Inspection on 06/03/07 for St Georges Care Home

This inspection was carried out on 6th March 2007.

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 Georges Care Home 10/08/10

St Georges Care Home 07/04/10

St Georges Care Home 14/10/09

St Georges Care Home 14/05/09

St Georges Care Home 08/04/08

St Georges Care Home 07/11/07

St Georges Care Home 27/09/06

St Georges Care Home 20/03/06

St Georges Care Home 11/07/05

St Georges Care Home 23/02/05

St Georges Care Home 20/10/04

St Georges Care Home 08/12/03

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE St Georges Care Home Kenn Road St George Bristol BS5 7PD Lead Inspector Jill Cornelius Key Unannounced Inspection 10:00 6th & 7th March 2007 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.V331797.R01.S.doc Version 5.2 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.V331797.R01.S.doc Version 5.2 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.V331797.R01.S.doc Version 5.2 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 27th September 2006 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.V331797.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Key inspection was conducted unannounced over 2 days and focused on the assessment of key standards and on following up the previous inspection requirements. The main purpose of the visit was to check on the welfare of the residents, ensuring the premises are well maintained and to examine health and safety procedures. During the site visit, the records were examined, a tour of the premises conducted and feedback sought from residents; staff and visiting health professionals. In addition to key records, surveys were sent to residents in advance of the inspection. Comment cards for relatives and people who visit the care home were also received. A number of residents and visitors were also spoken with about the quality of care provided at the home. The Commission for Social Care Inspection’s Pharmacist Inspector also examined the arrangements for administering and managing of medication. What the service does well: Residents spoke of St. George Care Home as a “caring place” “relaxed and friendly”. The home’s staff team have received a number of thank you letters from relatives praising the care provided and the dedication of the staff team. One of these highlighted ‘Our loved one is very happy here and his health and well being has improved considerably’. Prospective residents continue to receive clear details of the services the home provides, enabling them to make an informed decision about admission. It is clear that opportunities exist for residents to participate in a wide range of meaningful activities. Residents were positive about the recreational activities on offer. Visitors are made very welcome and meals are well managed and provide daily variation, nutrition and social contact for people. St. George remains a well equipped home with a safe standard of accommodation provided for the residents. St Georges Care Home DS0000020254.V331797.R01.S.doc Version 5.2 Page 6 Homeliness in communal areas and personalisation of individual rooms are both well promoted. Residents are supported and protected by the home’s recruitment policy. Staff at the home continue to be well supported with their training. What has improved since the last inspection? What they could do better: Improvements have been made in the way medicines are handled in the home to help safeguard residents’ health. However more action is needed to make sure that some short stay residents are better protected. St Georges Care Home DS0000020254.V331797.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. St Georges Care Home DS0000020254.V331797.R01.S.doc Version 5.2 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.V331797.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3,4, 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents or their families have all relevant information to make a decision about the nature of the home. Residents receive a contract and written terms and conditions on admission to the home. Prospective residents needs are assessed prior to admission to determine the suitability of placement to ensure that their needs can be met. Trial visits give prospective residents an opportunity to assess the nature of the home. St Georges Care Home DS0000020254.V331797.R01.S.doc Version 5.2 Page 10 EVIDENCE: A statement of purpose and resident guide is available, in loose-leaf format and presented as a whole document in a folder. This document is made available to prospective residents/families and has been issued to all current residents. Copies are also available from reception. Through discussions with residents in the home and residents surveys it was confirmed that they and their families had received adequate information about the home prior to admission. Two residents stated in their surveys that they had had other family members using St. George in the past, which gave them the opportunity to get to know staff and routines prior to moving in on a permanent basis. Residents’ files contained contracts and terms and conditions, which are signed on admission. Sixteen residents confirmed in their surveys that they had received a contract and four residents who didn’t know said that they thought their families had signed contracts on their behalf. The residents’ records and discussions with the manager confirmed that a letter is sent to the residents notifying them of any changes in the fees. The prospective resident, family and carers are involved in the pre-admission and all information is used to determine the suitability of the placement. Where possible the manager had also obtained comprehensive assessments and care plans from other professionals involved for example, social workers and hospital staff. Prospective residents are encouraged to visit the home either for the day or perhaps for lunch dependent on their wishes. A month’s trial period on both sides is usually undertaken to ensure that everyone is happy with the arrangements and to ensure that the placement is suitable. One resident informed the inspector, “It was a hard decision for me to make with regards to remaining a permanent resident at St. George. The home was very understanding and I was given the opportunity to extend my trial period”. St Georges Care Home DS0000020254.V331797.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care planning and risk management procedures are now demonstrating that all of the residents’ health and personal care needs are being met. Staff treats residents in a warm and respectful manner, which means that residents can expect to receive care and support in a sensitive way. Adequate improvements have been made in the way medicines are handled in the home to help safeguard residents’ health. However more action is needed to make sure that some short stay residents are better protected. EVIDENCE: The home has care planning documentation for assessing, planning and evaluating care. 7 care documents were tracked and I am pleased to say that St Georges Care Home DS0000020254.V331797.R01.S.doc Version 5.2 Page 12 the standard of those examined were up to date and reflected these residents changing or current needs and fully demonstrated how all of their assessed needs were being met. Of the seven viewed only four had residents’ signature of involvement. It is advised to document the reason why this cannot be undertaken. There are risk assessments for eventualities. In general the risks identified are formulated into an action plan via the care needs assessment process to identify the care / management required to reduce risks identified. Specialist equipment being used for individual residents’ i.e. alternating pressure relief mattresses / seat cushions are now recorded in the care plan following a risk assessment. This information is now being updated; as equipment needs change in relation to assessed need. If any form of restraint is used to minimise risks (for example, a lap belt or bedrails used for personal safety) a signed consent form is signed to support this. On the documents observed there were 3 residents requiring this. All were signed appropriately. Nutritional and fluid intake documentation has improved (Monitoring to ensure frail residents receive sufficient fluids and an adequate diet). Goals for the daily fluid intake of residents who are at risk of dehydration or urinary tract infections are set or their fluid intake recorded. These are kept at the nurse’s station for completion, 4 were observed. Entries were being documented. However, on the first day of inspection the days totalling of fluids was not being tallied. Discussion took place regarding this. Senior RN’s agreed to have the night staff completing these on a daily basis and write the totals in the daily records for close monitoring. On the second day of inspection it was pleasing to se this had taken place. All residents’ weight is now monitored on a monthly basis. If the resident’s weight is reduced there is a supported care plan in relation to their dietary input and the seeking of appropriate specialist advice/support. This was observed in 3 care documents. In one example, it was evident that he/she had not been weighed for 3 months even though an assessment indicated that this was undertaken with regularity. On questioning staff regarding this shortfall their reason for this was that he/she refused to be weighed. Discussion regarding other ways to monitor weight was then undertaken. Nutritional risk assessment for at risk residents should be considered, together with weight monitoring to act as a nutritional guide. Residents’ health would be further enhanced by the close monitoring of daily nutritional input for those residents at risk. Attention to fluid intake and output with close monitoring would enhance the health and tissue viability of vulnerable people. St Georges Care Home DS0000020254.V331797.R01.S.doc Version 5.2 Page 13 Wound care charts are kept in a ‘wound care file’. This was observed and it provided written entries relating to location, size, depth, condition, and dressing information about the wound. There were also entries relating to information from the tissue viability nurse and /or doctor. Care staff being aware of potential risks for all residents promotes residents’ safety and undertaking appropriate action plans to reduce these risks. The pharmacist inspector looked at medicine handling in the home. Evidence was seen that staff had worked hard to address the issues raised about medication in the last report. Additional locked storage has been provided to make sure that new medicines received into the home are stored securely. Daily records show that the medicine fridge temperatures are within the recommended range for safe storage of medicines. Action has been taken to help staff audit the stock not supplied in the weekly Nomad boxes, so that they can check that it has been given as prescribed. The pharmacy provides a printed medicines administration record sheet each month and action has been taken to make sure that wherever possible current medicines are included on this. Where handwritten additions had been made by staff, the information was clear to allow safe administration of the medicines. One member of staff has been involved in developing an audit system to check that medicines administration record sheets are completed accurately and that medicines have been given correctly. Action is taken to address any issues, which arise through this process. For example one person was often refusing to take their medicines so staff have asked the doctor to review the medication. Staff said that action is being taken to alter part of the ordering system to make sure that medicines not routinely supplied by the pharmacy on regular repeat prescriptions are ordered correctly and do not run out. Records of the receipt of medication were seen on medicines administration record sheets. Medication was looked at for one person staying in the home for just a short period. Records of the quantity of medicines received were not accurate and one box of medicines was not labelled with a list of the contents so staff could not easily check the medicines. St Georges Care Home DS0000020254.V331797.R01.S.doc Version 5.2 Page 14 St Georges Care Home DS0000020254.V331797.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. 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. Meals are well managed and provide daily variation, nutrition and social contact for people. EVIDENCE: St. George has a full time co-ordinator who organises the varied activity schedule. Time is spent with the residents gathering information on their likes / dislikes, feedback and suggestions for activities / events. There is a planned event most days which includes visitors / entertainers to the home as well as organised trips from the home. Residents spoken with were very St Georges Care Home DS0000020254.V331797.R01.S.doc Version 5.2 Page 16 complimentary of the activities and said they participated in and enjoyed most events. A request from the activities co-ordinator for families and friends to complete a pen profile was observed in all residents’ rooms. Two of these were observed for case tracking. These were then used in formulating person centred care for meaningful activities. A programme of in-house activities is maintained. Posters are displayed advertising four monthly programmes, supported by monthly activities. Awareness of what is available is also promoted by verbally by staff daily. 2 out of 25 feed back forms, ‘have your say’ highlighted that they ‘were unaware of family inclusions of planned events’. Discussion took place with the activities co-ordinator relating to this and her thoughts were to introduce a news letter and a schedule of activities to be sent to families and a copy placed in each resident’s room. It was noted by the inspector that a large number of residents were keen to make sure they were in place for the start of the afternoon’s activity on one of the days of inspection, ‘afternoon of entertainment’. This was greatly enjoyed and many residents joined in singing. 10 residents also enjoyed a movement session. 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’ whom come in once a week providing one to one to a number of residents who do not actively participate planned activities. One resident who has a listener attend said, “I do enjoy our time as I do not like to join in with other activities”. A record of resident participation is made along with recorded comments from the resident. Forthcoming events include Afternoon of singing and entertainment, Easter event with Table Top Sale; Church Service, Trip to Garden Centre. 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. During the inspection, there St Georges Care Home DS0000020254.V331797.R01.S.doc Version 5.2 Page 17 were a large number of visitors on both floors of the home. Residents spoken with said that they felt visitors were welcomed. Local clergy of different denominations visit the home. 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 dining room. During the inspection the inspector requested a number of residents in the dining room of their opinion of the meals, 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 received in relation to meals from the “have your say” forms completed by residents and visitors were mixed. One said; “I would like to have cheese and biscuits instead of a pudding”. The chef was asked about the monitoring of the returned plates following meals from around the home, in particular residents with a poor appetite. The chef stated that this is undertaken and a discussion with the senior RN’s takes place. From this the chef seeks further information for suitable diets. It was noted that cream is added to all ingredients that require milk to be added to raise the calorific value, such as soup, mash potatoes, sauces. This is to be commended. It was noted that those at risk, due to low weight, have over the past few months gained weight. See standard 7 also. St Georges Care Home DS0000020254.V331797.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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. Staff continues to have a good theoretical understanding of Adult Protection issues but this needs to be better applied in practice. EVIDENCE: There is a complaints procedure with a formatted document for recording complaints available. This was viewed and found to be correct with outcomes of complaints completed. Residents’, visitors and staff comments showed that people feel comfortable discussing any concerns with senior staff or management. The home has an Adult Protection policy and procedure and staff has received training making sure as far as possible that residents live in a safe environment. Four members of staff were asked to answer “what do you understand of the Protection Of Vulnerable Adults”. I am pleased to say that those staff answered in a knowledgeable way. These staff was also able to give me examples and how they would react to the situation. This was also true when questioning about St. Georges “Whistle Blowing Policy”. St Georges Care Home DS0000020254.V331797.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19- 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean, comfortable, well decorated and furnished. It provides a safe, peaceful and well-maintained environment for the residents. The bedrooms and communal rooms and facilities are suitable and well presented for their purpose and meet the resident’s needs. EVIDENCE: The home is purpose-built to care for elderly people. The gardens are attractive and designed to meet the needs of the residents. The residents spoken with were very complimentary about the home and the garden areas. The home is on two floors, with level access to all via a passenger lift. The inspector walked around the inside of the home and viewed, some of the St Georges Care Home DS0000020254.V331797.R01.S.doc Version 5.2 Page 20 bedrooms, and the communal living areas including the dining room and several lounges. Room sizes are adequate for their stated purposes, particularly the lounges and the bedrooms. Rooms have en suite facilities provided and communal bathing areas; showers and toilet facilities are located throughout the home. The manager informed me of the planned changes to completely refurbish 2 bathrooms during this financial year. All areas of the home were tastefully decorated, clean and well maintained. Great attention has been given to ensure that all areas are homely. Residents had been supported to personalise their bedrooms with pictures and ornaments and residents are able to bring small items of furniture should they wish. The gardens have well-stocked flowerbeds, established trees and shrubs, and a patio area. There are various semi-private seating areas with plenty of sun screening. The gardens provide peace, tranquillity and enjoyment for the residents and visitors throughout the year. Residents were making full use of these areas and their bedrooms on the day of the inspection. A number of residents said how much they liked the views over the horse fields, being able to enjoy trees and wildlife from their bedroom windows. All residents stated in discussion with the inspector that the home was always clean and smelled fresh and pleasant throughout. The home employs domestic staff on a daily basis. Residents’ surveys confirmed that the home is always fresh and clean and comments included, “There are very high standards of cleaning in all rooms and fresh flowers in reception” and “The home is spotless all the time”. St Georges Care Home DS0000020254.V331797.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels help to ensure that residents needs are met. Residents are supported and protected by the home’s recruitment policy. Caring staff are appropriately trained. EVIDENCE: The manager ensures that staffing levels are indicative of the needs and levels of care required by the residents twenty-four hours a day and confirmed that levels of staff would rise should dependency levels increase. Sixteen residents’ surveys agreed that staff were usually always available when they needed them comments included, “There are many residents in the home so I understand why sometimes the staff are not able to give me immediate attention when called”, “One doesn’t know where the staff are at times and sometimes they seem slow in responding” and “I find that most of the time staff response is extremely good”. A robust recruitment policy and procedure is in place and the files inspected showed all the appropriate documents and checks were in evidence. CRB St Georges Care Home DS0000020254.V331797.R01.S.doc Version 5.2 Page 22 (Criminal Reference Bureau) disclosures are being retained until the inspector has examined them. RN’S (Registered Nurse) Pin numbers are validated annually. On recruitment staff are given a handbook, which contains, many of the homes policies and procedures including manual handling, health and safety and first aid. There is an induction programme, which covers all mandatory training, including Fire, Manual Handling, Health and Safety and the Protection of Vulnerable Adults. The home has a mentor system where all new staff is linked with and shadow a senior staff member during each shift to enable continuity and continued training throughout the induction process. The manager and staff are conscientious in attending training relevant to the care needs of the residents, this year courses have included, “Wound care management”, “Catheter Care and managing bowel movements” and “Dementia Awareness”. Staff confirmed in discussions that they had valued the training they had received particularly in dementia care. The home continues to support their staff with their NVQ training. Staff records and the homes training matrix confirmed that training was up to date and future courses had been arranged. One visitor told the inspector “There is a warm and loving atmosphere at the home”. Staff was observed to be respectful, good humoured and sensitive towards the residents within a relaxed, calm environment. They demonstrated a very caring, committed attitude to their roles and responsibilities in ensuring they provide quality of care to the residents. Relatives comment cards expressed how pleased they were with the all aspects of the home, the staff and services provided. Comments included, “I am impressed by the professional and caring way staff treat my relative”, “Very pleasant approachable senior staff” and “My relative receives the best treatment from dedicated staff”. St Georges Care Home DS0000020254.V331797.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 36, 37, and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents and staff team benefit from an experienced manager who continues to encourage an open style management approach. The home demonstrates good, effective leadership and management that relates to the aims and purpose of the home. Residents’ needs and best interests are central to the management approach in the home. The health and safety of residents, staff, and visitors is protected. Staff are regularly supervised. Residents’ best interests are not consistently safeguarded by the home’s record-keeping practices. St Georges Care Home DS0000020254.V331797.R01.S.doc Version 5.2 Page 24 The safety of the building for service users and staff is well promoted. EVIDENCE: The home’s registered manager Mrs Alex Crew has over 10 years managerial experience working at St. George and is well qualified both in management and training. It was evident from discussions with the manager and staff that the home has a stable team that supports a commitment to providing quality care for the benefit of the residents. As detailed throughout the report there was a high degree of satisfaction expressed by all of the residents, relatives and visitors who stated, “I could not be more pleased with the way St. George is run” and “St. George is a caring well run home and place where I would happily be a resident if it were necessary”. Based on the comments made and through the inspectors observation it is evident that the home is run in residents best interests and to ensure that their needs are being met. A quality assurance system is in place, its annual audit to assess the satisfaction of residents with regards to the service that the home provides. Residents and relatives are asked to complete surveys. Information from the surveys is collated and documented effectively. The results have enabled the home to identify all strengths and any weaknesses within the service they provide, and to produce an action plan where necessary. There is an annual appraisal process, which ties in with supervision frequencies of 6 times a year for care staff. Overview sheets and individual training records both made reference to clinical supervision for Registered Nurses. Evidence of the level of staff supervision was observed. Evidence was obtained by viewing four staff records. This was verbally confirmed as being undertaken by two staff members when asked. The residents’ register was in order. The employment records viewed were satisfactory. St Georges Care Home DS0000020254.V331797.R01.S.doc Version 5.2 Page 25 Monthly reports related to unannounced visits by a representative of the registered provider were discussed. Copies are available at St. George for the Commission for Social Care Inspection to view. Accident reports were properly completed and reviewed. Care plan documentation is kept in the offices behind the nursing stations on each floor. Detailed comments about the quality of this documentation are to be found earlier in this report. Good maintenance records with all servicing and certificates being up to date were noted. Documentation showed that relevant checks were maintained correctly and at required intervals including all fire alarms and equipment, emergency lighting. St Georges Care Home DS0000020254.V331797.R01.S.doc Version 5.2 Page 26 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 x 3 n/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 x 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x 3 x 3 3 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 3 3 3 x 3 3 3 St Georges Care Home DS0000020254.V331797.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? yes 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 OP9 Regulation 13(2) Timescale for action The registered person shall make 30/04/07 arrangements for the recording, handling, safe keeping, safe administration and disposal of medicines received into the care home: Action must be taken to ensure that medication can be safely administered to residents admitted for short term care. Requirement 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 Georges Care Home DS0000020254.V331797.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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.V331797.R01.S.doc Version 5.2 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. 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