Inspection on 03/08/05 for St Giles Residential Home

This inspection was carried out on 3rd 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 Giles Residential Home 18/09/06

St Giles Residential Home 10/02/06

St Giles Residential Home 08/09/04

St Giles Residential Home 18/06/04

St Giles Residential Home 25/02/04

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

CARE HOMES FOR OLDER PEOPLE St Giles Residential Home St Giles Mews, Vicarage Road Stony Stratford, Milton Keynes Buckinghamshire MK11 1HT Lead Inspector Caroline Roberts Unannounced 3rd August 2005 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 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 Giles Residential Home Version 1.10 Page 3 SERVICE INFORMATION Name of service St Giles Residential Home Address St Giles Mews, Vicarage Road, Stony Stratford, Milton Keynes, Buckinghamshire, MK11 1HT 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) Category(ies) of registration, with number of places 01908 566077 Milton Keynes Council Mrs Anne Walker Care Home 35 St Giles Residential Home Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th September 2004 Brief Description of the Service: St Giles is a purpose built residential care home for elderly people suffering from dementia, it is run by Milton Keynes Council.. Accommodation is over two floors, the first floor accessed via a shaft lift. All of the bedrooms have washbasins in the room, ensuite facilities are not provided. The home has 3 separate lounge areas, each with its own dining area. A laundry is provided on site. Gardens are well maintained. The home is well situated for access to the local amenities. Public transport links are close by. St Giles Residential Home Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the summary of the unannounced inspection carried out at St Giles on the 3rd August 2005; commencing at 4.20pm the lead inspector was Mrs Caroline Roberts. The inspection consisted of meeting with Residents and staff, viewing records and documents pertaining to the provision of care and the running of the home. The inspector toured the building, gaining permission from a number of residents to enter their bedrooms and viewing a further number from the doorway. The inspector met and discussed the inspection findings with the senior on duty prior to leaving. The inspectors found staff polite, helpful and welcoming, and would like to thank them for their co-operation and assistance throughout the course of the inspection. The inspectors would especially like to thank the residents for their time and for allowing the inspectors into their home. What the service does well: The standard of the environment within this home is good providing residents with a clean, attractive and homely place to live. Permanent residents care plans, which are drawn up on admission, are satisfactory, complete, informative and subject to regular review. The home is equipped with pressure relieving devices and moving and handling equipment, thus enabling staff to meet specific health care needs. Residents have access to a variety of health care services external to the home. Residents appeared well cared for, and the inspector had the opportunity to speak with a relative during the visit that commented that “ “The girls are lovely and kind”, “The manager is very approachable”. Residents are able to choose where they spend their time, and to furnish their bedrooms with personal belongings. St Giles Residential Home Version 1.10 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. St Giles Residential Home Version 1.10 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 Standards Statutory Requirements Identified During the Inspection St Giles Residential Home Version 1.10 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 standard(s) 3 Respite care residents are not appropriately or adequately assessed prior to acceptance for admission, resulting in a failure to identify residents needs which has the potential to place their health and welfare at risk. EVIDENCE: Amongst the documentation looked at during the inspection was that of the respite care residents in the home at the time of the visit. It was noted that pre-admission assessments were not available for these residents. It is acknowledged that these residents use the services of the day centre attatched to the home and as such these clients are known to the staff at St Giles. However, this does not omit the need for an assessment to take place as the needs of anyone coming into a residential situation may be different to those evident while attending a day care provision. It is advised that these pre admission assessments are reviewed prior to every planned stay as needs can change. St Giles Residential Home Version 1.10 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 standard(s) 7,8,9,10 The home has a care planning system in place, however, those care plans viewed were inconsistent in the level of information recorded; therefore residents needs are not clear or up to date and do not enable staff to provide the most appropriate care. The home has developed good working relationships with external health care providers; therefore ensuring residents have access to a variety of health care services. Medication at this home is well managed promoting good health. Further work is needed to ensure that the medication system for respite residents is in line with Pharmaceutical guidelines therefore ensuring the safety of residents. The arrangements for health and personal care ensure that resident’s privacy and dignity are respected. EVIDENCE: Although a comprehensive care plan format has been developed, the respite residents care plans do not identify resident’s specific needs and conditions. St Giles Residential Home Version 1.10 Page 10 All of the respite care plans were viewed and all did not set out in detail the action which needs to be taken by staff to ensure how all aspects of health, personal and social care needs of the residents will be met. Moving and handling assessments were not completed in these care plans. One care plan was viewed for a permanent resident it was pleasing to note that this care plan was fully completed, with appropriate information that reflected the current needs and wishes of that resident. The home accesses the services of the tissue viability nurse, dietician, continence advisor, GP and other specialists as required to meet the specific needs of the residents. Equipment required for the prevention of pressure sores is also available at the home for those residents at risk of developing pressure sores. Policies and procedures for the receipt, recording, storage, handling, administration and disposal of medicines are in place. Only designated staff members administer medication. The medication administration records for one group in the home were viewed, these were found to contain no unexplained gaps or errors. It was noted that one respite resident had a handwritten MAR sheet, staff were unable to provide any evidence of the original prescription, hospital discharge summary or GP letter confirming the medication prescribed details. The manager needs to ensure that if staff are handwriting MAR sheets this is evidenced as correct by one of the above documents. At the time of the inspection, staff were observed to treat residents appropriately and with respect for their privacy, for example, knocking on bedroom doors before entering. Any visiting healthcare professional examines residents in their own rooms. Residents can meet their relatives in private if they wish. The home has a pay phone, which can be used for making/receiving calls in privacy. St Giles Residential Home Version 1.10 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 standard(s) EVIDENCE: This section was not assessed during this inspection. St Giles Residential Home Version 1.10 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: Not assessed during this inspection. St Giles Residential Home Version 1.10 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,26 The home is in need of redecoration and refurbishment in places, this will then enhance the living environment for residents. The standard of the cleanliness within this home is satisfactory providing residents with a clean and attractive place to live. EVIDENCE: The home is located close to a shopping area and is easily accessible by public transport. The home location and layout is suitable for its stated purpose. It is accessible, safe and meets the resident’s individual and collective needs in a comfortable and homely way. A number of bedrooms have been redecorated The manager is aware that a lot of decorating still needs to take place to improve the living conditions in some areas, it was pleasing to note that the refurbishment of the water system had commenced the week prior to the inspection. St Giles Residential Home Version 1.10 Page 14 During a tour of the building the following areas were noted as needing attention. • • • Room 1 door does not close fully onto its stops. Corridor at the top of the stairs requires redecorating, due to old and torn wallpaper. Elm corridor needs redecorating due to old and torn wallpaper. The new furniture that has been purchased has enhanced the living areas for residents. At the time of inspection, the premises were clean, hygienic and largely free from offensive odours. St Giles Residential Home Version 1.10 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 Staffing levels were not sufficient on the day of the inspection and need to be reviewed to ensure that resident’s needs are met. Paperwork relating to recruitment was not available for new staff, therefore it is not possible to make a judgement as to whether residents are supported and protected by the homes recruitment procedure. EVIDENCE: There is a staff rota in the home that provided evidence of the numbers and skill mix of the day staff. No night staff rota was available. During the inspection it was noted that the senior on duty was in the kitchen preparing the tea, 2 agency staff were supplementing the numbers of care staff on duty, a total of 6 staff were on duty during the time of the inspection. It was noted that 5 residents in the front entrance area where needing attention of staff, residents were seen and heard calling out for help and becoming distressed. All of the staff on duty where busy assisting either with tea or individually with residents. Due to the level of frailty and emotional and physical support the residents in this home require, a requirement is being made that the staffing levels are reviewed by the manager and responsible individual, to ensure that there are adequate numbers of staff to meet the needs of residents. A copy of this review with the outcome is to be forwarded to the Aylesbury office of The Commission for Social Care Inspection. Requirements have been made previously in this home that a copy of all recruitment paperwork is maintained in the home as detailed in Schedule 4 (6) St Giles Residential Home Version 1.10 Page 16 The Care Homes Regulations 2001. It was extremely disappointing that recruitment records were not available for new staff in the home. Agency profiles were also not available for the two members of staff on duty in the home at the time of the inspection. The administrator contacted the department within Milton Keynes Council that deal with agency use and requested that these profiles be faxed through. This was done. The manager is reminded of her responsibilities to ensure that any staff working in the home have references and CRB checks in place. St Giles Residential Home Version 1.10 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: Not assessed during this inspection. St Giles Residential Home Version 1.10 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 2 28 x 29 1 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x x x x x St Giles Residential Home Version 1.10 Page 19 x 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. .2 Standard 3 7 Regulation 14.1 15.1 Requirement Pre-admission assessments must be undertaken for all residents prior to admission to the home. Careplans must be in sufficient detail to provide clear guidance to staff on the actions to be taken to meet residents health and welfare needs. Residents care plans must be kept under regular review. Handwritten medication sheets, must be evidenced by a copy of the prescription, hospital discharge sheet of GP letter. The door of bedroom1 must be adjusted to ensure that it closes fully onto its stops. The decorating identified under standard 19 of this report is to be undertaken by 1.11.2005 Copies of paperwork required under Schedule 4.6 The Care Homes Regulations 2001 are to be maintained in the home. The RI and manager are to review the staffing requirements of the home in the light of the inspections findings and report the outcome to the Commission. Timescale for action 15.8.2005 30.8.2005 .3 9 13(2) 30.82005 .4 5 6 19/38 19 29 13(4)(c) 23 17 Schedule 4 18(1)a 15.8.2005 1.11.2005 1.9.2005 7 27 30.9.2005 St Giles Residential Home Version 1.10 Page 20 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 St Giles Residential Home Version 1.10 Page 21 Commission for Social Care Inspection Cambridge House, Smeaton Close 8 Bell Business Park, Aylesbury Buckinghamshire HP19 8JR 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 Giles Residential Home Version 1.10 Page 22 - 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. 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