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Inspection on 14/02/07 for St Helens Care Home

Also see our care home review for St Helens Care Home for more information

This inspection was carried out on 14th February 2007.

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

People had their needs assessed before making a decision to move into the home. People had their health and personal care needs met in a planned way. One person said, "The care and support cannot be faulted. The staff commit themselves wholeheartedly." People`s lifestyle met their needs and expectations. People said they had things to do, activities were organised and food was said to be good. "Meals provided are of good quality and the menu is varied." There were enough well trained staff to look after people. "Whenever there is a problem the staff are on hand." People could be assured their complaints and concerns would be dealt with and that procedures were in place to protect them from abuse. The home was clean and tidy. People liked their rooms and said the home was warm enough for them. The home was managed in the interests of the people who lived there.

What has improved since the last inspection?

The home had employed a person to organise activities for people. Several areas had been redecorated so the home was nicer for people.

What the care home could do better:

Some people did not have copies of contracts or terms and conditions so it wasn`t clear they had all the information they needed before making a choice to move in. The home needed to confirm in writing they could meet people`s needs, before they moved in. Improvement to the detail in care plans would ensure consistency of care at all times. Care plans needed clear risk management plans for bed rails and moving and handling. Some doors were wedged open and needed to have special guards fitted which would close them in the event of a fire. The home did not have a safety certificate to confirm the electrical and gas installations were safe and needed to have these checked at regular intervals as recommended.

CARE HOMES FOR OLDER PEOPLE St Helens Care Home 6 Manor Road St Helens Auckland Bishop Auckland Durham DL14 9DL Lead Inspector John Trainor Unannounced Inspection 14th February 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address St Helens Care Home DS0000000749.V328181.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 Helens Care Home DS0000000749.V328181.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Helens Care Home Address 6 Manor Road St Helens Auckland Bishop Auckland Durham DL14 9DL 01388 606093 01388 607962 sthelens@activecarepartnerships.co.uk www.schealthcare.co.uk Southern Cross Healthcare Services Limited 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) Mrs Beverley Denise Grimes Care Home 48 Category(ies) of Past or present alcohol dependence (5), registration, with number Dementia (6), Dementia - over 65 years of age of places (29), Mental disorder, excluding learning disability or dementia (19), Physical disability (4) St Helens Care Home DS0000000749.V328181.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th October 2005 Brief Description of the Service: St Helens is a forty-eight bedded home that provides 24hr care for people with mental health needs mainly dementia. The home is situated in St Helen’s West Auckland near Bishop Auckland. The accommodation is purpose built for the needs of the service users. The home consists of two units, upstairs is nursing and residential for older people with mental health needs and downstairs the Auckland and Barnard units provides nursing input for nineteen younger people with enduring mental health problems. Fees at the time of inspection were £398.50 to £870.00. St Helens Care Home DS0000000749.V328181.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection involved the home providing information to the Commission for Social Care Inspection, before a site visit, which was unannounced and lasted 7.5 hours. During this visit records were inspected including care plans and health and safety records. Care practices were observed. People were spoken to including people resident, staff and management. There was a tour of the building. What the service does well: What has improved since the last inspection? What they could do better: Some people did not have copies of contracts or terms and conditions so it wasn’t clear they had all the information they needed before making a choice to move in. The home needed to confirm in writing they could meet people’s needs, before they moved in. Improvement to the detail in care plans would ensure consistency of care at all times. Care plans needed clear risk management plans for bed rails and moving and handling. Some doors were wedged open and needed to have special guards fitted which would close them in the event of a fire. The home did not have a safety certificate to confirm the electrical and gas installations were safe and needed to have these checked at regular intervals as recommended. St Helens Care Home DS0000000749.V328181.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. St Helens Care Home DS0000000749.V328181.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 Helens Care Home DS0000000749.V328181.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 and 6. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People had their needs assessed before making a decision to move into the home but did not have enough detailed information to make a fully informed choice before they moved in. EVIDENCE: There was a statement of purpose and service user guide with information on the home. Commission for Social Care Inspection reports were available at the entrance to the home and were copied into the service user guide. All files inspected had evidence of pre admission assessment in the form of a pre admission, initial care plan. The home had a contract and terms and conditions but people suggested they did not get copies and there were none evidenced in care files. St Helens Care Home DS0000000749.V328181.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People had their health and personal care needs met in a planned way but improvement to the detail in care plans was needed to ensure consistency of care at all times. EVIDENCE: All files inspected had care plans on them with assessment and planning for health needs. People were seen to be treated with dignity and respect by the staff on duty. There was evidence in files of access to the doctor, district nurse, psychology, dietician and secondary psychiatric services. Medication was stored, administered and recorded safely. The manager did a monthly audit of the medication. One person nursed in bed with bed rails did not have a risk assessment in the care plan for the use of bed rails. Some care plans lacked task specific detail telling staff what to do and how to do it. One file showed significant weight loss and the care plan instructed to weigh weekly. No weights were recorded for St Helens Care Home DS0000000749.V328181.R01.S.doc Version 5.2 Page 10 some time and in fact the person could not be weighed due to their condition. The home had failed to find an alternative method of monitoring despite the identified need. Another care plan where the person was nursed in bed with rails had a risk assessment. In this case weight was being recorded according to the plan. Some moving and handling plans did not include the detail of how to move people with equipment to be used. This suggested care plans needed to be more consistent and needed task specific detail to describe exactly what to do and how to do it. St Helens Care Home DS0000000749.V328181.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s lifestyle met their needs and expectations. EVIDENCE: Files had activity plans on them. There was an activity programme for the home detailing when activities took place. On the day of inspection staff were playing dominoes with a small group of people. There was an activity coordinator employed but on leave the day of inspection. The home had smoking areas for those who wanted to smoke. There was aromatherapy hand massage available for a small donation which went into the activity fund. One man spoke highly of the gardening group and was looking forward to getting outside now spring was on the way. There was not a choice of meal on the day of inspection everyone had shepherds pie. There was a reason for this due to unavoidable staffing problems on that day. Menus normally had a selection so people could make a choice. One man said the food was “alright.” Most people when asked liked the food. Family and friends could visit when they wished and had good reports of the home. St Helens Care Home DS0000000749.V328181.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People could be assured their complaints and concerns would be dealt with and that procedures were in place to protect them from abuse. EVIDENCE: The home had an adult abuse policy and a policy on whistleblowing. Staff were trained in adult abuse except for those recently employed and training was planned. There was a complaints procedure and a recent complaint was being investigated within this process. The manager was not routinely recording concerns if she was able to deal with them. This did not follow the instruction in the procedure. It was pointed out and the manager planned to implement the procedure correctly in future. The complaints procedure was available in the service user guide and at the entrance to the home. All people had access to it. St Helens Care Home DS0000000749.V328181.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People lived in a clean and hygienic environment. EVIDENCE: Communal areas, corridors and rooms were clean and tidy. Liquid soap and paper towels were available in all areas to promote good practice in infection control. The sluice was dirty and needed cleaning. One radiator in the bathroom on the MH unit needed the cover repairing. People said the home was warm enough and they were comfortable. St Helens Care Home DS0000000749.V328181.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People were looked after by a well trained staff team, deployed in sufficient number to meet their needs. EVIDENCE: Staff were deployed in sufficient number and with sufficient skill to meet the needs of the people resident. “Whenever there is a problem the staff are on hand.” Staffing levels exceeded residential forum guidance levels and met the previous regulatory authority guidance. 83 of staff were trained to NVQ 2 or above. St Helens Care Home DS0000000749.V328181.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home was managed in the interests of the people who lived there, though health and safety matters were not managed in a consistent way. EVIDENCE: The manager was a qualified nurse and had the Registered Managers Award. Service user monies had been recently audited by the local authority and found to be acceptable. COSHH products were stored safely. The home had public liability insurance. Fire safety training was happening but frequency of refreshers needed to be increased to 6 monthly for day staff and 3 monthly for night staff. The home had a video to facilitate this. Some doors needed door guards fitted which could prop the door open safely but would close in the St Helens Care Home DS0000000749.V328181.R01.S.doc Version 5.2 Page 16 event of the fire alarm going off. This had been identified by the company’s own health and safety audit and these were planned. These guards must be fitted to avoid people inappropriately wedging doors open. In particular the lounge in the EMI unit upstairs needed a door guard. There was a clear refurbishment and repair plan and six weekly health and safety meetings to identify any problems in the home. There were not sufficient staff trained to ensure a person qualified in first-aid was deployed on each shift. Electrical hard wiring and gas safety certificates were not available for inspection in the home. The ones held were out of date. Certificates were needed to demonstrate the installations were safe and checked at regular intervals as recommended. The homes health and safety procedures including audit of records and meetings had missed these matters. St Helens Care Home DS0000000749.V328181.R01.S.doc Version 5.2 Page 17 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 2 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 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 X X X X X X 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 X 3 X 3 X X 2 St Helens Care Home DS0000000749.V328181.R01.S.doc Version 5.2 Page 18 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP1 Regulation 5(1(bd)), 6 Requirement The registered provider must revise the service user guide to make explicit any difference in fee between people paying for their own care and people whose care is funded, in whole or in part, by a person other than the service user. And shall notify the Commission for Social Care Inspection and service users of the revision when completed. The registered provider must provide people with a contract or statement of terms and conditions. They must also review and revise contracts and terms and conditions to make sure they are fair and give sufficient detail about peoples’ rights. The registered provider must confirm in writing that it is able to meet the health and welfare needs of a person, following assessment and before they move into the home. Timescale for action 30/04/07 2 OP2 5 14/02/07 3 OP2 14(1(d)) 14/02/07 St Helens Care Home DS0000000749.V328181.R01.S.doc Version 5.2 Page 19 4 OP7 13(4(c)) 5 OP19 23(4)) 6 7 OP38 OP38 18(1(a)) 13(4(a) Bed rails must not be used without a documented risk assessment and risk management plan. Moving and handling risk management plans must be detailed and include equipment to be used. Doors were wedged open. Wedges were moved during the inspection to ensure safety. It is required that doors must not be wedged open unless with devices approved by the fire officer for this purpose. More staff must be trained in first aid to ensure a qualified first aider on duty at all times. Electrical and gas installations must be checked for safety and maintained safely with checks conducted at required intervals. 14/02/07 14/02/07 31/08/07 31/03/07 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 2 3 4 Refer to Standard OP19 OP7 OP18 OP38 Good Practice Recommendations The registered provider should continue with the ongoing environmental improvement programme to enhance the comfort standards for the people who live in the home. Care plans should include task specific detail to tell carers how to deliver all aspects of a persons care. They should describe exactly what to do and how to do it. The manager should arrange training on POVA (Protection of Vulnerable Adults) for all staff not yet trained to ensure the protection of people in the home Fire safety training refreshers should be held six monthly for day staff and 3 monthly for night staff. St Helens Care Home DS0000000749.V328181.R01.S.doc Version 5.2 Page 20 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Helens Care Home DS0000000749.V328181.R01.S.doc Version 5.2 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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