Inspection on 09/02/06 for St Helens House

This inspection was carried out on 9th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 27/02/07

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 Liz Daniels Unannounced Inspection 9th February 2006 14:15 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.V282200.R01.S.doc Version 5.1 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.V282200.R01.S.doc Version 5.1 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 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) sthelens@house124.wanadoo.co.uk 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.V282200.R01.S.doc Version 5.1 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 11th August 2005 Date of last inspection Brief Description of the Service: St. Helens House is 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 28 residents. The owner has a wealth of experience, having managed the Home for the past twenty years and the Manager, who was registered with the Commission in December 2005, has also previously worked with older people. 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, the cliffs at Beachy Head can be seen. At the front of the building there is a small area providing off road parking facilities. St Helens House DS0000021220.V282200.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over a period of almost six hours, beginning at 2.15pm. The Registered Manager facilitated the inspection and the Inspector also met three other members of staff and chatted with three residents and a friend. There was also the opportunity to meet informally with nine residents as they sat together in the lounge. A range of documentation and key records was then inspected. This report should be read in conjunction with the report from the last inspection this year, on 11th August 2005. What the service does well: What has improved since the last inspection? Good documentation is now completed when a prospective resident is assessed prior to admission and the Home’s suitability for them is now confirmed in writing. There is contemporaneous information to ensure correct processes are in place for the protection of vulnerable adults and the procedure for staff reporting suspected Adult Abuse now clearly identifies the need to contact Social Services as the lead agency and to notify the Commission. These developments were all Requirements from the last inspection, which have been met. The water temperatures are being well monitored: for baths and showers this is now monthly and since the last inspection, the Manager has applied to the Commission to become the Registered Manager for St. Helen’s House. Supervision sessions have been well developed and their format expanded. These were Recommendations from the last inspection, which have been met. The Manager has developed a Quality Assurance Improvement Plan, which is a very good step towards an Annual Development Plan that is led by the needs of the residents. This partly meets the Recommendation from the last inspection. St Helens House DS0000021220.V282200.R01.S.doc Version 5.1 Page 6 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. St Helens House DS0000021220.V282200.R01.S.doc Version 5.1 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.V282200.R01.S.doc Version 5.1 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 the following standard(s): 3 and 6 Good documentation is completed when a prospective resident is assessed prior to admission and the Home’s suitability is now confirmed in writing. This meets the Requirement from the last inspection. EVIDENCE: A pre-admission assessment is undertaken prior to a resident being admitted to St. Helen’s House. This process was inspected in full at the last Inspection. Although good documentation was available for use it was found that it was not always completed, signed or dated. Previous practice had also been to inform prospective residents verbally whether or not the Home could meet their needs. Two files were therefore reviewed at this Inspection. Both residents have recently moved into the Home. An assessment pro-forma had been completed: for one resident there was a record that the Manager had had a discussion with Social Services and Health and also received their previous assessment, but they were unable to obtain a copy of the most recent assessment until after the resident had been admitted. For the other resident there was evidence of liaison with the Mental Health Team and a copy of the Mental Health assessment had been received. A letter of confirmation is then sent out to prospective residents to confirm that St. Helen’s House can meet St Helens House DS0000021220.V282200.R01.S.doc Version 5.1 Page 9 their assessed needs in respect of their health and welfare. The Inspector viewed a copy of the letter sent. St. Helen’s House offers respite care and also short-term rehabilitation following hospitalisation for non-surgical conditions. However, it does not provide intermediate care. St Helens House DS0000021220.V282200.R01.S.doc Version 5.1 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 the following standard(s): 9 A lack of space for the correct storage of medication poses the risk that the wrong medication could be administered. Residents must be administered with medication from their own stock. Medication in current use should be separated for each individual. EVIDENCE: Currently there are no residents at St. Helen’s House who self medicate. However, a policy is in place and a Risk Assessment is completed should a resident wish to be responsible for his or her own medication. Their medication is kept in the safe in the bedroom wardrobe. The Inspector was able to see a Risk Assessment for one resident who did self-medicate but who has recently decided they would now prefer not to. Their decision has been documented in the ‘Kardex’. The medication for the remaining residents is kept in two filing cabinets in the main office. Some is dispensed as blister packs and each resident has a MAR sheet of medicines prescribed. These were all found to be up to date and signed appropriately. Those medications not dispensed as blister packs are pooled together and stored in different drawers of the cabinet. Because of a lack of space, some medication is being administered from communal supplies. Stock supplies are stored in a separate drawer and medicines for disposal were being kept with the stock. This was St Helens House DS0000021220.V282200.R01.S.doc Version 5.1 Page 11 discussed at the Inspection and it was then subsequently separated. All staff are trained in the dispensing of medication and the Deputy Manager then assesses them before they dispense medication unaccompanied. St Helens House DS0000021220.V282200.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14 Residents at St. Helen’s House are enabled to exercise personal autonomy and choice. Their rooms appear homely and have been personalised with their own furniture and possessions. EVIDENCE: The philosophy at St. Helen’s House is that residents should be as independent as they are able for as long as possible. Residents were choosing to spend time in the lounge and in their rooms, during the inspection. The majority of the residents handle their own financial affairs and provision is made in their rooms for them to keep money and valuables in a safe place. The Inspector was able to view two bedrooms and found them personalised with residents’ own possessions and furniture. Two residents who met with the Inspector said they are happy at the Home and feel they can join in with the activities that are organised and the trips that are arranged, as much or as little as they wish. They also said they liked their rooms and felt they have been able to make them as homely as possible. St Helens House DS0000021220.V282200.R01.S.doc Version 5.1 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 the following standard(s): 18 St. Helen’s House has contemporaneous information to ensure correct processes are in place for the protection of vulnerable adults. The procedure for staff reporting suspected Adult Abuse, clearly identifies the need to contact Social Services as the lead agency and to notify the Commission. This meets the Requirement from the last inspection. EVIDENCE: This standard was assessed at the last inspection and therefore not inspected in full at this inspection. Good practice had been found to be in place but the Home did not have a procedure that identified Social Services as the lead agency and decision maker about the course of action to take if adult abuse is suspected. Since the last inspection the policy has been updated and a flowchart has been adopted for potential alerters. These guide the reader what action to take, including contacting Social Services as the lead agency and notifying the Commission. St Helens House DS0000021220.V282200.R01.S.doc Version 5.1 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 the following standard(s): 21,23,24 and 25 The residents at St. Helen’s House live in safe, comfortable surroundings. The water temperatures are now being well monitored: for baths and showers this is now monthly, which meets the Recommendation from the last inspection. There are sufficient and suitable lavatories and washing facilities available for the number of residents accommodated. EVIDENCE: A full tour of the Home was not undertaken at this inspection but the Inspector was able to meet nine residents as they relaxed in the lounge and to then chat with five residents and a friend who was visiting. The bedrooms that were seen at this inspection were homely and furnished appropriately to a good standard with personal furniture and belongings being evident. Sixteen of the thirty bedrooms have en-suite facilities and there are also three bathrooms and a shower room. The Manager reported that plans are underway to convert one of the bathrooms into a walk-in shower room. All the water outlets have thermostatic temperature controls for the water and it had been practice when reviewed at the last inspection, that all water temperatures were recorded three monthly. This was therefore reviewed at this inspection. The bath water St Helens House DS0000021220.V282200.R01.S.doc Version 5.1 Page 15 temperatures have been recorded monthly, last on 16th January 06. The sink water temperatures were last recorded on 9th November 05. St Helens House DS0000021220.V282200.R01.S.doc Version 5.1 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28,29 and 30 38 of the care staff at St. Helen’s House are undertaking or are trained to NVQ level 2 or above. The recruitment process that is in place must be amended to ensure staff are not employed until a POVA 1st has been received. They must then work under supervision until a CRB disclosure is received. Evidence of identity must be retained on file. A good training and development programme is in place for all staff. EVIDENCE: A team of 21 carers, including the Deputy Manager who works as a senior carer, are employed with the Registered Manager, to meet the needs of the residents. 7 carers are booked to start their NVQ level 2 training at the end of February and another will be starting her NVQ level 3 at the beginning of March. The Manager reported that she also has another 5 carers who would like to start their NVQ level 2 at the next opportunity (possibly September 06). Three staff files were reviewed, two of which were for care staff. All had completed application forms: two staff had been employed within the past year and had copies of two references, which had been received prior to their employment. The third has been in post sometime: the Manager had reviewed her file last year and references applied for then. The two more recently appointed staff had had a POVA 1st check applied for but had started work prior to it being received. One member of staff had a CRB disclosure received two months after appointment but the Manager has still not received the CRB disclosure for the member of staff who started work at the beginning of November 2005. She confirmed that she had applied through the Care Homes Association. There is a record of the CRB disclosure number for the member of St Helens House DS0000021220.V282200.R01.S.doc Version 5.1 Page 17 staff who has been in post for sometime. Copies of statements of terms and conditions were found on file. No evidence of identity is currently retained on file. The Home has developed a matrix for monitoring training. There are currently three staff undertaking induction training, meeting the ‘Skills for Care’ requirements. One member of staff has completed the foundation but the aim is that all staff will undertake their NVQ level 2. However the Manager confirmed that any member of staff not wishing to enrol would undertake the foundation course. The Home provides mandatory training for all staff and involves health professionals to provide specialist training. All staff therefore receive three days training per year and a training record is kept for them. St Helens House DS0000021220.V282200.R01.S.doc Version 5.1 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36 and 38 The Manager has applied to the Commission to become the Registered Manager for St. Helen’s House. This meets the Recommendation from the last inspection. She has the qualifications and experience for the role and there are clear lines of accountability between her and the owner. The Quality Assurance Improvement Plan she has developed is a very good step towards an Annual Development Plan that is led by the needs of the residents. This partly meets the Recommendation from the last inspection. Good financial arrangements for residents’ monies are in place and supervision sessions for staff have been well developed and their format expanded, meeting the Recommendation from the last inspection. Records of Fire Drills, fire alarm activations and routine fire bell testing should be separated. EVIDENCE: The Manager has applied to the Commission and is now the Registered Manager for St. Helen’s House. She is experienced in caring for older people and has worked in senior management roles. She has now completed both her St Helens House DS0000021220.V282200.R01.S.doc Version 5.1 Page 19 NVQ level 4 and the Registered Manager’s Award. She is also 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. She works closely with the owner of the Home who, having also been the previous Manager, is devolving responsibility as the Registered Manager becomes more familiar with the Home. The Home’s methods of quality monitoring were assessed at the last inspection and this standard was therefore not inspected again in full. However, since the last inspection the Manager has collated the results from the questionnaire that had been circulated to the residents and their relatives. She has subsequently developed a Quality Assurance Improvement Plan, which identifies action to be taken in response to their comments. This has not yet been incorporated into a general Annual Development Plan. However the Manager explained that a business meeting is planned between the owner and Manager and other key staff to finalise service provision plans for the next year. Most of the residents handle their own financial affairs and the remainder have instructed either Solicitors or their relatives to act on their behalf. The Home’s management team do not act as the appointees for the financial affairs of any of the residents and no personal allowances are paid directly to the Home. Some of the residents hold their own money in their room whilst others prefer to keep a balance of money in the Home’s safe. Extra 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 but separated out from the fees. Supervision of staff was assessed fully at the last inspection and reviewed again at this inspection as the Manager has introduced a new pro-forma. Supervision is in place for all staff. The sessions have been recorded as being held every two months and are used as an opportunity to share views about the service provided for the residents, to identify any training needs and to discuss further career development. The Fire records were examined again at this inspection, as it had found at the last inspection that fire alarm activations and fire drills were being recorded together. The records for fire drills, regular fire bell testing and fire training continue to be amalgamated. This was discussed at this inspection and the value of separate records agreed. The Manager confirmed that she would revise the format for recording. St Helens House DS0000021220.V282200.R01.S.doc Version 5.1 Page 20 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 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 X X 3 X 3 3 3 X STAFFING Standard No Score 27 X 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 3 X 2 St Helens House DS0000021220.V282200.R01.S.doc Version 5.1 Page 21 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 OP9 Regulation 13 (2) Requirement Residents must be administered with medication from their own stock. A more suitable storage space for medication must be explored, enabling medication in current use to be separated for each individual. A minimum of 50 of the care staff must be trained to NVQ level 2 or above. Staff must not be employed until a POVA 1st has been received. They must then work under supervision until a CRB disclosure is received. Evidence of identity must be retained on file. Timescale for action 31/03/06 2. 3. OP28 OP29 18 (1)(a)(c) 19 (1)(b) Sched. 2 30/09/06 31/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations St Helens House DS0000021220.V282200.R01.S.doc Version 5.1 Page 22 1. OP33 2. OP38 The Home should produce an Annual Development Plan that includes the plans for service provision, any refurbishment and necessary maintenance. This should be underpinned by the views of the residents and relatives about the care provided, as identified in the service user questionnaire. Fire Drills and occasions when the Fire Alarm is activated should be recorded separately (This was a Recommendation from the last inspection). St Helens House DS0000021220.V282200.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Helens House DS0000021220.V282200.R01.S.doc Version 5.1 Page 24 - 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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