Inspection on 22/11/05 for St Georges Nursing Home

This inspection was carried out on 22nd November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 Nursing Home 09/10/08

St Georges Nursing Home 26/10/06

St Georges Nursing Home 05/07/05

St Georges Nursing Home 03/02/05

St Georges Nursing Home 04/06/04

St Georges Nursing Home 15/03/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE St Georges Nursing Home 13 Vigo Lane Harraton Washington Tyne & Wear NE38 9AH Lead Inspector Mr Tom Moody Unannounced Inspection 22nd 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 Nursing Home DS0000018208.V253865.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 Nursing Home DS0000018208.V253865.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service St Georges Nursing Home Address 13 Vigo Lane Harraton Washington Tyne & Wear NE38 9AH 0191 4191879 0191 4157037 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) Wellburn Care Homes Limited Care Home 38 Category(ies) of Dementia - over 65 years of age (4), Old age, registration, with number not falling within any other category (38), of places Physical disability over 65 years of age (3), Sensory Impairment over 65 years of age (1) St Georges Nursing Home DS0000018208.V253865.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th July 2005 Brief Description of the Service: This home has two stories and was purpose built. It provides both personal care, and nursing, for up to 38 elderly persons, all within single rooms. There is a passenger lift to give access to the first floor. The home has recently undergone internal alteration to improve the layout. Although the grounds are not extensive they are adjacent to the local church, this and the absence of a boundary fence, gives them a spacious feel. A sheltered patio area is located at the rear of the home. The home is in a quiet residential area of Washington, close to the main North / South highway (A182). There are some local shops and facilities within walking distance, and a large retail development (The Galleries) is only a few minutes away by motor transport. St Georges Nursing Home DS0000018208.V253865.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day on 22 November 2005. One inspector carried out the inspection. The manager was not present at the time of inspection. The views of people living at the home were gathered during the day of inspection, by talking to them, their visitors and reviewing the comments they had made in surveys. Positive feedback was received from all of those people the inspector spoke to. The inspector talked to staff and documents were sampled including care plans. A tour of the home took place. The home was warm, well ventilated, decorated to a good standard and well lit. A mealtime was observed but the inspector did not have a meal on this occasion. What the service does well: What has improved since the last inspection? Inappropriate door handles continue to be replaced, and fire precautions have improved. The home has a new call system in place. St Georges Nursing Home DS0000018208.V253865.R01.S.doc Version 5.0 Page 6 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 Nursing Home DS0000018208.V253865.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 Nursing Home DS0000018208.V253865.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): 4, 5 Service users and their relatives can visit the home and they are given accurate information on which to make their choices. EVIDENCE: The home provides a variety of information to prospective service users and their families. The results of service user surveys are available and service users comments have been included, even when those comments have been unfavourable. This honest and accurate appraisal is to the company’s credit. Service users relatives confirm they could look at the home before making their choice and that they received accurate information. Staff confirm that visitors are welcome and relatives usually visit the home and others to make comparisons. St Georges Nursing Home DS0000018208.V253865.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): 7,8, 9, Although service users clinical needs were fully addressed in care plans examples were seen where social needs had not been properly assessed. Service users health care needs are met and although the home has most of the equipment and facilities it needs, there is no loop system for service users with a hearing problem. Medication policies and procedures are appropriate and protect service users however the timing of drug rounds may not always be appropriate to service users requirements. EVIDENCE: Some examples of very comprehensive care plans were seen. In others the social needs of service users had not been noted. In one case the service user was relatively new to the home but sufficient time had elapsed for some observations on this to be made. There is written evidence that clinical specialists are involved in service user’s care. The home is well equipped to meet most service users needs but the home has no “loop” system for hearing aid users. St Georges Nursing Home DS0000018208.V253865.R01.S.doc Version 5.0 Page 10 Service users comments such as, “I get looked after well,” and, “the staff are a good lot,” confirm that they feel cared for by staff. Medication storage, recording and administration was seen and the system was largely appropriate to service users needs. Nursing staff told the inspector that drugs to aid mobility, antibiotics or pain relief were given to service users before they were helped out of bed and records confirmed that timings were appropriate. There were some concerns expressed by qualified staff that pressures of other work might delay drug rounds and the morning drug round was still taking place after 11 am. St Georges Nursing Home DS0000018208.V253865.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): 12, 13, 14, 15 The home has good community links and encourages contact with service users, from friends and families. Service users have access to all healthcare services that they need. Service users are assisted to make choices and exercise control over how they live. The home provides appetising meals and appropriate choice, and support, to ensure service users receive a good diet. EVIDENCE: The home is well equipped with assisted bathing equipment, mobility aids and hoists. A new call system is in place to ensure more rapid response from staff. Some service user’s told inspectors that they could choose where to spend their time and what they enjoyed doing. One service user stated that they, “preferred their own company” and this was respected by staff. One service user had their own refrigerator, as well as radio, TV and other items of interest in their room. Service users spoke highly of the staff and comments such as, “I get on with them well” were made to the inspector. The staff stated that service users are assisted with recreational pursuits and a monthly social programme is placed in each room. This corresponded with the activity available on the day which was a jewellery “party”. Care staff were also St Georges Nursing Home DS0000018208.V253865.R01.S.doc Version 5.0 Page 12 observed talking to service users about this event and encouraging them to attend. There is evidence of art and craft work in service users rooms and people are pleased with what they have achieved. Other service users said that they were able to go out into the garden or visit local facilities such as shops, when the weather was good, and that staff helped them if they could not go out on their own. The staff confirmed the home maintained links with the church that is adjacent to the home. A number of visitors were seen during the time of the inspection and visitors confirmed that they are welcomed into the home at any time. The meal that was seen was well presented and looked appetising. The dining tables were nicely presented with tablecloths, condiments and napkins. Menus were available and offered a variety of meals and staff said that service users had alternatives to what was on the menu. Service users are asked about their menu choice the night before and senior staff review the sheet to ensure dietary needs are maintained. The inspector saw care staff challenge what was being supplied to one service user and point out that their repeated choice of sandwiches was not ensuring balance in their diet. This is good practice and the inspector saw several other examples of care staff being aware of service user’s needs and acting in their interests. The inspector saw alternatives being provided at lunchtime. The kitchens were clean, well organised and staff were enthusiastic about their role in the home. Service users needing help to eat were assisted appropriately. Service users commented positively on the quality of the food. A frequent visitor to the home also said, “There’s always good food here.” St Georges Nursing Home DS0000018208.V253865.R01.S.doc Version 5.0 Page 13 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): 16 Service users and relatives are able to raise issues with staff and the manager and they are sure that these will be acted upon. EVIDENCE: Relatives and service user confirm that they would be happy to raise issues with staff or the manager if they had concerns. The staff survey results contain comments that are accurate and the company has not selected only praiseworthy comments. St Georges Nursing Home DS0000018208.V253865.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25, 26. The environment is, largely, well maintained to ensure service user’s safety and is clean, hygienic and pleasant to be in. Communal facilities are easily accessible inside and outside of the home. Service users have most of the equipment they require to meet their needs. Bedrooms are safe, comfortable, well-furnished and meet service users needs. EVIDENCE: The new call system ensures staff can reach service users quickly and efficiently in most cases but it is not easily heard in the downstairs sitting room. The home was warm, well ventilated and well decorated. Heating is provided from a safe, low surface-temperature source. No extremes of temperatures were experienced during the inspection. The home has good levels of natural and artificial light. The home has ramped access and appropriate lifts. St Georges Nursing Home DS0000018208.V253865.R01.S.doc Version 5.0 Page 15 There is ample space in communal areas and service users have a variety of lounge, dining and sitting space to choose from. Unfortunately there was no loop system in any area to help service users with hearing problems. The home has a patio area at the rear, although this is not used much in the winter. Although fire precautions were being observed some cupboards did not have self-closure devices fitted and one self-closure on a bedroom door was defective. These devices should be fitted where appropriate and kept in good order. Bedrooms are well furnished and contain personal items belonging to the occupants. The soft furnishings match the décor and the overall effect is homely. A number of service users have been provided with adjustable beds. There are touch-pad switches at wheelchair user’s height. There are adequate numbers of toilet and bathing facilities and these are fitted with appropriate handrails, hoists or other mobility aids. Staff are aware of safety issues and they were discussing modifications to one service user’s en suite toilet in light of their known needs. The inspector saw staff having to lift and carry oxygen cylinders. A suitable trolley should be provided for this, and to ensure the cylinder is secure when it is in use. The home now has suitable disposal facilities in the sluices on each floor and the home is kept clean and tidy in all areas. There were no unpleasant odours in the home at any time. St Georges Nursing Home DS0000018208.V253865.R01.S.doc Version 5.0 Page 16 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 The home usually has an appropriate number of staff, with the right skills, to meet service users needs although there do seem to be problems at certain busy periods. EVIDENCE: Service users told the inspector that they feel secure and are attended to quickly. It was observed that call buzzers were responded to promptly as soon as staff were aware of this The Morning drug round was still taking place at 11am. Some qualified staff felt under pressure to assist care staff but felt this left them under time constraints to carry out nursing tasks such as drug rounds and maintaining accurate records. It did seem that drug rounds were compressed into an 8-10 hour span and this is not good practice, although some time critical drugs were given at other times. The senior management of the company should ensure this potential conflict of interest is resolved. St Georges Nursing Home DS0000018208.V253865.R01.S.doc Version 5.0 Page 17 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): 38 The health and welfare of service users is largely being protected by appropriate management. EVIDENCE: The manager of the home was not present during this inspection and the home was being managed by a registered nurse. This meant that a number of management issues were not addressed during this inspection. The home staff have good morale and are very attentive to service users needs. Staff have good awareness of health and safety issues and this was seen during discussions between staff. Staff were observed lifting and carrying oxygen cylinders. These cylinders were unsupported in service users rooms and there had been incidences of then being knocked over. An appropriate trolley would minimise any hazards posed by these practices. St Georges Nursing Home DS0000018208.V253865.R01.S.doc Version 5.0 Page 18 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 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 x 2 3 3 2 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x x x x 2 St Georges Nursing Home DS0000018208.V253865.R01.S.doc Version 5.0 Page 19 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 OP7 Regulation 4, 7, 8 Requirement Timescale for action 31/01/06 2 OP8OP22 23 3 4 OP9 OP38 13 13, 23 Assessments must ensure that all aspects of the service users’ care needs have been identified and care plans formulated to address those needs. Service users must have access 31/01/06 to suitable aids and adaptations including those that would aid sensory loss. Administration of medicines must 31/01/06 be made at the appropriate times. All fire check doors must close 31/01/06 effectively. 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 Refer to Standard OP27 Good Practice Recommendations It is recommended that the responsibilities of staff are made clear and sufficient time is available to allow qualified staff to maintain accountable practice. St Georges Nursing Home DS0000018208.V253865.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection South of Tyne Area Office Baltic House Port of Tyne Tyne Dock South Shields NE34 9PT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI St Georges Nursing Home DS0000018208.V253865.R01.S.doc Version 5.0 Page 21 - 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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