home, have a meal and meet the other residents and staff. Unplanned admissions are avoided where possible. St Georges Care Home DS0000020254.V284656.R01.S.doc Version 5.1 Page 11 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 Through the involvement of the home manager and deputy the new care planning format has been implemented. This provides a comprehensive framework for clear and prescriptive plans of care to be formulated. Staff have a good awareness of individuals needs and treat the residents in a warm and respectful manner, which means that they can expect to receive care and support in a sensitive way. This respect extends to the way staff will treat them and their family at the end of their life. Some medication records were not clear enough to demonstrate that medication had been administered as prescribed. Improvements are needed to ensure that residents are not put at risk. EVIDENCE: The home has updated its care planning documentation for assessing, planning and evaluating care. Nine were sampled. The new care plans were comprehensive and evidenced clear directions of detailed care to be provided. Discussion with senior RN’s when reviewing these or any changes, require the involvement of service users/ representatives with recordable evidence. Staff spoken with expressed positive views about the new format. St Georges Care Home DS0000020254.V284656.R01.S.doc Version 5.1 Page 12 Health care needs were evidenced in the care files and included, wound care, nutritional, and pressure area risk assessments. Some of the information had not been regularly reviewed and information was out of date. Risk assessments had been developed to identify potential risks including manual handling and the use of bed rails. However, when touring the home on the first day of inspection it was noted that one resident over the weekend had chosen to use a door guard. The resident was insistent that her family bought one into the home for her to use. After discussion with the staff who had supported this resident over the weekend, it was evident that the staff member had omitted to undertake a risk assessment and consenting documentation was not evidenced in their care plans. This was completed by the end of day one of the inspection providing a record of the chosen restraint with agreed limitations with the service user and their family. Records of the General Practitioner visits/contacts with resident’s and outcomes were available. The home had access to various pressure relieving equipment and this was documented in the plan of care. Specialist referrals and visits from other professionals were evidenced in care files including St.Peters Hospice, Nutritionist, Audiologists, Chiropodists, Opticians and Dentists. Medication is supplied weekly in Nomad boxes from a local pharmacy. Medication seen was stored securely in locked cupboards. Containers of waste medication awaiting collection were not locked in cupboards and action must be taken to address this. Medicine fridges are available on both floors. It is recommended that a minimum/maximum thermometer be obtained for the upstairs fridge to allow accurate monitoring of the temperature. Policies and risk assessments are available allowing residents to look after their own medicines if they wish to, particularly those people admitted via the rapid response team. Temazepam tablets for one resident had been supplied in a Nomad box with other medication. Under the Misuse of Drugs Act Temazepam tablets administered by staff must be stored in the Controlled Drugs cupboard. Medicines administration record sheets are printed by the pharmacy but these generally include only those medicines supplied in the Nomad boxes. All other medication is handwritten on the medicines administration record sheet by the nursing staff. The nurse writing the additions signs the chart, this should be checked by a second nurse. Many of the handwritten additions seen were not of a satisfactory standard. In one case it appeared that the incorrect strength of medication had been written on the medicines administration record sheet for many months, with no indication on the record sheet of the actual dose St Georges Care Home DS0000020254.V284656.R01.S.doc Version 5.1 Page 13 administered. A requirement has been made concerning this to ensure that records are accurate and that medicines have been administered as prescribed by the doctor. It is strongly recommended that action be taken to ensure that printed medicines administration record sheets supplied by the pharmacy include all the medicines supplied by them, reducing the need for handwritten additions. Several gaps in the administration record were seen with no indication of whether medication had been administered or the reason for its’ omission, a requirement concerning this has been made. One prescription for the possible use of a syringe driver was seen. It is recommended that specific medicines administration record sheets be obtained, designed for use a syringe driver, to ensure that there is room for all the relevant information to appear on the record sheet. A small number of residents are admitted via the rapid response team. In some cases nursing staff keep and administer their medication however it appears that staff often receive very little written information about current medication and have to rely on the medicines brought in with the person. It is recommended that action be taken to ensure that staff have written information about the prescribed medication for residents admitted in this way to allow them to check that medication brought in is complete and correct. Records of the medicines received into St Georges are kept on the medicines administration record sheet. A separate record is kept of medicines disposed of via the waste disposal company. It is recommended that records of disposal include two staff signatures. St Georges Care Home DS0000020254.V284656.R01.S.doc Version 5.1 Page 14 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. St. George continues to provide residents with opportunity to experience a stimulating and varied life where various informal activities are regularly made available. Visitors are made very welcome and meals are well managed and provide daily variation, good nutrition and social contact for people. EVIDENCE: St. George has a full time activity organisers and hostess, who organises the varied activity schedule. Time is spent with residents gathering information on their likes / dislikes, feedback and suggestions for activities / events. A programme is then formulated over a four-month period. There is planned event every day which includes visitors / entertainers to the home as well as organised trips from the home. There was information in the activities book to confirm residents were included and their thoughts of the event. Musical entertainers also visit the St. George on regular basis and the ”Pat” dog Scheme visitor visits the home. Those unable to participate were observed having one to one involvement with carers at different times in the day. Also there is two volunteers ‘listening team’ who come in once a week. Their CRB’s were viewed. St Georges Care Home DS0000020254.V284656.R01.S.doc Version 5.1 Page 15 Groups of residents are encouraged to join in with activities such as “Reminiscence School days”, “Easter Craft”, “Card Games”, “Sherry Morning”, “St. Georges Treasure Hunt”, and “Musical Movement”. Some residents were observed enjoying a reminiscence session, painting, listening to the reading of a daily newspaper, which led to a sumptuous discussion on a topical subject. It was noted on day two that five residents were going to “Bowplex, followed by a pub lunch”. Residents spoken with were very complimentary of the activities and said they participated in and enjoyed most events. St. Georges’ have a library of videos that are appropriate for residents accommodated in the home. The home holds a number of annual fetes; coffee mornings; and members of the local community are invited. This was confirmed in the relatives meeting minutes. It was noted that all relatives are invited to the organised functions where food, drink and entertainment are provided. There is a church service that takes place on a monthly basis. Reflexology and aromatherapy sessions are held once a week in addition to visits from the hairdresser. The staff and management team also confirmed this information. Rising and retiring choices are indicated by the residents’ daily and accommodated in balance with assessed needs. The residents spoken with also confirmed this, as did documented evidence in some care plans. Meal times are appropriately spaced throughout the day. There is also opportunity to use the refreshment service areas on each floor. A four-week menu plan is provided and this is on display in the home. There is also a menu board with the menu of the day displayed in the dinning room. During the inspection the inspector joined a number of gentlemen for lunch, everyone commented on the food said how “good it was”, “there is always seconds on offer”. Menus are balanced and interesting, and are flexible enough to accommodate individual preferences. Staff see each person individually the day before, and ask for their choices. Comments from residents included “I am very happy here. There are lots of people to talk to”, “I like it here”, “staff are very nice and caring”. A relative said, “My mum has lived here for two years. It is a happy atmosphere. Staff are very supportive and pleasant. Residents like a smiling face. There is enough going on for the residents. The entertainment is good. I have been present and joined in with several events. The food is good, always looks nice and is well presented. The Christmas Celebrations was very good”. St Georges Care Home DS0000020254.V284656.R01.S.doc Version 5.1 Page 16 Another relative said, “The activities are good here. There are meeting social needs very well. One member of staff is encouraging my relative to follow the cricket, which they had previously enjoyed and had recently lost interest in sport”. St Georges Care Home DS0000020254.V284656.R01.S.doc Version 5.1 Page 17 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): Arrangements remain in place for responding to concerns. These are satisfactory so that residents and their relatives and friends can feel that any complaints will be taken seriously. Residents’ legal rights are protected. Staff knowledge and understanding of Adult Protection issues provides a safe environment to protect residents from abuse. EVIDENCE: Residents’, visitors and staff comments received during this inspection showed that people continue to feel comfortable discussing any concerns with senior staff or management. A log of complaints and the outcomes is maintained. The Commission for Social Care Inspection has become involved with three recent complaints. The outcomes of which evidenced conclusion. All residents are on the electoral roll and a number voted in the last election. The role of advocacy in facilitating resident’s rights to exercise their rights and details of an advocacy service were supplied. The home has clear policies and procedures for Adult Protection and Whistle Blowing; staff receives training on Adult Protection and attend “Bristol City” training on the Protection of Vulnerable Adults. When questioned with scenarios staff where able to respond appropriately showing their knowledge of how to report and alert. St Georges Care Home DS0000020254.V284656.R01.S.doc Version 5.1 Page 18 St Georges Care Home DS0000020254.V284656.R01.S.doc Version 5.1 Page 19 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): 19,20,21,22,23,24,25,26. The standard of the environment within this home is good providing residents’ with an attractive and homely place to life. EVIDENCE: The home was purpose built to care for elderly people almost ten years ago. There is ongoing programme of decorating and refurbishment. There are appropriate arrangements in place for the service and maintenance of plant and equipment. Two maintenance men work full time at the home. At the time of inspection the home was nicely presented and well maintained. The gardens benefited from a recent building of a gazebo with a seating area. Residents spoke of their enjoyment with this and the advantage of observing, “people busy on their allotment” and “enjoying seeing the horses”. During my visit all the residents’ with whom I spoke were very complimentary about the home, its staff as well as the garden areas. St Georges Care Home DS0000020254.V284656.R01.S.doc Version 5.1 Page 20 The majority of residents choose to use their own en-suite toilet facility. However assisted bathing including an Arjo system / showers (x3) and communal toilet facilities are located within easy access to designated bedrooms, lounge and dining areas. Some of the bathrooms had been creatively decorated to promote visual stimulation as well as physical relaxation. The home is over two floors, with level access to all areas via a passenger lift. Service user areas are fitted with appropriate aids such as grab rails, fixed and mobile hoists. All rooms have a nurse call system with audible alarm facility. Generic environmental risk assessments had been carried out. The residents’ bedrooms looked very homely, as residents are able to bring in small items of furniture and personal possessions with them. All areas of the home smelled pleasant and were cleaned to a high standard. The home afforded a continuous pleasant odour throughout the two days of inspection and was well presented; the standard of cleanliness is of a high standard. Sluice areas demonstrated control of infection procedures and included a sluicing disinfector on each floor. Good maintenance records with all servicing and certificates being up to date were noted. St Georges Care Home DS0000020254.V284656.R01.S.doc Version 5.1 Page 21 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. Staff at the home provide are well trained, supported and are employed in sufficient numbers to meet the residents needs. Residents are supported and protected by the homes recruitment policy. EVIDENCE: The numbers of staff deployed currently meet the needs of residents. The hours needed for personal and nursing care needs are kept under review and altered according to need. It is noted that the rotas viewed for the month of March are above the previously set staffing notice. Residents’ asked confirmed that they were happy with the response time from using their call bells. The home has a formal policy and procedure on the Protection of Vulnerable Adults. All staffs have received training in the protection of vulnerable adults. The files of 5 employees examined randomly demonstrated good employment practice being followed. The details of the status of CRB checks on staff was viewed and there was evidence that all staff have been through the process of a police check through the Pova / Criminal Records Bureau. A record is kept of the outcome of all staffs CRB; this record is kept separately to other staffing records and where available for inspection in accordance with CRB Code of Practice. St Georges Care Home DS0000020254.V284656.R01.S.doc Version 5.1 Page 22 A random sample of the training records for a range of staff was observed. These evidenced a broad range of skills available amongst the staff team and an on-going commitment to staff training and development. All staff individual training records evidenced signatures of attendance and certificates in the training file. Members of staff confirmed opportunity to training and its uptake. St Georges Care Home DS0000020254.V284656.R01.S.doc Version 5.1 Page 23 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): 31,32,36,37,38 The residents and staff team continue to benefit from an experienced manager who continues to encourage an open style management approach. EVIDENCE: The manager Mrs. Crew has been in post since the opening of St. George and has had previous management experience. Mrs. Crew is accountable to the Board of Directors who provides management supervision. The service users and staff spoken with felt that they were supported and that Mrs Crew was accessible. Mrs Crew stated that she tries to speak to most of the residents’ and staff each day. Mrs Crew likes to have an open door policy for staff and residents’ to speak with her at any convenient time. St Georges Care Home DS0000020254.V284656.R01.S.doc Version 5.1 Page 24 Regular relatives meetings continue to take place. Minutes were available for residents’ relatives and staff to see. Regular supervision with associated records is established for all staff. This was supported verbal by staff spoken with on the inspection period. A sample of records that is required to be available for inspections were found to be secure and well maintained. The fire logbook was found to be up to date and included all required information. There are appropriate arrangements in place for the service and maintenance of plant and equipment. Maintenance staffs are employed providing full time cover for the home and gardens. St Georges Care Home DS0000020254.V284656.R01.S.doc Version 5.1 Page 25 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 3 3 x X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 x x x 3 3 3 St Georges Care Home DS0000020254.V284656.R01.S.doc Version 5.1 Page 26 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 OP38 Regulation Schedule 3.3(q) 14(2) 15(2b,c) 13(2) Requirement Ensure restraint and limitations of movement are assessed, agreed, documented and reviewed. Review service user care plans in a manner that demonstrates the involvement of service users. Temazepam tablets must be stored in the Controlled Drugs cupboard. Medicines awaiting disposal must be kept in a locked cupboard. To ensure that all medication records are accurate and that medicines are administered as prescribed, handwritten additions to the medicines administration record sheet must be to the same standard as those printed on the sheet by the pharmacy. They must include the name and strength of the medicine, full dosage instructions and any additional warnings for safe administration. All medication administered by staff must be recorded on the medicines administration record sheet. If regular medication is DS0000020254.V284656.R01.S.doc Timescale for action 20/03/06 2. 3. OP7 OP9 20/03/06 20/03/06 4. OP9 17(1)(a) Schedule 3 (k) 20/03/06 5. OP9 17(1)(a) Schedule 3 (k) 20/03/06 St Georges Care Home Version 5.1 Page 27 omitted a reason must be noted on the record sheet. 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. 2. 3. Refer to Standard OP7 OP7 OP9 Good Practice Recommendations Document rising and retiring choices as indicated by the residents in all care plans. Maintain plans of care which enable a consistent manner in meeting individuals’ needs to be promoted. 1. Obtain a minimum/maximum thermometer be obtained for the upstairs fridge to allow accurate monitoring of the temperature. 2. Record sheets specifically designed for use with syringe drivers should be used for medicines prescribed in this way to ensure that accurate records can be kept. 3. Ensure that staff have written information about the prescribed medication for residents admitted via the rapid response team to allow them to check that medication brought in is complete and correct. 4. Records of the disposal of medication should be signed by a second member of staff. St Georges Care Home DS0000020254.V284656.R01.S.doc Version 5.1 Page 28 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 Care Home DS0000020254.V284656.R01.S.doc Version 5.1 Page 29 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!