Inspection on 10/05/07 for St Georges House

This inspection was carried out on 10th May 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

St Georges House 18/11/05

St Georges House 14/04/05

St Georges House 22/11/04

St Georges House 17/05/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE St Georges House Park Road Tiverton Devon EX16 6AU Lead Inspector Dee McEvoy Key Unannounced Inspection 10th May 2007 09:15 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 House DS0000022037.V341183.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 House DS0000022037.V341183.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Georges House Address Park Road Tiverton Devon EX16 6AU 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) 01884 252436 01884 252436 st_george@btinternet.com Mrs Maureen Mary Lindley Mr Brian Douglas Lindley Mrs Maureen Mary Lindley Care Home 19 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (19), Old age, of places not falling within any other category (19), Physical disability over 65 years of age (19) St Georges House DS0000022037.V341183.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th November 2005 Brief Description of the Service: St Georges House is a care home providing personal care and accommodation for up to 19 older people. The home is privately owned and managed by Mr and Mrs Lindley, who purchased the property in 1982. The home is located a short distance from the centre of Tiverton, a market town offering a full range of amenities and facilities. The home is situated next to a large public park, which is enjoyed by residents. The home, originally a small hotel, comprises a large detached Georgian two-storey building, surrounded by attractive and well-maintained gardens. There is ample parking to the front of the property. There are 16 bedrooms in the home, 13 single and 3 double, although all bedrooms are used as singles. There are 10 bedrooms with en-suite facilities. The shared communal rooms are spacious, comfortable and cosy. The home is best suited to residents who are ambulant and able to manage stairs as there is no stair lift at present. The cost of care ranges from £360 to £425 per week depending on individual needs. Additional costs, not covered in the fees, include chiropody, hairdressing, and personal items such as toiletries, some continence products and newspapers. Current information about the service, including CSCI reports, is available to prospective residents, relatives and others who may have an interest such as care managers. St Georges House DS0000022037.V341183.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took nine hours to complete and we looked at key National minimum standards. There were 16 people living at the home at the time with no vacancies. In order to understand the experiences of people using the service, we looked closely at the care planned and delivered to three residents. Most residents living at the home were seen or spoken with during the course of the day and six residents were spoken with in depth to hear about their experience of living at the home. Other people contributed to a lively group discussion about life in the home. Time was also spent observing the care and attention given to residents by staff. During the inspection, time was spent talking with staff about the support and training available to them. One relative was also spoken with during the day. As part of the inspection CSCI surveys were sent to residents, relatives, staff and outside professionals. Completed surveys were received from 7 residents; 3 relatives and 8 staff expressing their views about the service provided at the home. A tour of the premises was made and we inspected a number of records including residents’ assessments and care plans and records relating to medication, recruitment and health and safety. The manager had completed a pre-inspection questionnaire prior to the inspection, which provides general information about the home. A thematic inspection was carried out at the home in January 2007. A thematic inspection is a short, focused inspection that looks in detail at a specific theme. This inspection was carried out as part of a national pilot where we looked at the quality of information that people get about care homes for older people. What the service does well: When people at the home were asked what it did best, comments included, “It’s been home. I did the right thing coming here”, “They respect us and give us independence”, “They look after you and treat you very well”, “The staff are wonderful, very respectful and kind” and “It’s a lovely place”. The home operates a comprehensive system of pre-admission assessment, assessing the needs and expectations of potential residents. This means people can be confident that they will receive the care and support they want and need if they move into the home. St Georges House DS0000022037.V341183.R01.S.doc Version 5.2 Page 6 Care planning and delivery is good. The care provided meets the personal, health and social care needs of people living at the home in a way that reflects people’s personal preferences. People said that the daily routine was flexible, “We can do as we like!” and there is an emphasis on promotion of the people’s privacy, dignity and independence. The management and staff are committed to providing high quality care for all of the people living at the home. People are encouraged to engage in valued and meaningful activities, and are supported to retain contact with the local community and continue with their social interest outside of the home. People liked the food and the mealtimes offer a pleasant and sociable occasion. Meals are varied, well balanced and nicely presented. The home is generally well maintained. Communal areas are decorated and furnished to a good standard. People living at the home were very happy with the environment. Bedrooms have been personalised and people have been encouraged to bring furniture and personal effects in order to make their rooms feel homely. All areas of the home were clean and fresh, people told us it was “always” like this. Staffing levels are good and people told us their needs were “always” met. Staff feel well supported and receive a good level of training, including regular updates in all health and safety related topics. New staff receive good induction training to ensure they can do their job safely. The home is well managed, with systems in place to encourage open communication between people living at the home, staff and relatives. There are good arrangements for managing peoples’ personal monies. Health and safety issues are generally managed well, protecting people’s welfare. What has improved since the last inspection? No requirements were made at the last inspection; the two recommendations issued have been acted upon and met. The home promotes independence and encourages people to take control of their own medicines, where possible. Risk assessments have been completed for people who wish to manage their own medication, which ensures the practice in place is safe. Since the last inspection, a number of bedrooms have been refurbished and redecorated, to ensure that people enjoy a pleasant and comfortable environment. The staff rota is accurate, showing who is on duty at any given time, including the registered manager’s hours and the sleep-in cover. St Georges House DS0000022037.V341183.R01.S.doc Version 5.2 Page 7 The home is successfully implementing the ‘Safe food better business’ initiative to ensure that standards remain high. 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 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. St Georges House DS0000022037.V341183.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 House DS0000022037.V341183.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 & 6 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. This home provides clear, detailed and accurate information to people interested in moving in, which helps them understand what they can expect if they do choose the home. People can be confident that they will receive the care and support they want and need if they do move into the home. EVIDENCE: The thematic inspection in January looked at information available about the home and found the home’s statement of purpose, brochure and service user’s guide provide clear detailed information about peoples rights and responsibilities as well as the service they can expect if they choose to move in. The documents indicated and the manager confirmed that all written information could be provided in alternative formats, for example large print, on request. CSCI surveys for this key inspection showed that all people responding had enough information about the home before they moved in. St Georges House DS0000022037.V341183.R01.S.doc Version 5.2 Page 10 The thematic inspection in January found that contracts are issued to people living at the home which are fair, helping to make sure people are clear about the terms of their stay, their rights and responsibilities. All people responding with CSCI surveys had received a contract. New admissions to the home are managed in an effective and sensitive way. People confirmed that they had been invited to visit the home before moving in, one person told us “I came with my daughter and we liked it here”, another said, “I used to visit a friend here. I knew it would be right for me”. Several people told us they had chosen the home because of its “good reputation locally”. One person who had recently moved to the home said, “I have been very welcome here and feel settled and happy”. Three relatives told us that us the home provides the support and care to their relative that they expected and agreed. People are encouraged to complete their own written appraisal of needs and describe the sort of help they require prior to moving into the home, if possible. The home receives good information from care managers for people referred through social services and one care file looked at contained important detailed information from a family to support the assessment process. The home also completes a comprehensive assessment to ensure individual needs can be met. Staff surveyed said they had not been asked to care for people outside of their area of expertise, suggesting the home admits people appropriately. St Georges does not provide intermediate care. St Georges House DS0000022037.V341183.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. Staff demonstrate a good understanding of the health and personal care needs of individual people through good care planning. People are treated with respect and dignity by staff that are friendly and knowledgeable. Medication is generally well managed, but improvements are needed in one area to prevent people being at risk. EVIDENCE: Three care plans were looked at in order to judge how care is planned and five staff, including the manager, were spoken with about how care is delivered. Care plans and assessments cover all aspects of daily care needs and those seen had been regularly reviewed. People spoken with were happy with the care they received, people told us they “Always” receive the care and support they needed. Comments included, “I am cared for very well”, “The staff are always happy to help”, and “Wouldn’t be any where else. It’s all first class!” Staff were aware of people’s needs and could describe the care delivered, which reflected what was written in individual care plans. St Georges House DS0000022037.V341183.R01.S.doc Version 5.2 Page 12 Risks are managed in a positive way to help people using the service to lead the life they want. The care plans include risk assessments for all areas of care where there may be a risk. These include moving and handling assessments, nutritional needs, skin care and tissue viability and continence assessments. General environmental risk assessments had been completed in files looked at, which highlighted any risk and measures in place to reduce risk, for instance when using the stairs. People living at the home told us that they “always” receive the medical support they need. Three relatives were happy with the overall care provided, one wrote, “There is a lot of genuine love and care administered”, another said, “They are meticulous about ensuring residents get good medical care”. People receive good support from relevant health care professionals including G.P, district nurse, practice nurse, community mental team and chiropodist, which ensure their heath needs are met. Records are kept of contact with professionals and show the positive outcomes for people. For example, the home have referred and supported people to access appropriate mental health professionals, which resulted in improvements in people’s health and enabled them to engage with life again. Feedback received by the home from health professionals, for example community nurses, was good. One professional described their overall impression of the home as “excellent” and felt that people living at the home received “excellent” care. Where possible people are supported to manage their own medication, which is to be commended. Risk assessments have been completed for those choosing to retain their medication and secure storage is provided in individual rooms. The storage of medicines was safe and good systems are in place for checking medication in and out of the home. The pre-inspection questionnaire shows that all staff involved in administering medication have had training to ensure their practice is safe. The home receives good support from the local pharmacy, which supplies all medicines for the home. One area of practice needs to be reviewed, as currently it is not entirely safe. Medicines used “when required”, which are generally painkillers, are “potted up” by the manager or deputy for staff to give when needed. This poses issues around accountability, as the person dispensing the medicine is different to the person administering it. The managers were keen to find a solution and said that the practice of “potting” medicines would cease. Interactions between the residents and staff, throughout this inspection, confirmed that people are supported by staff, who provide care in a flexible, sensitive and respectful manner. Staff value individuals and appreciate individual characters. People told us, “All staff are respectful, including the St Georges House DS0000022037.V341183.R01.S.doc Version 5.2 Page 13 younger staff” “They (staff) are respectful and kind” and, “They respect us and gives us independence”. St Georges House DS0000022037.V341183.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, 14 & 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People are supported to make choices and have control over their lives; this is enhanced by the positive relationships that have been formed between the residents, staff and relatives. Opportunities are provided to ensure that people take part in a variety of valued and fulfilling activities that reflect their individual interests and that they enjoy. EVIDENCE: Residents spoken with felt that routines within the home were flexible, one said, “You can do your own thing” and another said, “There is no strict routine. I please myself”. There was a lively atmosphere at the home and the sitting room provides people with an opportunity to come together to socialise, talk about the days news, do the cross word and generally enjoy the company. There was lots of chatting and laughing during the morning and people appeared relaxed. Several people described the friendships they had made at the home, one said, “I have all I need and want here”. St Georges House DS0000022037.V341183.R01.S.doc Version 5.2 Page 15 The home encourages and supports people to retain contact with the local community and continue with their social interest outside of the home. Several people attend different churches in the town; others attend a senior citizens club, arts society and walking club. Others enjoy independent trips to town and other places of interest. People told us there were “always” or “sometimes” activities arranged by the home that they can take part in. Activities are provided within the home, including a regular communion service, which was held on the day of the inspection and was attended by several people. Regular poetry readings, walks in the local park or gardens (weather permitting), quizzes, library visits and coffee mornings are also organised. People spoken with during the inspection were satisfied with the social opportunities available to them. Staff were seen to spend one to one time with less able residents to ensure their social needs were met, for example chatting, reading or playing their chosen game. One relative told us, “They have spent time trying to get Mum interested in hobbies etc”, another wrote, “They make particular effort to engage residents in activities appropriate to their conditions”. The home is happy to enable and support people to take part in any domestic chores, providing people with meaningful occupation. Some people are involved in assisting with laying tables and clearing away and washing up. Others like to clean their own rooms and make their beds. Peoples’ preferences and wishes are recorded in their care plans. It is up to the individual and emphasis is on choice and independence. One person was busy arranging the flowers in the home on the day of the inspection, the resident described the lovely flower arranging as her “job” at the home, and obviously took great pride in her “job”. Relatives and other visitors, including pets, are welcome at any time. On the day of the inspection several visitors were seen coming and going, one with the family dog. One relative was spoken with and said that they were always welcome to visit. CSCI surveys completed by 3 relatives showed that visitors felt free to come and go. The home’s satisfaction surveys show that feedback from relatives was very positive; four were looked at, all were satisfied with the overall care, one described the care as “excellent”. Relatives felt that the home communicated well and kept them informed of any important matters affecting their relative. The home provides a relaxing, comfortable and supportive environment for people to live in. The staff were observed to support people in a sensitive and discreet way that promoted dignity, choice and independence. One person told us, “Staff encourage you to be as independent as possible but are always there if needed”. One relative told us, “Residents are allowed to go out as and when with friends or relatives and visitors are allowed whenever”. St Georges House DS0000022037.V341183.R01.S.doc Version 5.2 Page 16 People at the home enjoy the food, many positive comments were received, including, “The food is excellent”, “The food is always good here” and “I’ve given up going out on Sunday as lunch is so good here!” One person said, “I’m eating more than ever before!” No menus were available and no-one knew what was for lunch, all spoken with said this was not a problem. Comments included, “It’s always a surprise”, “It’s different every day” and “They know what we like”. People told us that alternatives were always available. There are plans to have a chalkboard menu in the dining so that people know what is available daily. The cook was spoken with and was aware of people’s likes and dislikes as well as their dietary needs. Good records were available of the food served daily and showed that a varied and balanced diet was provided. Lunchtime was relaxed and unrushed; there was laughter and chatting in the dining room. Residents can choose to take meals in their rooms if preferred. St Georges House DS0000022037.V341183.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 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints system, with evidence that people feel that their concerns or complaints would be listened to and acted on. Residents are protected from abuse by well-informed staff and robust policies and procedures. EVIDENCE: We looked at how the home responds to complaints during the thematic inspection in January 2007. The home’s complaints procedure is clearly presented and provides all the information residents or their representatives would need to make a formal complaint, including how to contact the Commission. The Commission has not received any complaints about this service. All people spoken with and those responding with CSCI surveys said they knew who to speak with should they have any concerns. The home has a clear complaints procedure, which helps residents to feel confident to speak up if they have a concern or complaint. When complaints do arise managers address them thoroughly and try to put things right. People told us, “You can speak with the managers at any time should you have a problem”. One person told us, “I am happy and safe here”. A relative wrote, “All care and kindness is shown to residents”. Staff spoken with had received training to help them recognise adult protection issues such as abuse. One said, “I St Georges House DS0000022037.V341183.R01.S.doc Version 5.2 Page 18 wouldn’t hesitate to report any concerns”. The managers have both attended the local authority training for adult protection and are aware of the procedures to be followed should any incidents be reported to them. Good policies and procedures are available to guide staff in the event of any concerns raised. St Georges House DS0000022037.V341183.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, 22, 25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment within the home is good, providing people with a comfortable, safe, clean and homely place to live. EVIDENCE: A tour of the premises included all communal areas, some private bedrooms and communal bathrooms, the kitchen and laundry area. People spoken with during the inspection were happy with the communal areas and their own private bedrooms. Private bedrooms were personalised with small pieces of furniture, personal items, photographs and pictures. The garden is accessible and attractive, providing pleasant areas for people to sit or stroll. The home is generally kept in good condition but does require considerable upkeep being an older style property. The management team told us that maintenance was on going and the providers agree an annual maintenance programme in order to ensure that the home remains comfortable and safe. St Georges House DS0000022037.V341183.R01.S.doc Version 5.2 Page 20 Since the last inspection several bedrooms have been redecorated and there are plans to move the office in order create a morning room at the front of the house to add to communal space. There is a large, comfortable lounge and a smaller snug room where people can meet with visitors in private. All rooms are single occupancy and most have en-suite facilities. If people require assistance with bathing, aids are available for use in en-suite rooms or in the assisted bathroom on the ground floor. A hoist is also available, for use. Although there are some aids and adaptations around the home to support people with mobility needs, the home does not have a stair lift and people moving into the home or living at the home need to be fairly mobile and able to manage stairs. There are a number of ground floor rooms, which tend to accommodate less mobile people. The only improvement one person could think of was a stair lift. The providers have investigated the possibility of installing a stair lift but due to space constraints on the stairs the fire service have advised against this. The providers are to consult with an architect to find a solution, which will ensure that the changing needs of people living at the home can be met. In order to reduce the risk of scalds and burns to people, hot water temperatures are controlled by thermostatic valves and radiators seen in communal areas and bedrooms were covered. Where extra heaters are in place, individual risk assessments were completed following a visit from the health & safety officer. There were fresh flowers around the home and all areas were clean and hygienic. People said the home was always fresh and clean, and all people returning CSCI surveys said that the home was “always” fresh and clean. The laundry is a small area set off the kitchen, which staff access from outside of the building so that laundry is not brought through the kitchen. This is not ideal but staff told us that it works. The area is cramped, and staff do not have easy access to the hand-washing facilities. Larger items of laundry, such as sheets, are sent out to an external laundry. Smaller personal items are laundered daily at the home. At previous inspections the manager and deputy identified relocating the laundry as an area for improvement. St Georges House DS0000022037.V341183.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels are sufficient to ensure that peoples’ needs are met in a timely way and skilled, experienced and friendly staff support people properly. One area of staff recruitment does not fully protect peoples’ welfare. EVIDENCE: All residents responding with CSCI surveys said that staff were available when needed, suggesting that sufficient staff are on duty to meet people’s needs. Staff told us that there were enough staff on duty to enable them to do a good job, one wrote, “Always well staffed enabling one to one care, time and attention”. People living at the home were generally very positive about the staff supporting them, comments included, “Nothing is too much trouble for them” and “They do everything to make you happy”. There is a stable, competent staff team employed by the home, that are experienced and skilled in working with older people. Survey responses from staff showed that they felt valued and well supported. Morale is good amongst the team and this is demonstrated by their enthusiasm for their role. The staff rota is now accurate, showing the hours worked by the registered manager, which are considerable, and who is on duty for the sleep-in nights. St Georges House DS0000022037.V341183.R01.S.doc Version 5.2 Page 22 Three staff personnel files were inspected to check recruitment procedures. One did not have the necessary references and these could not be found during the inspection, although the deputy said they had been returned completed. Another had a poor employment history. The new style application form addresses this and ensures that employment history is clearly stated. All files contained Protection of Vulnerable Adult (POVA) checks, which had been obtained before staff started working at the home. Criminal Record Bureau (CRB) checks had also been obtained to protect the welfare of people living at the home. People living at the home and their relatives were confident that staff had a good understanding of individual needs. Relatives responding to CSCI surveys told us that staff have the right skills and experience to look after people properly. One relative told us, “Staff are superb and take great care over their clients”, another wrote, “They treat residents as one of their own”. The pre-inspection questionnaire shows that around 73 of staff have achieved a nationally recognised qualification in care (NVQ), which is to be commended. The pre-inspection questionnaire showed that a variety of training had been undertaken since the lat inspection, including diabetes awareness, safe medication handling, and other mandatory courses (refer to standard 38). All staff contacted said they had received an induction training, which helped them to understand how to work safely and respectfully with people. The home has adopted the Skills for Care induction programme, a national recognised programme to ensure good standards. One staff member said, “There are always courses offered here. They keep you up to date with everything”. Staff felt valued and told us they enjoyed working at the home, one said, “There is a lovely family atmosphere here, I wouldn’t work anywhere else”. St Georges House DS0000022037.V341183.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, 33, 35 & 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There is a good management structure in place to ensure that the home is well managed. The home is run in the best interests of people living there, with systems to review, develop and improve the service in place. Health and safety is promoted in order to protected people living at the home and staff. EVIDENCE: The Registered Manager, deputy manager and other senior staff have created a management style, which is positive, open and accessible. People living at the home expressed their confidence in the management, and said that the manager and deputy were “lovely” and “easy to talk to”. One relative wrote, “Please convey our thanks for their professional service”. Staff were also very positive about the leadership at the home, the managers were described as St Georges House DS0000022037.V341183.R01.S.doc Version 5.2 Page 24 “supportive” and “freely available when needed”. One staff member told us, “We have good management”. The manager has many years of experience and is very “hands on” in her approach, ensuring she is well-known to all people living at the home and her staff. Her deputy, who also has considerable experience, supports her. Both are aiming to complete the Registered Managers Award later this year. All people responding with CSCI surveys and those spoken with on the day of the inspection said that staff listen and act on what they say. People told us that they feel free to give feedback to the manager and staff and that staff work to ensure their preferences are met. The home has a quality assurance system, which enables people living at the home, their relatives and professionals to ‘have their say’ about how well the home is performing and what improvements could be considered. The annual satisfaction questionnaire is due shortly and the results will be audited and a summary shared with all interested parties, including CSCI. The pre-inspection questionnaire shows that the home does not deal with financial matters on behalf of any one living at the home. The home will administer small amounts of personal allowance. A secure system is in place to ensure people are protected, including individually kept accounts and cash balances and two signatures obtained for each transaction. One account was checked and tallied correctly. All staff responding with CSCI surveys said the home provided funding and time for relevant training. The pre-inspection questionnaire shows that staff have received the necessary training to maintain good standards of health and safety. Staff have attended food hygiene, infection control, first aid and fire safety. Currently six members of staff hold a valid first aid certificate, and the deputy manager said that a first aider was always on duty. Fire safety was well managed, with staff receiving the necessary training, internally and from an external trainer. Regular fire drills and practices are held to ensure staff know the procedure in the event of a fire. The deputy manager said that all recommendations from the last fire officer’s visit had been met. Records confirm that regular checks and maintenance of fire equipment and systems are in place. The pre-inspection questionnaire showed maintenance of equipment, water, electrical and gas systems was up-to-date. St Georges House DS0000022037.V341183.R01.S.doc Version 5.2 Page 25 The kitchen was clean and well organised. The last Environmental health report praises the home saying, “Continue your excellent progress with Safe food, better business”, showing that standards are high. St Georges House DS0000022037.V341183.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 4 3 4 X X X 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 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 2 X X 3 2 STAFFING Standard No Score 27 3 28 4 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 3 St Georges House DS0000022037.V341183.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. 1. Standard OP9 Regulation 13(2) Requirement In order to ensure that medicines are administered safely you must ensure that medicines are only dispensed immediately prior to the administration taking place. The practice of ‘potting up’ and storing medicines in the office before the medicines are given is not considered safe. Timescale for action 28/06/07 2. OP29 19 (1) Schedule 2 1-7 No member of staff must be employed to work at the home without first obtaining all the necessary information required, in this case two written references. 28/06/07 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 Good Practice Recommendations DS0000022037.V341183.R01.S.doc Version 5.2 Page 28 St Georges House 1. Standard OP22 2. 3. OP26 OP33 It is recommended that suitable adaptations, such as a stair lift, are made available to ensure that the changing needs of the people living at the home can continue to be met. It is recommended that the laundry facilities be reviewed and that hand-washing facilities should be prominently sited in the laundry. You should ensure that the results of surveys (with any action plan) are made available to people living at the home, CSCI & other interested parties. St Georges House DS0000022037.V341183.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Devon Area Unit D1 Linhay Business Park Ashburton Devon TQ13 7UP 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 House DS0000022037.V341183.R01.S.doc Version 5.2 Page 30 - 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. 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