Inspection on 27/02/07 for St Helens House

This inspection was carried out on 27th 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.

Other inspections for this house

St Helens House 21/01/09

St Helens House 09/02/06

St Helens House 11/08/05

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 Gary Bartlett Key Unannounced Inspection 27th February 2007 09:45 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 House DS0000021220.V330585.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 House DS0000021220.V330585.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Helens House Address 3 The Ridge Ore Hastings East Sussex TN34 2AA 01424 439239 01424 439239 sthelens@house124.wanadoo.co.uk 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 Gloria Williams Janet Susan Holding Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (31) of places St Helens House DS0000021220.V330585.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users to be accommodated is thirtyone (31) Service users must be older people aged sixty-five (65) years or over on admission 9th February 2006 Date of last inspection Brief Description of the Service: St. Helens House is a family owned and run care home on The Ridge in Hastings. Twenty-four hour care is provided for up to 31 older people, most of who have lower levels of dependency care needs. 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. At the front of the building there is a small area providing off road parking facilities. Current fees range from £345 to £400 per week. St Helens House DS0000021220.V330585.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection was conducted by Gary Bartlett, Regulatory Inspector, who was in St Helens House from 9.45 a.m. until 5.30 pm. During that time the Inspector spoke with some residents, a visitor and some staff. Parts of the Home and some records were inspected and care practices observed. Residents responded that they liked the home and staff. Statements made included: • “It’ lovely here”. • “There’s a friendly, family atmosphere”. • “Everyone is very kind to me”. Further statements are quoted in the text of the report. The Manager and staff gave their full co-operation throughout the inspection. What the service does well: What has improved since the last inspection? The storage of medicines is much improved. Some extra laundry equipment had been purchased. One of the bathrooms has been converted into a walk-in shower room. A 14 seat, adapted minibus has been acquired. There is now a more comprehensive Quality Assurance Improvement Plan. More staff are trained to NVQ level 2 standard. The fire-alarm system has been updated and there are improved records of fire systems checks and fire drills/training. Parts of the home have been redecorated. St Helens House DS0000021220.V330585.R01.S.doc Version 5.2 Page 6 Residents and their visitors now have the facility to make coffee or tea when they choose. What they could do better: 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 House DS0000021220.V330585.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 House DS0000021220.V330585.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): 3, 4, 5 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident that they are appropriately placed due to good preadmission assessments and benefit from being able to visit the home prior to admission. The home does not provide intermediate care. EVIDENCE: The Manager described how a pre-admission assessment is made of each prospective resident using an aide-memoir. Records show that prospective residents, their families, advocates, and relevant health care professionals are involved in the assessment process. Specialist advice is sought from external sources where required. St Helens House DS0000021220.V330585.R01.S.doc Version 5.2 Page 9 Residents said they or their families had been able to visit St Helens House before moving in. They also said staff had been very helpful in assisting them to settle in. This was confirmed by a relative present. Intermediate care is not offered at St Helens House. St Helens House DS0000021220.V330585.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ personal health needs are assessed and maintained through their individual care plans. A list of specimen signatures of staff trained to dispense medications needed to be compiled to further safeguard residents’ safety. Residents’ health needs are met with good liaison with relevant health care professionals. EVIDENCE: Each resident has a care plan and three were inspected in detail. Different files are used to ensure staff have ready access to the information they need according to their roles and duties. Care plans are reviewed and risk assessments are being developed to be more comprehensive in their St Helens House DS0000021220.V330585.R01.S.doc Version 5.2 Page 11 scope. The standard of daily record keeping is generally very good. Staff have a very good knowledge of individual residents health care needs. A visiting relative said staff are very good at keeping them informed. The storage of medicines is much improved. The Manager is in the process of procuring a new medicines refrigerator and introducing a system to monitor the temperature of the room to ensure medicines are stored at an appropriate temperature. The Manager stated that all staff administering medications have been trained and signed off as being competent to do so. Medicines were seen to be administered in accordance with current guidelines and the Medication Record Administration Record (MAR) sheets seen were completed appropriately. A list of specimen signatures of staff trained to dispense medications needed to be compiled to further safeguard residents’ safety. Records show the Home continues to have a good working relationship with the specialist and local health care professionals. This greatly assists in supporting residents in their health care needs. Residents said they can have access to their G.P. and other services such as dental, hearing and sight etc. when they needed to. A chiropodist was visiting at the time of inspection. Residents feel that staff are kind and gentle and this was confirmed by observation. Staff are very considerate of the age and dignity of residents and treat them with courtesy. St Helens House DS0000021220.V330585.R01.S.doc Version 5.2 Page 12 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. Residents enjoy routines of daily living and activities that are flexible and varied to suit their preferences. Where practicable, residents can participate in local community activities and their autonomy and choice is promoted. Dietary needs of resident are well catered for with a balanced and varied selection of food that meets their tastes and preferences. EVIDENCE: Staff spoken with are aware of the rights of residents to have the opportunity to have choice in daily routines and activities. An example being breakfast, which is mostly self-serving with assistance being given where required. Residents spoke very favourably of the activities available. They were very happy with the outings made possible by the acquisition of an adapted minibus. Most Tuesdays, the “Boy’s Club” meets in the Budgie lounge, when some of the men like to watch a war film whilst enjoying a beer and crisps. St Helens House DS0000021220.V330585.R01.S.doc Version 5.2 Page 13 Residents are content with the manner in which their inks with the local community are maintained according to their wishes and take account of their capabilities. One resident regularly uses his own car to drive around the locality. The visitors book shows regular visits by families, friends and others. Residents can meet with visitors in various communal rooms or in their bedrooms. Residents said they are happy with the arrangements. A visitor described how they can visit at any reasonable time and is always made welcome by staff. The Manager stated residents are supported to manage their own affairs for as long as they wished and are able. Residents enjoy the meals. Comments made included: • “The food is lovely here”. • “You always get plenty to eat”. • “They always make sure you get something you like”. The main, cooked meal is at lunchtime and an alternative is offered if the meal is not to a resident’s particular tastes. Mealtimes are relaxed; staff are patient and helpful and allow residents the time they need to finish their meal comfortably. There are drinks in the lounges and residents or their visitors can now prepare tea or coffee when they wish. The Cook and Manager had arranged to attend a nutrition training course in the very near future. St Helens House DS0000021220.V330585.R01.S.doc Version 5.2 Page 14 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. Residents and their relatives know their complaints will be listened to and acted on. There are systems to ensure residents are protected from abuse. EVIDENCE: A resident’s said: • “I feel safe and cared for here”. The residents and their relatives are aware of the home’s complaints procedure and said they feel confident that they would be listened to. A record is kept of each complaint and of its outcome. No complaints had been made to the Commission since the last inspection. There are procedures for responding to suspicion or evidence of abuse or neglect to ensure the safety and protection of residents. The Manager and other staff spoken with have a sound understanding of adult protection procedures and stated that any allegation of abuse would be referred to the concerned agencies without delay. St Helens House DS0000021220.V330585.R01.S.doc Version 5.2 Page 15 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, 20, 21, 23, 24, 25 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home provides residents with and comfortable and homely place to live. All radiators must be made safe and appropriate soap dispensing and hand drying facilities provided in all communal toilets to ensure residents’ safety. EVIDENCE: St Helens House is very “homely”, warm and residents said they are comfortable. Everywhere is very clean and there are no offensive odours. There is an ongoing programme of redecoration and refurbishment and it is planned to re-carpet some of the ground floor areas and redecorate some of the communal rooms in the near future. St Helens House DS0000021220.V330585.R01.S.doc Version 5.2 Page 16 Residents said they have all they need and are very happy with their bedrooms. The bedrooms seen are comfortably furnished and contain the residents’ own furniture and effects. Lockable facilities are provided to secure personal items and money. Many residents have televisions and some have their own landline telephones for which they pay the rental and bills. The Manager is particularly attentive that residents’ care needs can be met in the bedrooms they occupy. For example, ensuring they can access them with ease if they use mobility aids. The home was registered under the 1984 Registered Homes Act. Consequently, some facilities would not meet current registration standards. The Manager is aware of this and is looking into the possibilities of improvement, for example where hand wash-basins are not provided in some communal toilets. Where there are hand-basins, there is a need to provide appropriate soap dispensing and hand drying facilities that promote infection control to better ensure residents’ safety. Staff and residents consider the bathing facilities to be suitable for their needs. Since the last inspection, one of the bathrooms has been converted into a walk-in shower room. The laundry is well maintained and some extra equipment had been purchased since the last inspection. The radiators in the communal areas are not fitted with thermostatic controls or guarded. Some of these radiators are very hot to touch and potentially place residents at risk. The registered person undertook to address this. Residents spoke of how they like to use the patio and well kept grounds in more clement weather. One resident has purchased a bird table and enjoys watching it from the lounge room. As, perhaps, do the 2 cats that have recently moved in and contribute to the homely feel of St Helens House. St Helens House DS0000021220.V330585.R01.S.doc Version 5.2 Page 17 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 adequate. This judgement has been made using available evidence including a visit to this service. The home provides ongoing training for staff so they have the skills to meet the needs of the residents. The home needs to be able to more readily show its recent recruitment processes consistently offer protection to people living there. EVIDENCE: Residents and visitors spoke highly of the staff and consider them to be very caring and hard working. Comments included: • “They are only too happy to help you”. • “They are all very friendly”. • “The staff here are second to none”. The Manager uses a matrix for easy monitoring of staff training/update requirements. This indicated there is a range of training for staff. NVQ training is encouraged. The Manager has a sound understanding of good staff recruitment processes and this is underpinned by the home’ s policies and procedures. Most staff files showed robust recruitment processes had been adhered to, thereby St Helens House DS0000021220.V330585.R01.S.doc Version 5.2 Page 18 ensuring only people properly vetted work at the home. However, the files of 2 recently recruited staff members do not show that necessary C.R.B. checks and references had been obtained prior to these people commencing duties. The Manager stated this was because these people were known to be already working elsewhere in the care sector. The Manager undertook to ensure appropriate recruitment processes were used for every potential staff member, with immediate effect. She also agreed to arrange for the staff application documentation to be updated and to introduce a system of monitoring the total hours worked by staff that have additional employment elsewhere. The staff roster seen indicated that staffing levels are geared to peak times of activity. Residents said staff were always available to give help when required. St Helens House DS0000021220.V330585.R01.S.doc Version 5.2 Page 19 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, 32, 33, 35, 36, 37 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a Manager who is accessible and has high expectations of the service to be delivered. The home regularly reviews aspects of its performance through a programme of self-review and consultations, which includes the opinions of residents and relatives. Residents’ financial interests are protected. St Helens House DS0000021220.V330585.R01.S.doc Version 5.2 Page 20 EVIDENCE: The Manager is experienced in caring for older people and has worked in senior management roles. She has completed the Registered Manager’s Award and the NVQ level 4, is an NVQ Assessor and has trained as a trainer for Moving & Handling. Having also attained the City & Guilds C24 & C25, she is qualified to provide both group and 1:1 training. The management approach to St Helens House creates an open, positive and inclusive atmosphere in which people who live there are able to influence the way in which the home is run. St Helens House operates a comprehensive quality assurance system based on seeking the views of residents, their relatives/representatives and other concerned parties to measure the success in meetings the aims and objectives of the home. The results are used in a Quality Assurance Improvement Plan. A lot of work in developing this has been done in recent months. Residents are encouraged to manage their own financial affairs or to have assistance from their families / representatives. The home’s management team do not act as the appointees for the financial affairs of any of the residents. Some residents prefer to keep a balance of money in the home’s safe. Services such as the hairdresser or any sundries required by the residents are paid for from petty cash. Receipts are kept and records kept in a book, under each resident’s name. These are then added to the resident’s invoice, separated from the fees. The kitchen is due to have a much needed refurbishment in the near future. The standard of cleanliness in the kitchen is good. An Environmental Health Officer inspected the kitchen on the 4th December 2006 and there are not any resultant recommendations. Appropriate insurance cover is provided for the home and a current insurance certificate is displayed. There are arrangements to ensure all staff receive the supervision necessary to ensure good standards of care practice. The Managers strives to ensure that feedback and discussions with staff is carried out at least every two months with records kept. Staff spoken with have a sound understanding of emergency procedures. The fire-alarm system has been updated and there are improved records of fire systems checks and fire drills/training. The Manager described a system of ongoing environmental risk assessments. St Helens House DS0000021220.V330585.R01.S.doc Version 5.2 Page 21 The Manager stated that all records of maintenance and safety checks are up to date and that policies and procedures are regularly reviewed by a competent individual to ensure they comply with current legislation and good practice advice. These were not inspected on this occasion. Records seen are kept in a manner that preserve confidentiality. St Helens House DS0000021220.V330585.R01.S.doc Version 5.2 Page 22 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 X X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 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 3 3 X 3 3 2 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 3 3 St Helens House DS0000021220.V330585.R01.S.doc Version 5.2 Page 23 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 OP9 Regulation 13 (2) Requirement “The registered person shall make arrangements for the recording, handling, safekeeping, safe administration of medicines” in that a list of specimen signatures of staff trained to dispense medications must be compiled. This must be completed by the given timescale and maintained thereafter. “The registered person shall ensure that all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their safety” in that all radiators must be guarded or have guarunteed low temperature surfaces. This must be completed by the given timescale, if not sooner. “The registered person shall make suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home”, in that appropriate soap dispensing DS0000021220.V330585.R01.S.doc Timescale for action 31/03/07 2. OP25 13(4) 31/08/07 3. OP26 12(1), 13(3) 16(2)(j) 31/08/07 St Helens House Version 5.2 Page 24 and hand drying facilities must be provided in all communal toilets. This must be completed by the given timescale, if not sooner. 4. OP29 19 The registered person shall not employ a person to work at the care home unless(b) subject to paragraphs (6), (8) and (9) he has obtained in respect of that person the information and documents specified in paragraphs 1 to 9 of Schedule 2 in that staff must not be employed prior to obtaining a satisfactory Protection Of Vulnerable Adults check, a satisfactory Criminal Records Bureau check and satisfactory references. Records must be in place to clearly show this is being done by the given timescale and maintained thereafter. 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. Refer to Standard OP7 Good Practice Recommendations It is recommended the Manager continues in their efforts to developed risk assessments to be more comprehensive in their scope It is strongly recommended the Manager proceeds with the stated intention of improving the staff application documentation and to introduce a system of monitoring the total hours worked by staff that have additional employment elsewhere. 2. OP29 St Helens House DS0000021220.V330585.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 House DS0000021220.V330585.R01.S.doc Version 5.2 Page 26 - 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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