Inspection on 19/02/09 for St Georges Residential Care Home

This inspection was carried out on 19th February 2009.

CSCI found this care home to be providing an Excellent service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

St Georges Residential Care Home 19/02/07

Similar services:

Hillside

Applegarth

Trevayler Residential Care Home

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: St Georges Residential Care Home 100 St Georges Avenue Northampton Northamptonshire NN2 6JF     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Ann Wiseman     Date: 1 9 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: St Georges Residential Care Home 100 St Georges Avenue Northampton Northamptonshire NN2 6JF 01604713269 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Compass Care Name of registered manager (if applicable) Janet Elizabeth Hollman Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: No person falling within category MD maybe admitted into St Georges Residential Care Home unless that person falls within category LD ie dual disability. No person to be admitted into St Georges Residential Care Home in categories LD or MD when 5 persons in total of these categories/combined categories are already accommodated in this home. Date of last inspection Brief description of the care home This home is located in a detached house in a popular residential area in Northampton. The property is pleasantly decorated throughout and peoples rooms are personalised with belongings. The home can accommodate up to five people with a learning disability and associated mental health issues. They have easy access to a range of local facilities such as parks, pubs and shops. Care Homes for Adults (18-65 years) Page 4 of 27 care home 5 Over 65 0 0 5 5 Brief description of the care home Fees are typically £1800 to £2200 per week - this information was provided on the day of the inspection. There are costs for personal extras - hairdressing, toiletries, etc. Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced inspection; we arrived at 8.30am in the morning and left soon after 2pm. The manager was on duty when we arrived and facilitated the inspection, which she did in an open and helpful manner. Whatever files and documents we asked to see were quickly produced and were well ordered. During the day we had a look around the home and talked to the staff on duty and some of the people who live in the home. We looked at information belonging to two people and the personnel information of two of the staff. We also assessed some of the homes policies and procedures and sampled a random selection of the health and safety files and records. Care Homes for Adults (18-65 years) Page 6 of 27 Before the inspection the manager has sent us the Annual Quality Assurance Assessment (AQAA) she had completed. The AQAA is a self-assessment that focuses on how well outcomes are being met for people living in the home. It also gave us some numerical information about the service. The AQAA was sent to us within our set timescales and showed that the home recognised areas that need further improvement. Prior to the inspection we sent surveys to the home for distribution amongst the people there, their relatives and the staff. Seven surveys were returned and all of them said positive things about the home. The house was clean and tidy, interaction between the staff and the people there was observed to be friendly and open. When talking about the people staff did so in a supportive and respectful manner and notes were also written appropriately. The program of redecoration and maintenance is ongoing and the house is well maintained. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People thinking of moving into this home are offered enough information to enable them to make an informed choice about the home and everyones needs are assessed before they move in and they are given an opportunity to visit the home first. Evidence: The homes statement of purpose is available in a clear and comprehensive format. People are provided with a contract that sets out the terms and conditions of the placement. We examined two peoples files during this inspection and they contained comprehensive assessments carried out by their care manager and another done by the service to ensure that the home can meet their needs and that care offered is fully appropriate. Contracts are given to people and are signed by them or their representative. Assessments are also carried out by a consultant regarding developing strategies to manage peoples challenging behaviours. Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: The manager told us that people thinking of moving in are given the opportunity to visit the home before they make a decision and there will be a review before the placement is made permanent. There is a Company policy and procedure regarding how to properly admit people into the home. Care Homes for Adults (18-65 years) Page 11 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in this home have care plans and are assisted to make decisions about their life and are consulted about the way they want to live. People are enabled, through risk assessments, to take some risks as part of an independent lifestyle. Staff are trained to respect confidences and to handle personal information in a way that will maintain confidentiality. Evidence: The files and care plans of two people were examined, they were very detailed and reflected the needs and aspirations of the person involved. They have been updated since the last Inspection and have been reviewed at regular intervals. There has been a change of manager since the last inspection and she has changed the ethos of the home to better support and encourage people to become more independent and to make decisions for themselves. People are now able to decide when to go to bed and are free to watch the television as they wish. Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: House meetings are held where everyone gets a chance to voice their feelings and make requests. People are asked their views on important issues in the meetings and these are recorded, the topics involved food, holidays and outings etc. The files contained a range of risk assessments, which addressed activities chosen by people that may present risks to their safety, these included safety in the community. Other risk assessments identified aspects of each persons care needs that resulted in increased vulnerability. This is good practise. The company has a consultant who, when requested by the home, will help them to develop behaviour management plans. He is able to respond quickly and has helped the home to support people who have highly challenging behaviours. Induction training includes the importance of keeping confidences. When not in use private information is stored in a locked cupboard in the office and is not left lying around in communal areas. Care Homes for Adults (18-65 years) Page 13 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to advance personal development by attending adult education classes. A full range of activities is offered in and out of the house that makes people a part of the local community. Friends and family are welcomed in the home and peoples rights and responsibilities are recognized and upheld. Food offered is varied and served in pleasant surroundings. Evidence: We spoke with two people who said they were happy living in the home and with what they do with their leisure time, another three people returned our survey and they also said they were able to get out and about. Records showed that they take part in leisure activities such as the Gateway club, going to pub, the cinema, play golf, listening to music and eating out. There was also evidence that people attend colleges to further their personal development. Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: House meeting notes showed that they have been consulted on holidays, activities and that trips are planned for the future. Staff said that residents use a range of community facilities including local shops, pubs, the park and use the local post office to get their money as well as attending specific support groups. People said they could invite visitors to the home and that there were no restrictions on visiting times. The service has a policy on intimate relationships, which respects the ability of people to have consensual relationships. People are helped to keep their rooms clean and tidy by the staff. They are also asked to make suggestions for the menu, which is varied and offers a balanced diet. The food cupboards, freezers and fridge were well stocked with fresh, tinned and frozen food as well as snacks and treats. The dinning table is in the lounge, which is a large attractive room and a pleasant area to enjoy a meal. Care Homes for Adults (18-65 years) Page 15 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This home records peoples personal care needs in a way that enables them to be supported in the way they want to be. People have access to doctors and specialist care and medication is managed properly. Evidence: We looked at two care plans and found that, peoples support needs were recorded and they were written in a way that reflected peoples personal preferences. The care plans were reviewed regularly enough to give people an opportunity to change their minds about how they want to receive personal care. We found evidence, in the files we examined, that people have access to medical practitioners as and when they need to, they also get support from specialists such as speech and language therapy, psychology, psychiatric, dentists and opticians. We examined the medication and its records and found that they were as required. We were told that the pharmacist trained all staff that deal with medication, and the manager said that she assesses staff competence before allowing them to dispense Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: medication. The home has a policy and procedure for the safe administration of medications, which staff can refer to. We chose a box of tablets at random that had not been blistered by the pharmacist and checked the total against the recorded number of tablets. There was one pill less in the box than should have been, but when we checked the records there was an explanation why there was a tablet missing and also showed that arrangements had been made to replace it. Care Homes for Adults (18-65 years) Page 17 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaint policies and procedures are in place and complaints are properly recorded. People are protected from abuse by staff being properly trained in safeguarding and managing challenging behaviour. Evidence: The home has complaint and safeguarding policies and the complaints procedure is displayed throughout the home. Complaints and concerns are recorded in a way that makes it possible to follow them from start to finish easily. Residents said that if they were worried about anything they would speak to staff or the manager and they generally thought it would be followed up. We havent received any complaints regarding the service since the last inspection and when we examined the complaints procedure we found it reflected the national minimum standard. In a survey returned to us, a relative of someone living in the home raised a concern about how the complaints procedure was reflected in the homes user guide. They dont think it makes clear how a complaint could be made without involving the manager if necessary. We raised this concern with the manager and she explained that this oversight had already been bought to their attention and changes have been made to the user guide. Care Homes for Adults (18-65 years) Page 18 of 27 Evidence: There are residents meetings held where all residents are invited to attend and share their views about the home. A record of these meetings is kept for reference. Staff members on duty were asked about their understanding of whistle blowing procedures and both demonstrated a generally good understanding of the protection of people from abuse and they confirmed that they had received safeguarding training. The home uses a consultant to help draw up management guidelines for people with challenging behaviour. Care Homes for Adults (18-65 years) Page 19 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This home is safe, comfortable, clean and hygienic. Bedrooms suit peoples needs and lifestyle and there are sufficient bathrooms and toilets. Evidence: The home is in an attractive building; it is homely, well decorated and safe. The home has a maintenance person who manages simple repairs and keeps the home well maintained. There is a garden and the house overlooks a park where local functions and activities are held. One person likes to ride their bike in the park and others like to use the football pitch. Two people invited us to have a look at their rooms and told us that they liked them and were happy with how they were furnished. The rooms were individual to each person and were clean and tidy. The communal rooms are spacious and furnished in a contemporary manner. New flooring has been laid in some areas in the home. There are sufficient bathrooms and toilets to meet peoples needs and some have been fitted with equipment and aids to maximise independence. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are aware of their roles and responsibilities. The home has recruitment policies and procedures in place that are being followed. Training is in place and staff are receiving supervision. However more work needs to be done to achieve the minimum required ratio of staff being qualified. Evidence: Staff personnel files are in the home and we examined two of them, which we found to contain all the required information. This shows that safeguarding procedures are carried out prior to people being employed at the home. The files also contained job descriptions, evidence of staff training and of their qualifications. We are told in the AQAA that the home has a training plan, which is revised every year to meet the assessed training needs of the staff and we were shown the training matrix. We spoke to two staff members on this occasion. They confirmed that they undertook CRB checks and had two references taken before they started work. They also told us that they had an induction and received the mandatory training as well as some that are more relevant to the client group, such as mental capacity act training, mental health care and care planning. Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: While talking to us they displayed a good knowledge of the people in the home and understood their needs. However information given to us in the AQAA indicates that the home has not met the minimum requirement of 50 of it’s staff having attained an NVQ 2 in care or it’s equivalent. There are sixteen staff and only five of them have the qualification. It will be required that all staff should be supported to undertake an NVQ in care qualification. Levels of staffing at the time of the inspection was adequate to offer the five people individual uninterrupted time, continuity of care and to be able to manage emergency situations. There were four people on duty, although some of the people need 3 to 1 support to access the community and this needs to be taken into consideration when arranging outings. Staff reported that they receive regular supervision and appraisal, we saw the supervision notes on file that confirmed this. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This home is well run and the ethos of its management is empowering to the people living in it and their views underpin its running. The policies and procedures and the record keeping protect people’s rights and best interests. Health and safety is promoted and necessary checks are made and records kept. Evidence: The manager was at the home when we arrived and she facilitated the inspection, which she did in an open and helpful way and was able to produce everything we asked for quickly. She proved knowledgeable about the running of the home and the people living in it, she was organised and comments we received indicated that she is well liked by the people living in the home and the staff. A relative who returned the survey to us said, They have provided an ideal person as the house manager. She has the qualifications and personal attributes to give our relative the quality of care they need. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: The home sends annual surveys to staff, people in the home and their relatives. Once they are returned the information is collated and action is taken when shortcomings are highlighted. A report is produced and a copy is sent out to interested parties. House meeting are held where people are encouraged to speak their mind about how the home is run and how it can be improved. Records are kept of these meetings and we were able to see them. The organisation’s polices and procedures are comprehensive and are reviewed and updated as legislation dictates. Records are kept up to date and are stored appropriately. Personal details are stored in a locked cupboard in the office and are not left unattended, staff are asked to read and sign the organisations policy on confidentiality when taking up their post. A sample of health and safety records were inspected and were found to be in order. A fire risk assessment has been carried out and the fire points are tested weekly and fire equipment is tested annually. Fridge and freezer temperatures are taken and recorded daily. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 32 18 Steps must be taken to 25/06/2009 ensure that the home meets the minimum requirement of the home having at least 50 of its staff having attained an NVQ 2 in care or it’s equivalent. It is important that staff have the competencies and qualities required to meet the needs of the people they are caring for and they can evidence that this by attaining qualifications in care. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!