Inspection on 25/08/05 for St Germans House

This inspection was carried out on 25th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

St Germans House 17/04/07

St Germans House 10/01/06

St Germans House 14/03/05

St Germans House 19/08/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 St Germans House 14 Lynn Road St Germans Kings Lynn PE34 3EU Lead Inspector Jenny Rose Announced 25 August 2005 th 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 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. I55 s27381 stgermanshouse v239062 250805 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service St Germans House Address 14 Lynn Road, St Germans, Kings Lynn, Norfolk, PE34 3EU 01553 617491 01553 617194 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Exceler Healthcare Services Limited Mrs Penny Ann Clare Care Home 9 Category(ies) of Learning disability (9) registration, with number of places I55 s27381 stgermanshouse v239062 250805 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Up to nine (9) Service Users who a learning disability may be accomodated Date of last inspection 14th March 2005 Brief Description of the Service: St. Germans is a care home providing residential care for nine people who have a learning disability. It is owned by Exceler Healthcare Services Limited. The home is located in the village of St. Germans approximately five miles from Kings Lynn. The home is close to the village shop, post office , church and village pub. The home, previously a pub, was converted into a residential home and opened in 1984. The home comprises of the ground floor accommodation of two reception rooms, dinning room, kitchen and office. There is one single bedroom on the ground floor. The first floor has three shared rooms and two further single rooms. St. Germans shares its garden area with Abbotsford another small home for people with learning difficulties, owed by the Proprietors. Staff and service users from both homes freely mix. I55 s27381 stgermanshouse v239062 250805 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection taking place on a weekday over 5 and half hours. There was preparation beforehand in the CSCI Office, a pre-inspection questionnaire and 3 positive comment cards. The Manager, Mrs Penny Clare was in attendance during the inspection. There were 8 service users in residence. Many records were seen, five members of staff were spoken to privately, 7 service users spoken to in a group and one in her room. What the service does well: What has improved since the last inspection? What they could do better: I55 s27381 stgermanshouse v239062 250805 stage 4.doc Version 1.40 Page 6 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. I55 s27381 stgermanshouse v239062 250805 stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR 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) Scoring of Standards Statutory Requirements Identified During the Inspection I55 s27381 stgermanshouse v239062 250805 stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 There is a clear admission procedure, which ensures that individual needs are assessed and recorded to ensure, as far as possible, that the service user and their relatives/representatives know that the home will meet their needs and aspirations. EVIDENCE: There is a clear admission procedure, although there had been no new admissions since the last inspection. The Manager said that any prospective service user would meet with herself and the Regional Manager in the first instance and there was a detailed procedure, which was seen, which would be followed to ascertain the service users’ needs in the first instance. The service user would then visit the home, perhaps for a meal. Following this, there would be an overnight stay, or longer, if appropriate and this would be followed by meetings with staff and the service user group in order to ascertain whether the prospective service user would be accepted within the resident staff group. On admission the service user and/or their relatives or representatives would be supplied with a copy of the Statement of Purpose, Aims and Objectives as well as the Complaints Procedure for the home. This would be reviewed after a month and three months. I55 s27381 stgermanshouse v239062 250805 stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,9,10 The home is to be commended for its comprehensive care plans and risk assessments which ensure that staff support service users in caring for their needs and achieving personal goals. EVIDENCE: Five care plans were seen. They were comprehensive, with photographs of individual service users and providing details of reasons for admission, past medical history and care needs. Personal and social care needs with preferences and dislikes were detailed, together with input from other healthcare professionals where appropriate, life history, individual aspirations and risk assessment management plans. The care plans were signed by the service user and/or their representative where possible. Changing needs were reviewed monthly, again with the service user and/or their representative. There is a key-worker system in place. One service user spoken to described how she was deciding whether to take part in a new activity at the day centre and that she went to church on her own and sometimes went to the shops in the village. She said she had chosen not to use the lock on her bedroom door. I55 s27381 stgermanshouse v239062 250805 stage 4.doc Version 1.40 Page 10 There are weekly meetings with service users who decide on the activities and food. These are minuted and displayed. There had been a collective decision to go out for a fish and chip supper with the mini bus and service user’s reaction to past activities was also recorded. Service users were also given the opportunity to decide on next year’s holiday destinations and gardening and blackberry picking, followed by cooking projects, were also planned. One service user spoken to liked to do cooking, in the house or as part of her day care programme. Within the house there was a risk assessment for this and she was seen helping to prepare the supper. A lockable trolley containing the care plans was seen to be in use following a recommendation for this for confidentiality in the last inspection report. I55 s27381 stgermanshouse v239062 250805 stage 4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,15,16,17 The home gives high priority to service users’ personal development and appropriate activities in and outside the home. Service users are consulted on menus and supported in choosing a healthy diet, in which they partake in pleasant surroundings. EVIDENCE: From speaking to one service user in her room, it was clear that she had many opportunities for personal development and she was anxious to show the certificates she had gained from various training courses in which she had participated and photographs of personal achievements in creative activities. She and other service users participate in a Club and in the local church activities, where it is evident that they are well accepted. Service users are also welcomed in the village shops and the pub. She also described how she keeps in touch with her ‘adoptive’, extended family of several ‘children’ and another who sees his relatives on a regular basis. The local school visits the home at Christmas to sing carols. There is a monthly diary of activities which is displayed in the home and also is flexible according to the circumstances of individual service users. I55 s27381 stgermanshouse v239062 250805 stage 4.doc Version 1.40 Page 12 Family and friends are also welcomed to the home. Service users are able to choose whom they see and can see visitors in private in their own rooms. There was evidence in minutes of service users’ meetings that there were outings, not only as a group, but also individual outings which were in accordance with personal preferences of service users. An example of this is in one service user’s interest in trains and tractors, and he is taken to the local station and also to fields where tractors are at work. There is a pictorial staff rota displayed on the noticeboard in the dining room and it is the responsibility of one of the service users to change this each day. A member of staff commented that she felt the home was run very much as the service users’ home, which was respected by all members of staff. Four service users are to be allocated a designated social worker, at the home’s request and one service user had recently been given the services of an advocate from a voluntary organisation. Service users are supported in choosing a healthy diet and some enjoy participating in the preparation of meals, as well as laying tables. Meals are taken in a pleasant dining room, which has recently been refurbished. Meal times are flexible to meet the individual needs of residents. There are weekly meetings with service users to choose menus. I55 s27381 stgermanshouse v239062 250805 stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, 20 Service users appear to receive personal support in a way acceptable to them. The policies and procedures for the administration of medication and the training of the staff ensure, as far as possible, that service users are protected. EVIDENCE: The service user spoken to who could communicate verbally confirmed that she received support in the way in which she found acceptable. There were good details of sleep patterns and individual preferences for personal care in the care plans. There is good evidence that the service users’ physical and emotional health needs are met and advice sought from other healthcare professionals if necessary. The Community Nurse attends to the catheter of one service user and the psychiatrist is involved currently with another service user. Medication was not observed being administered, but the home uses a monitored dosage system. The MAR sheets were seen, which were appropriately kept with photographs of individual service users. The Manager said that staff who administer medication have been trained to do so and there is a list of staff signatures of those who administer medication. Medication is always administered by a senior carer and one other. I55 s27381 stgermanshouse v239062 250805 stage 4.doc Version 1.40 Page 14 There were no Controlled Drugs in use at the time of the inspection, but there are facilities for the secure keeping and recording of these. The home has a medication policy and the medications are kept in a locked cupboard, which was seen. The Manager also reported that the home has a good relationship with the pharmacy. There were no service users in the home administering their own medication at the time of the inspection. Household remedies are recorded on the back of MAR sheets. The home undertakes a regular medication audit. I55 s27381 stgermanshouse v239062 250805 stage 4.doc Version 1.40 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 There is a clear procedure and simple format for ensuring that service users’ complaints would be listened to and acted upon. The policies and procedures and training of staff in the issues of the Protection of Vulnerable Adults ensures, as far as possible, that service users are protected from such possibilities. EVIDENCE: There is a clear complaints procedure, which is also printed in pictorial form for service users, as was seen in the file of one service user in her room. This service user also confirmed that she understood the complaints procedure, should she have any. There was one old complaint in the complaints book concerning staff and cars, but this had been dealt with satisfactorily. All the staff spoken to were aware of the home’s Whistle Blowing Policy and the issues surrounding the Protection of Vulnerable Adults and there is inhouse training in Adult Abuse, which is repeated yearly. All staff spoken to were aware of the issues and said they would know what to do in the circumstances should they arise. I55 s27381 stgermanshouse v239062 250805 stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,30 The improvements in the interior of the home since the last inspection, carried out in consultation with service users provides a clean, homely, comfortable and safe home for service users. EVIDENCE: The home is comfortably furnished in a homely manner with good quality furniture and there is a health and safety audit carried out annually on the , premises, as well as ongoing attention to maintenance issues, notes of which were seen. There is access to a secure area to the rear of the house, which can be used for outdoor games, sitting and some gardening if service users wish. Since the last inspection, curtains had been fitted in service users’ rooms to obscure the contents of shelves. The hallway had been lightened by redecoration, attractively executed with stencils by a member of staff, in consultation with service users. Tiling had been replaced in the kitchen and this had been commented on positively by one service user, in a comment card received in the CSCI office. There had been new bedroom carpets and laundry equipment. I55 s27381 stgermanshouse v239062 250805 stage 4.doc Version 1.40 Page 17 Service users have also been involved in choosing new crockery for every day use. One service user had chosen her favourite colour for the redecoration of her room and another was in the process of choosing the colour scheme for her room. The Manager said it was intended to change the colours of the doors on the first floor according to service users’ taste. Service users’ rooms seen were comfortable and personalised with personal possessions, TV and music systems. One service user has an interest in trains and had models in his room. Many bedrooms had pleasant views over the river. All staff undergo COSHH training and all the areas seen were clean and hygienic. The staff cleaning rooms at the time of the inspection said that service users often helped them, or chose to be in the room whilst it was being cleaned. I55 s27381 stgermanshouse v239062 250805 stage 4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34, 35, 36 The staff are well supported, trained and supervised which ensures a good quality of life for the service users. EVIDENCE: Five staff were spoken to and their files seen, which contained photographs of individual service users and other necessary information. The recruitment procedures were seen to be in order and a new member of staff had not started work until the necessary police checks had been carried out. She was also aware of the Whistle Blowing Policy in the home and had signed to say that she had read this. She was also aware of the issues of confidentiality. All members of staff spoken to were enthusiastic about working in the home. One said: “I love every minute of this work. The team work is brilliant”. She said they have one to one supervision and staff meetings every other month. Another member of staff reported that “It is a happy home and I enjoy it. We have a good team of people.” She also reported that she is very satisfied with the opportunities for training offered by the home and she was about to embark on her NVQlll. I55 s27381 stgermanshouse v239062 250805 stage 4.doc Version 1.40 Page 19 The Senior Support Worker responsible for training said that she was awaiting her NVQlll verification and together with the Manager they have devised many in-house training sessions for staff and there are also company-wide training packs for various issues. She had also undertaken the company Home Trainer’s Course. She was about to undergo training in year- long course in Team Building supported by a local agency. All members of staff undertake training in issues surrounding the Protection of Vulnerable Adults every 12 months. Fire training takes place every 6 months and every 3 months for night workers. There is also training in health care issues, such as epilepsy and dementia. A member of staff who had been off for some weeks on sick leave said that she was well looked after by management and had a risk assessment for returning to work. She gave a good account of her awareness of the issues of Adult Abuse and the procedure for reporting any such incidents. I55 s27381 stgermanshouse v239062 250805 stage 4.doc Version 1.40 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39, 42 The home’s management style is open and inclusive and it is run, as far as it is possible, in the service users’ interests, promoting their health, safety and welfare. EVIDENCE: Staff reported that they find the management in the home open and inclusive and that they are able to raise any issues of concern. As stated elsewhere in the report, service users are involved in many decisions in the daily life of the home, with decisions for their individual personal development, as well as their own preferences for their personal care and these underpin the policies and procedures within the home. There is a comprehensive, quality audit for all homes in the company, which was seen. This covers such issues as medication and health and safety audits. A Minute was also seen dated 16 June 2005 concerning the company’s I55 s27381 stgermanshouse v239062 250805 stage 4.doc Version 1.40 Page 21 intention to investigate entering all the homes in the company with the Investors in People Award. The regular meetings with staff and service users and the good recording thereof ensure that the home, as far as is possible, is run in the service users’ interest. The Health and Safety Meeting Records were seen dated 22 August 2005. These meetings take place every 4 months, covering such items as door closers, maintenance and safety issues, such as latches on the gates to the garden and car access. I55 s27381 stgermanshouse v239062 250805 stage 4.doc Version 1.40 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 3 x 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x x x x 3 Standard No 11 12 13 14 15 16 17 3 4 3 x 3 3 4 Standard No 31 32 33 34 35 36 Score x x x 3 4 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 x I55 s27381 stgermanshouse v239062 250805 stage 4.doc Version 1.40 Page 23 N/A 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 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. Refer to Standard Good Practice Recommendations I55 s27381 stgermanshouse v239062 250805 stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection 3rd Floor, Cavell House St Crispins Road Norwich NR3 3BN 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. 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