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Inspection on 26/10/06 for St Georges Nursing Home

Also see our care home review for St Georges Nursing Home for more information

This inspection was carried out on 26th October 2006.

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.

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

The home provides good information for service user`s wishing to come to the home including realistic comments from existing service users. Service users have access to appropriate health care. Service users feel they are well cared for by friendly staff and a good manager. The home has good contacts with the community and encourages visiting. The home is well decorated and well maintained, with a good level of equipment. The home provides good quality meals in pleasant surroundings.

What has improved since the last inspection?

The moral of staff has improved and there seems to be a better sense of teamwork within the staff group. The home has improved their fire precautions and provided a safer environment for all in the home. The home is installing new carpeting in corridors and communal areas. An effective induction loop system has been installed for service users with hearing problems.

What the care home could do better:

The manager needs to have extra hours of registered nurse time to enable her to carry out her managerial and administrative tasks.

CARE HOMES FOR OLDER PEOPLE St Georges Nursing Home 13 Vigo Lane Harraton Washington Tyne & Wear NE38 9AH Lead Inspector Mr Tom Moody Key Unannounced Inspection 26th October 2006 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 Nursing Home DS0000018208.V309216.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 Nursing Home DS0000018208.V309216.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Georges Nursing Home Address 13 Vigo Lane Harraton Washington Tyne & Wear NE38 9AH 0191 4191878 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 Mrs Hazel Khan 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 (1), Physical disability over 65 years of age (3), Sensory Impairment over 65 years of age (1) St Georges Nursing Home DS0000018208.V309216.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The PD service user category relates to one current service user only. That the PD place be for the named service user under 65 only. 22nd November 2005 Date of last inspection 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.V309216.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day on 26 October 2006. One inspector carried out the inspection. The manager was 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? The moral of staff has improved and there seems to be a better sense of teamwork within the staff group. The home has improved their fire precautions and provided a safer environment for all in the home. The home is installing new carpeting in corridors and communal areas. St Georges Nursing Home DS0000018208.V309216.R01.S.doc Version 5.2 Page 6 An effective induction loop system has been installed for service users with hearing problems. 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.V309216.R01.S.doc Version 5.2 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.V309216.R01.S.doc Version 5.2 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): 1, 2, 3, 4, 5, The quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. Service users and their relatives can visit the home and they are given accurate information on which to make their choices. Service users needs are assessed accurately to ensure they receive appropriate care. EVIDENCE: The home provides a variety of information to prospective service users and their families. A copy of the homes service user guide is in service user’s rooms. 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. The manger said that the assessment of service users needs is carried out by placing authorities and this was confirmed by documents in service users care plans. Care plans contain an accurate assessment of service users needs before they are St Georges Nursing Home DS0000018208.V309216.R01.S.doc Version 5.2 Page 9 admitted to the home and that there needs are matched to the homes ability to deliver the service. The Manager and staff confirm that visitors are welcome and relatives usually visit the home and others to make comparisons. St Georges Nursing Home DS0000018208.V309216.R01.S.doc Version 5.2 Page 10 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, 10. The quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. The care plans are well written and contain all the information necessary to ensure service user’s needs are met. Equipment is appropriate to fully meet service user’s needs. The home has appropriate policies, storage and practice to ensure service users receive their medication in an appropriate way. Service users are treated with respect by staff and, practice and procedures in the home ensure their privacy. St Georges Nursing Home DS0000018208.V309216.R01.S.doc Version 5.2 Page 11 EVIDENCE: Care plans for selected service users were examined. They are well written and contain all the information necessary to ensure service user’s needs are met. This includes nutritional assessments, pressure damage risk and moving and handling. It is evident from records that clinical specialists, such as tissue viability nurses and speech and language therapists, are involved in servcie users care. There is also evidence of hospital appointments, as well as dental and optician appointments The home has appropriate policies, storage and practice to ensure service users receive their medication in an appropriate way. Observation of the administration and storage indicated this was generally good and in line with policies. The Medicine Administrations Records for case tracked individuals was accurate and well kept and the timing of medication rounds was appropriate. Service users confirmed they felt well cared for and comments such as , we are well cared for here were typical of those made to the inspector. St Georges Nursing Home DS0000018208.V309216.R01.S.doc Version 5.2 Page 12 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 quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. Service users are offered the opportunity of participating in a range of leisure and social activities, within and outside of the home.Service users can make choices and are generally encouraged to take a degree of control over their surroundings. Service users are offered and receive a varied, wholesome, nutritious and wellpresented menu. This contributes to their health and wellbeing and offers opportunities to make choices. EVIDENCE: Service user and relative comment cards express positive opinions about the home. The Providers self-assessment indicates the home employs an activities co-ordinator. It also indicates a wide variety of social and recreational events are planned within the home and in the surrounding community. One service user said that , “It’s not bad for entertainment.” He inspector spoke to a lay preacher, who spoke of supporting service users and staff , and who obviously had a warm relationship with the home. St Georges Nursing Home DS0000018208.V309216.R01.S.doc Version 5.2 Page 13 There were also posters advertising the services of a visiting coplimantary therapist. The manager confirmed this person was qualified and provided therapies such as hand massage. A visiting hairdresser was in the home during the time of the inspection. She confirmed that she “enjoyed visiting the home because the staff and service users were so friendly.” The menus supplied by the home indicate a choice of midday meals are available, usually two hot choices and a salad. the evening meal is also usually a hot meal on most nights of the week. The meal that was seen was appetising and well presented. Staff were observed to support service users in a sympathetic and appropriate way during mealtimes. All service users who were spoken to were happy with the food available to them. Comments such as “I thoroughly enjoyed my meal” and “The food is always good here” were typical of those made to the inspector. St Georges Nursing Home DS0000018208.V309216.R01.S.doc Version 5.2 Page 14 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, 18. The quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. Complaints in the home are handled objectively and openly with the manager and staff encouraging service users, their friends and families to offer comment on the services that are offered. Service users are confident that any complaints made would be acted upon. EVIDENCE: Service user and relative comment cards express positive opinions about the homes performance in this area. Past reports have confirmed that Relatives and service user said they would be happy to raise issues with staff or the manager if they had concerns. Providers self assessmet records 11 minor complaints in the year which is not excessive. Relatives and service users that were spoken to told the inspector that they would be happy to raise issues with staff or the manager if they had concerns. One service user stated that, “ If I had any problems the staff would sort them out.” The staff also made positive comments on how the manager would ensure things are done properly There are good records kept of complaints or concerns expressed about the service. This includes the outcomes of any of these incidents. St Georges Nursing Home DS0000018208.V309216.R01.S.doc Version 5.2 Page 15 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 The quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. The environment is generally well maintained and provides for the service user’s safety and comfort. Communal facilities are easily accessible inside and outside of the home. Service users have the equipment they need to meet their needs and the home is clean hygienic, and pleasant to be in. EVIDENCE: 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 is well ventilated and there were no unpleasant odours in any part of the home. The home has level access and appropriate lifts. St Georges Nursing Home DS0000018208.V309216.R01.S.doc Version 5.2 Page 16 Electronic holdfasts have been fitted to all doors and the staff and manager have a good awareness of fire precautions. There is ample space in communal areas and service users have a variety of lounge, dining and sitting space to choose from. new carpetting was being fitted in some of these areas on the day of the site visit. A loop system has now been installed and is working well. Bedrooms are well furnished and contain personal items belonging to the occupants. The soft furnishings match the décor and the overall effect is well co-ordinated and homely. There are suitable aids and adaptations in the home including specially adapted cutlery for service users with grip problems. The home has suitable disposal facilities in the sluices on each floor and the home is kept clean and tidy in all areas. The garden and grounds are compact, but accessible, and there is a sheltered pation at the back of the home that can be used in good weather. St Georges Nursing Home DS0000018208.V309216.R01.S.doc Version 5.2 Page 17 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, 29, 30 The quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. The home generally has an appropriate number of staff, with the right skills, to meet service users needs, although additional nursing hours are needed. Staff receive appropriate training and they are able to carry out their work in an appropriate manner. EVIDENCE: Service user and relative comment cards express generall positive opinions about the homes parformance in this area but they indicate there may be occasions when staff are hard pressed. The number of staff in the home of the day of the inspection was appropriate and the care needs of service users were being met. Duty rotas that were seen were satisfactory and reflected the staff that were on duty. The manager stated she has ajusted the rotas to ensure more staff are available at busy times. Call buzzers were responded to promptly by staff and staff had time to carry out support tasks in a sensitive manner. Staff induction training and a high number have completed NVQ 2 or higher qualifications. Staff confirmed that, There are always training courses, to atend. a number of staff were wearing badges confirming their NVQ status and they expressed pride and pleasure in there achievments. The manager was hard pressed to cope with management and administrative demands and at the same time complete clinical tasks. It was observed that St Georges Nursing Home DS0000018208.V309216.R01.S.doc Version 5.2 Page 18 some of this pressure included advice to senior managers on Continuing Care issues. The nurse in charge of the home should be supported by additional nursing hours to ensure service users can recieve nursing attention and that management tasks can be carried out. St Georges Nursing Home DS0000018208.V309216.R01.S.doc Version 5.2 Page 19 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, 32, 33, 36, 37, 38 The quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. The home is run by an experienced and competent manager who’s leadership and approach is benefiting service users. The health, safety and welfare of service users is generally being protected by efficient management. EVIDENCE: Service user and relative comment cards express positive opinions about the homes performance in this area. The previous reort indicated that the home was well managed apart from some minor heath and safety problems. The manager is an experienced clinician who has managed this care home for some time. She is supported by a company that have good policies and procedures, although additional nurse hours are needed to ensure management and clinical tasks can be completed. St Georges Nursing Home DS0000018208.V309216.R01.S.doc Version 5.2 Page 20 The manager has a good awareness of health and safety and the inspector witnessed her taking the appropriate action when a defective fire door was reported by staff. There is good morale in the staff team. The manager stated that the home works as a cohesive team and she adopts a practical approach involving a high level of contact with service users, relatives and staff. The home produces a newsletter . The home have a quality assurance system. The majority of comments from the last survey were positive, and the manager is awaiting the analysis of the latest survey. Regular supervision is carried out and the schedule for this was seen. Staff also have an annual appraisal. A variety of records were available for inspection and were well kept. Staff confirm the manager is approachable and comments from most staff indicate an attitude of mutual respect is present. One said that the manager would not acept anything less than perfection, in relation to care practice. St Georges Nursing Home DS0000018208.V309216.R01.S.doc Version 5.2 Page 21 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 3 3 3 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x x 3 3 3 St Georges Nursing Home DS0000018208.V309216.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? 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 OP27 Regulation 18 (1) (a) Timescale for action Sufficient registered nurse, hours 31/12/06 must be available to allow qualified staff to maintain accountable practice and manage the home. Requirement RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations St Georges Nursing Home DS0000018208.V309216.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection South Shields Area Office Baltic House Port of Tyne Tyne Dock South Shields Tyne & Wear 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.V309216.R01.S.doc Version 5.2 Page 24 - 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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