CARE HOMES FOR OLDER PEOPLE
St Georges House Park Road Tiverton Devon EX16 6AU Lead Inspector
Announced Inspection 18th November 2005 10:00 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.V266628.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. St Georges House DS0000022037.V266628.R01.S.doc Version 5.0 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.V266628.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 14th April 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. St Georges House DS0000022037.V266628.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the second inspection of the current year and took 5 hours to complete. The home provides care for people with low to moderate needs. The home is a family run business and the atmosphere is relaxed and welcoming. There were 14 residents living at the home and the inspector met and spoke with 11 of them during the day. The home continues to provide a very good quality of care for residents. The residents spoken with had a high regard for the staff who support them, and were very positive and complimentary about life at the home in general. Comment cards were received from 10 residents; all were very happy living at the home, one wrote, “This is a very kind friendly place”, and another “I feel at home here”. No relatives were met during this inspection but comments cards were received from 5; all were satisfied with the overall care. Staff on duty contributed to the inspection and the manager and deputy manager assisted the inspector in a friendly and professional way. The inspector toured parts of the premises and a number of records were inspected including the pre-inspection questionnaire, care plans, training, records, and staff recruitment files. What the service does well:
When residents were asked what the home did best comments included, “Everything!” Residents said that the care was “excellent” and that the all staff were kind and friendly, one resident told the inspector, “This is the best place to be”, another said, “I always have someone to attend to me when needed.” One relative wrote, “Residents receive the most excellent care at St Georges”, another wrote, “Knowing my relative is happy and well cared for is a great relief”. The manager and staff encourage independence and choice and during the day residents were engaged in a number of different activities. Many of the residents are local and those who are able enjoy almost daily visits to the town or local clubs, churches and park. The home is managed in an open and inclusive way. Staff are motivated, willing to learn and clearly enjoy their jobs, which shows in their contact with the residents. Staff training is good and staff are supported and encouraged to develop their skills in order to continue to provide a high standard of care for the residents. St Georges House DS0000022037.V266628.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. St Georges House DS0000022037.V266628.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection St Georges House DS0000022037.V266628.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3 was not inspected as met at the previous inspection. Standard 6 does not apply to this home. EVIDENCE: St Georges House DS0000022037.V266628.R01.S.doc Version 5.0 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 9 & 10 The staff have a good understanding of the health and personal care needs of residents, which is documented clearly in care plans. The management of medication is generally good but one area could be improved upon. Personal support is offered in such a way as to promote residents’ privacy and dignity. EVIDENCE: Two care plans were examined, including the file for the most recently admitted resident. Each contained detailed information ensuring that staff had all the relevant information to satisfactorily meet the needs of the residents. Care staff have been encouraged to develop their care planning skills by participating with regular reviews. Some residents are supported to maintain control of their medication; consent had been obtained and medication is generally stored safely in residents’ rooms. A suitable locked box is available for safe storage but one resident has declined to use it; a disclaimer has been signed. A risk assessment of storage facilities would ensure that any areas of concern, regarding those residents who manage their medication, were highlighted and minimised.
St Georges House DS0000022037.V266628.R01.S.doc Version 5.0 Page 10 All residents responding with comment cards felt that staff respected their privacy and dignity; all felt well cared for. Residents spoke highly of staff, comments included, “They are kind and very friendly”, “They are wonderful here” and “They are lovely”. Care staff were observed to be respectful and sensitive in their dealings with residents and obviously knew them well. St Georges House DS0000022037.V266628.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Many of these standards were exceeded at the last inspection. EVIDENCE: St Georges House DS0000022037.V266628.R01.S.doc Version 5.0 Page 12 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 Residents are protected from the risk of abuse or harm by well-informed staff. EVIDENCE: The majority of staff have received training to ensure they understand the issues of adult protection and recognise their responsibility to act when concerned. Staff spoken with demonstrated a good knowledge of subject and would report any incidents of concern. All residents responding with comment cards felt safe at the home; those spoken with at the inspection echoed this. St Georges House DS0000022037.V266628.R01.S.doc Version 5.0 Page 13 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were either met or exceeded at the last inspection. EVIDENCE: St Georges House DS0000022037.V266628.R01.S.doc Version 5.0 Page 14 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 & 30 Residents’ benefit from having skilled experienced and friendly staff who have a good understanding of their needs. EVIDENCE: The manager and deputy are keen to develop training opportunities for staff and a staff training plan in is place to ensure that all staff have the necessary skills to meet the residents’ needs. Pressure area care and diabetes training have been organised and mental health training is being planned. A staff member spoken to said, “We are well supported and work well as a team”. All staff have the opportunity to undertake NVQ 2, or above. 75 of staff have obtained such a qualification and this is to be commended. The staff rota did not show the hours worked by the registered manager, which are considerable, nor did it show who was on duty for the sleep-in nights. St Georges House DS0000022037.V266628.R01.S.doc Version 5.0 Page 15 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 35 & 38 The home is well managed and the health and safety of residents is protected by safe working practices and the Home’s systems. EVIDENCE: The manager and deputy manager give a clear lead and direction to staff. Residents and staff feel the manager and deputy are approachable and all expressed their confidence in their abilities; one resident said, “You can always talk to them.” Both manager and deputy are completing the Registered Managers Award. The home does not manage residents’ financial affairs but in some instances they assist with the management of personal allowances. Personal monies records were checked for one resident. Evidence of good practice included individually kept accounts and cash balances and two signatures had been obtained for each transaction.
St Georges House DS0000022037.V266628.R01.S.doc Version 5.0 Page 16 Fire safety is well managed; Records showed that regular fire drills and staff training are undertaken. Fire alarms and safety lighting are regularly checked and fire equipment is maintained. A variety of policies and procedures are available and mandatory training was up-to- date to ensure safe working practices are maintained. The pre-inspection questionnaire showed maintenance of equipment, water and gas systems was up-to-date; the home was awaiting an electrical wiring certificate. St Georges House DS0000022037.V266628.R01.S.doc Version 5.0 Page 17 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 X X X X X X X X STAFFING Standard No Score 27 2 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 X X 3 St Georges House DS0000022037.V266628.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP9 OP27 Good Practice Recommendations It is recommended that risk assessments be completed for residents who are administering their own medication, including the appropriate storage required. It is recommended that the staff rota show which staff are on duty at any time during the day or night. St Georges House DS0000022037.V266628.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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