Inspection on 11/08/05 for St Helens House

This inspection was carried out on 11th 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

St Helens House 21/01/09

St Helens House 27/02/07

St Helens House 09/02/06

St Helens House 31/01/05

St Helens House 21/09/04

St Helens House 24/02/04

St Helens House 29/01/04

St Helens House 29/11/02

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

CARE HOMES FOR OLDER PEOPLE St Helens House 3 The Ridge Ore, Hastings East Sussex TN34 2AA Lead Inspector Liz Daniels Unannounced 11 August 2005 09:30 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 Helens House H59-H10 S21220 St Helens House V237550 110805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service St Helens House Address 3 The Ridge Ore Hastings East Sussex TN34 2AA 01424 439239 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) Mrs Gloria Williams Mrs Gloria Williams Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (OP) 31 of places St Helens House H59-H10 S21220 St Helens House V237550 110805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of residents to be accommodated will be thirty one (31) 2. Residents will be aged sixty five years and over on admission Date of last inspection 31 January 2005 Brief Description of the Service: St Helens House ia a large detached property situated on The Ridge in Hastings. It provides care for up to 31 residents of an older age: at the time of the Inspection there were 26 residents. The owner has a wealth of experience, having managed the Home for the past twenty years. The Home is set out on three floors and a passenger lift provides access to all floors. It provides 27 single rooms and 2 double rooms. There is a large lounge and two smaller lounge areas: to the rear of the property, there is a large garden. Some of the rooms have some spectacular views of the sea and on a clear day, of the cliffs at Beachy Head. At the front of the building there is a small area providing off road parking facilities. St Helens House H59-H10 S21220 St Helens House V237550 110805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over a period of seven hours, beginning at 10am and finishing at 5.20pm. The Inspector met with the owner who is currently the Registered Manager. However a new Manager has recently joined the Home and the aim is that she will become the Registered Manager: she therefore facilitated the majority of the Inspection. The Inspector also met with three other members of staff and had a tour of the Home, meeting with five residents and a relative before inspecting documentation and other key records. What the service does well: What has improved since the last inspection? What they could do better: Following the pre-admission assessment of a prospective resident, the Home should confirm in writing that they could meet their needs in respect of health and welfare. The policy for the protection of Vulnerable Adults needs to be amended to include Social Services as the lead agency for investigation and the Home’s Service User guide should also be amended to reflect the Commission. The Home should produce an Annual Development Plan that reflects the views of the residents and relatives about the care provided, as identified in the service user questionnaire. Staff are well supervised in their practice but the Homes format for supervision should be expanded upon to allow for discussions regarding career development, training needs and the sharing of views about the service provided for the residents. The Home should test the water temperature more frequently in the baths and showers that are used by the residents. Fire Drills should be recorded separately from Fire Alarms. St Helens House H59-H10 S21220 St Helens House V237550 110805 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. St Helens House H59-H10 S21220 St Helens House V237550 110805 Stage 4.doc Version 1.40 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 Helens House H59-H10 S21220 St Helens House V237550 110805 Stage 4.doc Version 1.40 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) 1,2,3 and 5 The Home provides good opportunities for prospective residents and their relatives to be involved, prior to admission. There is good pre-admission assessment documentation in place but this must be completed. The Home should then confirm in writing that they could meet the needs of the prospective resident in respect of health and welfare. The Home should amend its Service User guide to reflect the Commission. EVIDENCE: The Home has a detailed Statement of Purpose, and Service User guide, which is given to all prospective residents but has not yet been distributed within the Home. As identified at the last inspection, the Service User guide should be amended to include the change of Regulatory body from the NCSC to the Commission. On enquiry, prospective residents and their relatives are invited to visit the Home to view the available rooms and stay for a meal if possible, to meet the other residents. If satisfactory, the Registered Manager then assesses residents prior to their admission: the new Manager is also starting to undertake this role. Formal assessment documentation is used, although this had not all been fully completed, signed and dated. Prospective residents are told verbally during their assessment whether or not the Home can meet their needs. Four Resident’s files were viewed during the Inspection: each resident St Helens House H59-H10 S21220 St Helens House V237550 110805 Stage 4.doc Version 1.40 Page 9 signs a Contract confirming the terms & conditions of their residence within the Home. A copy of an assessment from Health, completed prior to a resident being admitted to the Home, was viewed in one Care Plan. Another included an assessment from Social Services although this had been received after the resident‘s admission. All the residents who met with the Inspector are pleased with the Home. St Helens House H59-H10 S21220 St Helens House V237550 110805 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8 and 10 The Care Plans reflect the health, personal and social care needs of the residents in general, and a good programme of review is in place whereby the care needs appear to be met well. The Home has good contact with local health services. EVIDENCE: Four resident’s files were viewed and all had a comprehensive plan of care. Specific health needs are reflected and there is evidence that the Care Plan is reviewed and updated with the resident, who then signs it to demonstrate they are aware of it. The Home invites relatives to also be involved in the Care Plan review unless the resident wishes otherwise. All residents have Risk Assessments, also signed by residents and reviewed. The period of review is very variable but all Care Plans seen appeared contemporaneous with the resident’s needs. The Home enables residents to have access to external health professionals, including chiropodists, dentists, district nurses, and opticians. Staff accompany them to health appointments as needed. Accidents are recorded and individual care plans updated to reflect trends such as frequent falls. During the Inspection, staff were observed to be attentive and considerate. Staff confirmed the importance of promoting privacy and respect when residents are undergoing examinations or personal care. St Helens House H59-H10 S21220 St Helens House V237550 110805 Stage 4.doc Version 1.40 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) 12,13 and 15 The staff at St. Helen’s House recognise the importance of ensuring individual needs and beliefs are met and promote alternative activities for the residents. The menus are varied to provide a balanced diet. Specific dietary requests are accommodated. EVIDENCE: The Inspector found that residents are encouraged to pursue their own interests, by going out as able and being involved with activities within the Home. There is a weekly programme of activities planned and one carer is designated each day as responsible for organising that afternoon’s recreation. Trips in a minibus are organised on Tuesday and Thursday afternoons. Books and videos are readily available in the lounge and dining area. There are two lounge areas enabling both an area for activity, television, or music and a quieter area for residents to sit and read, or meet with their visitors if they wish. Staff confirmed that visitors are welcome at any time but are asked to ring first if they anticipate visiting after 8pm. A varied, nutritious menu is offered, rotated every four weeks: there is a main meal mid-day with a lighter snack or sandwiches for supper. The menu for the day is publicised midmorning and the cook confirmed that residents can choose an alternative and that special diets can be accommodated. Each resident has the opportunity to sit down with the cook and discuss the food, at least once a month. The cook then assesses if there needs to be any change to suit that resident. The Inspector met with four residents who described the food as good and St Helens House H59-H10 S21220 St Helens House V237550 110805 Stage 4.doc Version 1.40 Page 12 confirmed that they are given the opportunity to choose alternatives to the main menu if they wish. The food preparation area was found to be clean: meals can be taken in the Dining Room, which is welcoming and comfortable, or residents can choose to eat in their rooms. Food and drinks are available throughout the 24-hour period: there is also a resident’s fridge in the dining area, where they can keep their own food and drink. St Helens House H59-H10 S21220 St Helens House V237550 110805 Stage 4.doc Version 1.40 Page 13 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) 16 and 18 There is a comprehensive complaints policy at St. Helen’s House which the residents and staff have confidence in. The policy for the protection of Vulnerable Adults needs to be amended to include Social Services as the lead agency for investigation. EVIDENCE: There have been no complaints forwarded to the Commission, since the last Inspection. The last complaint raised within St. Helen’s House was on 23rd January 2005, which was investigated. The Home has a complaints procedure which staff, when asked, said they are aware of and know how to access. All complaints and the action taken are recorded and the outcomes fed back to the complainant. Two residents stated that they can discuss any concerns they have with the person-in-charge for the shift, or the Manager. They have confidence that their concerns will be listened to and acted upon. There is a policy for the Protection of Vulnerable Adults. This does not reflect Social Services as the lead agency for investigations. However three staff, when asked, can identify when to raise any concerns, what action to take and the need to involve Social Services. All staff receive training in abuse awareness and are made aware of the East Sussex multi-agency guidelines. St Helens House H59-H10 S21220 St Helens House V237550 110805 Stage 4.doc Version 1.40 Page 14 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) 19,20,25 and 26 The Home is well maintained, comfortable and well adapted to ensure safety but enable independence as far as is possible. The Home should test the water temperature more frequently in the baths and showers that are used by the residents. EVIDENCE: A full tour of St. Helen’s House was undertaken. The entrance into the Home is level and a passenger lift enables easy access to all floors. Although not purpose built, the Home has been adapted to meet the needs of the residents. There are two lounges, one of which provides a quieter area to read or meet with visitors. Two dining areas, which are furnished in a homely manner and a large well maintained garden provide additional communal space. A patio area with furniture to sit out, is easily accessible from one of the lounges. Each bedroom has been personalised to suit individual taste. A nurse call system is available in each room and residents can choose to have their own telephone line. Some rooms have beautiful views over the sea and some look towards Beachy Head. The bedrooms have lockable doors and residents can choose to have their key if they wish their room to be locked. The five residents who met with the Inspector all feel their rooms are homely and comfortable. The St Helens House H59-H10 S21220 St Helens House V237550 110805 Stage 4.doc Version 1.40 Page 15 crack in the wall on the stairwell, has been assessed and repaired by a builder, meeting the Requirement of the last Inspection. The carpet in one of the bedrooms, which was rucked, has been stretched. This meets the Requirement of the last Inspection. All areas seen were clean and free from odour. Water temperature checks are undertaken three monthly. The need to increase this was discussed; all outlets have a thermostatic control but the Home plans to increase the frequency of testing for baths and showers used by the residents. St Helens House H59-H10 S21220 St Helens House V237550 110805 Stage 4.doc Version 1.40 Page 16 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 An appropriate number and skill mix are rostered throughout the 24-hour period, to enable personal and social care for the residents in the Home. EVIDENCE: On the day of Inspection, the new Manager and the current Registered Manager, who is the proprietor, were on duty. Either the Manager or Deputy Manager leads each day shift. Three carers are rostered to work in the mornings and two in the afternoons and evening. A cook works from 9am – 1.30pm and the care staff then prepare the evening meal. At night one carer is awake and on duty from 8pm – 8am and there is also a sleep-in carer on duty. Other staff include cleaners, a maintenance man and a gardener in the summer months. The owner’s son is responsible for some of the Home’s administration and for the shopping for the Home. St Helens House H59-H10 S21220 St Helens House V237550 110805 Stage 4.doc Version 1.40 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) 31,33,36 and 38 The Home is well run by an experienced Registered Manager. A new manager is receiving a good Induction before applying to the Commission to be the Registered Manager. Staff are well supervised in their practice but the Homes format for supervision should be expanded upon to allow for discussions regarding career development, training needs and the sharing of views about the service provided for the residents. Fire Drills should be recorded separately from Fire Alarms. EVIDENCE: The Inspector found that St. Helen’s House is managed in a professional way. The owner of St. Helen’s House is very experienced, having been the proprietor for the past 20 years and she is currently the Registered Manager. However, a new Manager has been in post since July 05. Having completed the Registered Manager Award (RMA) and almost completed the NVQ level 4, the plan is that she will apply to the Commission to become the Registered Manager. She is also an NVQ Assessor. Feedback from the residents and their relatives is encouraged and a questionnaire has been circulated. The aim is St Helens House H59-H10 S21220 St Helens House V237550 110805 Stage 4.doc Version 1.40 Page 18 that the Manager will collate the results and analyse them to identify trends that can then be used to influence how the service develops. There is currently no Annual Development Plan although any maintenance needs are recorded and undertaken. The staff are offered formal supervision, some of which is discussion and some observation coaching followed up by discussion. Each session is documented but the Home aims to refine its process of supervision further. All staff that met with the Inspector said they feel they are well supported by the management team and other staff: they also believe there are good training opportunities. Documentation for safety checks were viewed and found to be in order. The Fire Alarm system and Emergency Lighting were last inspected on 26th April 2005 and the Fire Extinguishers were checked on 24th November 2004. The last organised Fire Drill was on 17th May 2005, which is recorded alongside all Fire Alarm activations. All staff and residents are trained in fire procedures and a record kept. Residents sign that they have had been trained: all training was completed in July 2005. St Helens House H59-H10 S21220 St Helens House V237550 110805 Stage 4.doc Version 1.40 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 2 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 x x x x 2 3 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 3 x 3 x x 2 x 2 St Helens House H59-H10 S21220 St Helens House V237550 110805 Stage 4.doc Version 1.40 Page 20 Are there any outstanding requirements from the last inspection? Yes 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 3 Regulation 14 Requirement A Pre-admission assessment must be completed prior to a resident being admitted. The Home should confirm in writing that they could meet their needs in respect of health and welfare. The policy for the protection of Vulnerable Adults must reflect Social Services as the lead agency for investigation. Timescale for action 30 September 05 2. 18.2 21(1)(2) 31 August 05 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. Refer to Standard 25 31 33 Good Practice Recommendations The frequency of the testing of hot water temperatures should be increased to monthly for baths and showers. The Manager should apply for registration to the Commission, by December 2005. The Home should produce an Annual Development Plan which is underpinned by the views of the residents and relatives about the care provided, as identified in the service user questionnaire. The Homes format for supervision should be expanded upon to allow for discussions regarding career H59-H10 S21220 St Helens House V237550 110805 Stage 4.doc Version 1.40 Page 21 4. 36 St Helens House 5. 38 development, training needs and the sharing of views about the service provided for the residents. Fire Drills and occassions when the Fire Alarm is activated, should be recorded separately. 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