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Inspection on 07/11/07 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 7th November 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

People living at St. Georges Care Home continue to speak of it as a "caring place" "relaxed and friendly". The home`s staff team continue to receive a number of thank you letters from relatives praising the care provided and the dedication of the staff team. One of these highlighted `Very helpful and friendly staff`. Our survey responses include comments that ` There are high quality people who take their work seriously. They are friendly, respectful and anxious to do their best`. Prospective residents continue to receive clear details of the services the home provides, enabling them to make an informed decision about admission. People living at St. Georges Care Home have the benefit from regular reviews of changing care needs. People health living at St. Georges Care Home is enhanced by the close monitoring of daily nutritional input for those residents at risk. There is better attention to fluid intake and output with close monitoring which is enhancing the health and tissue viability of vulnerable people.The good theoretical understanding that staff have of Adult Protection issues needs is reflected in practice via their delivery of care. 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. 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 are well supported with their training opportunities. Constantly review working systems.

What has improved since the last inspection?

Improvements have been made in the way medicines are handled in the home to help safeguard all residents` health at St. George. Improvements have been made in relation to the standard of recording in care files.

CARE HOMES FOR OLDER PEOPLE St Georges Care Home Kenn Road St George Bristol BS5 7PD Lead Inspector Jill Cornelius Unannounced Inspection 7th November 2007 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.V352337.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.V352337.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 stgeorgecarecentre@tiscali.co.uk St Georges Care Home Ltd Ms Alexandra Crew Care Home 68 Category(ies) of Old age, not falling within any other category registration, with number (68) of places St Georges Care Home DS0000020254.V352337.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. May accommodate up to 68 persons aged 50 years and over requiring nursing care. Staffing Notice dated 22/06/2001 applies Manager must be a RN on parts 1 or 12 of the NMC register. 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.V352337.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 1 day 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. Prior to the inspection, information was gathered and reviewed by an Annual Quality Assurance Assessment returned by the Manager. Also the sending out 30 survey forms. 14 were returned prior to the inspection date. During the site visit, records were examined, a tour of the premises conducted and verbal feedback sought from staff and visiting health professionals. A number of residents and visitors were also spoken with about the quality of care provided at the home. There have been no Requirements or Recommendations made as a result of this inspection. What the service does well: People living at St. Georges Care Home continue to speak of it as a “caring place” “relaxed and friendly”. The home’s staff team continue to receive a number of thank you letters from relatives praising the care provided and the dedication of the staff team. One of these highlighted ‘Very helpful and friendly staff’. Our survey responses include comments that ‘ There are high quality people who take their work seriously. They are friendly, respectful and anxious to do their best’. Prospective residents continue to receive clear details of the services the home provides, enabling them to make an informed decision about admission. People living at St. Georges Care Home have the benefit from regular reviews of changing care needs. People health living at St. Georges Care Home is enhanced by the close monitoring of daily nutritional input for those residents at risk. There is better attention to fluid intake and output with close monitoring which is enhancing the health and tissue viability of vulnerable people. St Georges Care Home DS0000020254.V352337.R01.S.doc Version 5.2 Page 6 The good theoretical understanding that staff have of Adult Protection issues needs is reflected in practice via their delivery of care. 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. 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 are well supported with their training opportunities. Constantly review working systems. 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. St Georges Care Home DS0000020254.V352337.R01.S.doc Version 5.2 Page 7 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.V352337.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.V352337.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, 3, 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. EVIDENCE: St Georges Care Home DS0000020254.V352337.R01.S.doc Version 5.2 Page 10 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”. Another resident spoken with on the day of inspection stated “ I came to look round with my daughter and saw this room and liked it. I like it here staff are very good and kind to us.” The home provides prospective residents with a written confirmation that their needs will be met in respect of health and welfare after assessment. Another resident spoken with, stated, “that they signed a contract at the home”. Staff spoken with demonstrated understanding of the needs of the resident. St Georges Care Home DS0000020254.V352337.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 outcome in this area is good. This judgement has been made using available evidence including a visit to this service. Care planning and risk management procedures continue to demonstrate that all of the residents’ health and personal care needs are being met. Staff treats people living at St. Georges in a warm and respectful manner, which means that they can expect to receive care and support in a sensitive way. EVIDENCE: The care planning files for four residents were examined. Care planning and risk management procedures demonstrate that all of the residents’ health and personal care needs are being met. The care plans on the whole were well written and detailed the needs of the resident and what St Georges Care Home DS0000020254.V352337.R01.S.doc Version 5.2 Page 12 actions the care staff were to take two plans required, minor improvements. This was discussed with the Senior Registered Nurse during the inspection. Residents care plans have been reviewed on a monthly basis. There was evidence in three of the care files of evidence in the form of signatures from resident and /or their representative. Wound care documents are included in individual care files – those examined gave clear instructions for staff to follow and provided evidence of progress or deterioration. It was pleasing to note that for one resident wound it was almost healed. Relatives survey responses include; “Their family member was well looked after and that they were always kept up to date with any changes or significant events” “The Doctor is always been called whenever I have had a problem” “I am always looked after well in all sorts of ways” One GP responded via a comment card said “they were satisfied with the overall care provided to residents and that any advice given is acted upon and that staff have a clear understanding of each residents care needs”. It is recognised that there has been a big challenge for staff due to the new paper work from the new proprietors. Residents are registered with a local health centre or GP of their choice. Records are maintained of all contacts with GP’s and other healthcare professionals. Daily and monthly observations to monitor healthcare are undertaken. The home has sound procedures in place for ordering, receipt, and storage, the recording, handling, safe keeping, safe administration and disposal of medicines received into the care home. Since the last inspection the home has accessed a new Pharmacy. This has assisted in the prompt access to emergency and routine medication. This helps to safeguard residents’ health. The short stay residents (safe haven beds) continue to be better protected by the homes arrangements with the PCT. Signage was in place where oxygen cylinders are stored and upon advice, a more visible sign was placed on a resident’s bedroom door. The registered person shall make arrangements for: Action must be taken to ensure that medication can be safely administered to residents admitted for short-term care. During the course of the inspection, the staff team were seen going about their duties in a kind, friendly and courteous manner. They were heard being respectful and in general, using first names to address each resident. One resident said “they were helped with personal tasks in privacy, but the staff encourages them to do for themselves where possible”. The person was satisfied with the level of support. St Georges Care Home DS0000020254.V352337.R01.S.doc Version 5.2 Page 13 St Georges Care Home DS0000020254.V352337.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15 Quality outcome in this 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 St Georges Care Home DS0000020254.V352337.R01.S.doc Version 5.2 Page 15 organised trips from the home. Residents spoken with were very 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. 14, feed back forms, ‘have your say’ highlighted that they ‘were aware of family inclusions of planned events’. The introduction of a New’s letter and the schedule of activities sent to families with a copy placed in each resident’s room works well. All are informed about activities that are undertaken at St. George. 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 included A Fire Work Barbeque held in the evening with a residents meeting. An afternoon of singing and entertainment was observed. Some planed events include a Christmas 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 were a large number of visitors on both floors of the home. Residents spoken with said that they felt visitors were welcomed. St Georges Care Home DS0000020254.V352337.R01.S.doc Version 5.2 Page 16 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 “it’s very, very good”, “there is always another choice if I decide at the last minute I would like something else”, “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”, “meals are always good”, “it is a highlight to the day”, “ I would like to have our tea in the dinning room as well as lunch as it is good to chat with people over a meal”. The chef monitors the returned plates following meals from around the home, in particular residents with a poor appetite. The chef undertakes a discussion with the senior RN’s regarding this. From this the chef seeks further information for suitable diets. It was again 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. St Georges Care Home DS0000020254.V352337.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16. 17, 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. 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. One complaint is still being undertaken. It was requested that the Commission for Social Care receive an outcome letter in relation to this. Residents’, visitors and staff comments showed that people feel comfortable discussing any concerns with senior staff or management. The home has written procedures for adult protection, whistle blowing, management of aggression, abuse, bullying and management of service users money/valuables. The ‘No Secrets’ document was also available. The home St Georges Care Home DS0000020254.V352337.R01.S.doc Version 5.2 Page 18 actively promotes staff training and education in these areas, all staff receive training in dealing with difficult behaviours, aggression / violence and protection of vulnerable adults. Staff training records viewed evidence this commitment. 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. Three 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”. The home’s policies were viewed in detail and were comprehensive. St Georges Care Home DS0000020254.V352337.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 remains clean, comfortable, well decorated and furnished. It provides a safe, peaceful and well-maintained environment for people living at St. George. The bedrooms and communal rooms and facilities are suitable and well presented for their purpose and meet the resident’s needs. EVIDENCE: St Georges Care Home DS0000020254.V352337.R01.S.doc Version 5.2 Page 20 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 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. Two bathrooms have been refurbished with ARJO bathing systems. Comments from residents include: “I love the new bath” “My room is cleaned very well” “I would like to formal thank all those who keep my room clean” “ It is kept clean and tidy” Comments from our survey include; “ No problem with their room” “One occasions I had to complain about the table top being sticky but this was seen to straight away”. “I have a defective window which has been problematic to repair” All areas of the home were tastefully decorated, clean and general well maintained. The viewing of the maintenance log highlighted the window problem; this also showed what action had been taken to replace this. The Manager forwarded the progress of this to the resident. 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 are attractive and residents spoke of their enjoyment of them. The home has an air purifier system for communal areas, affording a pleasant odour around the home. Sluice areas demonstrated control of infection procedures and included a sluicing disinfector. The laundry off has two washing machines and two large tumble dryers with appropriate specified programmes. There was also evidence of appropriate infection control procedures in the sorting of laundry, equipment use and cleaning schedules. The standard of cleaning was found to be good throughout the home. St Georges Care Home DS0000020254.V352337.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, 28, 29, 30 Outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels help to ensure that resident’s needs are met. Residents are supported and protected by the home’s recruitment policy. Caring staff is 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. Fourteen 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”, “ the response from the call bell could be quicker”, “One doesn’t know where the staff are at times and sometimes they St Georges Care Home DS0000020254.V352337.R01.S.doc Version 5.2 Page 22 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 (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 always a warm and loving atmosphere at the home”. Staffs 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 survey forms 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.V352337.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, 35, 36, 38 Quality outcome in this 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 is regularly supervised. Residents’ best interests are not consistently safeguarded by the home’s record-keeping practices. St Georges Care Home DS0000020254.V352337.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 11 years managerial experience working at St. George and is well qualified both in management and training. The home has recently being taken over by Caring Homes. This has been a challenge for all staff in relation to the paperwork. It was pleasing to note that no residents highlighted this as a concern to their care during the time of inspection. 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 some comments include, “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 remains 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 three staff members when asked. The residents’ register was in order. St Georges Care Home DS0000020254.V352337.R01.S.doc Version 5.2 Page 25 The employment records viewed were satisfactory. Monies are held for one person living at St. George on checking the amounts these were found to be correct. The system in place was robust therefore protecting this person’s finances. On reviewing the fire log, evidence was reviewed that the weekly testing of October alarms and emergency lighting was found to be correct. Fire training was reviewed and found to be up to date in line with the fire regulations. This promotes the safety of all at St.George’s. St Georges Care Home DS0000020254.V352337.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 3 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 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 3 3 x 3 3 3 St Georges Care Home DS0000020254.V352337.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations St Georges Care Home DS0000020254.V352337.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection South West Regional Office 4th Floor, Colston 33 33 Colston Avenue Bristol BS1 4UA 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.V352337.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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