Inspection on 01/08/05 for St Helier`s Residential Hotel

This inspection was carried out on 1st August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

St Helier`s Residential Hotel 03/01/07

St Helier`s Residential Hotel 15/02/06

St Helier`s Residential Hotel 25/01/05

St Helier`s Residential Hotel 20/07/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Anchorstone Services Limited

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

CARE HOMES FOR OLDER PEOPLE St Heliers Residential Hotel 25/26 Clifton Gardens Folkestone Kent CT20 2ED Lead Inspector Susan Hall Announced 01/08/05 at 09:30hrs 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 Heliers Residential Hotel H56-H05 S23583 ST HELIERS V231627 010805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service St Heliers Residential Hotel Address 25/26 Clifton Gardens, Folkestone, Kent. CT20 2ED 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) 01303 254980 Fraser Residential Ltd Registered Care Home 30 Category(ies) of Older Persons registration, with number of places St Heliers Residential Hotel H56-H05 S23583 ST HELIERS V231627 010805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Three (3) OP beds are designated for three (3) residents with Mental Disorder (Elderly) (MD(E)), whose dates of birth are 26/04/1927; 19/07/1921; and 25/08/1919. These beds to revert back to Old Age, not falling within any other category (OP), when any of these residents leave the Home. Date of last inspection 25/01/05 Brief Description of the Service: St.Heliers is made up of 2 Victorian style semi- detached properties, which have been linked internally to provide one large facility. It is situated in a quiet residential area of Folkestone, close to The Leas, the sea-front, and the town centre of Folkestone. Accommodation is provided for up to 30 residents in large rooms for single use; most of the rooms have en-suite toilet facilities. A number of rooms are of sufficient size for 2 people to share if that is their wish (eg: a married couple). Bedrooms and bathrooms are situated on the ground, first and second floors, and the dining area, kitchen and office facilities are situated in the basement. A passenger lift provides easy access to all floors. The Home has private access to shared gardens at the rear of the property, which are very well maintained, and have beautiful trees and shrubs. There is also a patio area outside the dining room, and easy access to The Leas - a public park area overlooking the sea. The Providers, Fraser Residential Limited, have been running the Home for several years, and are committed to ensuring that residents receive high standards of care. St Heliers Residential Hotel H56-H05 S23583 ST HELIERS V231627 010805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection commenced at 09.30am, and finished at 6.00pm. The Inspector was able to chat with 9 residents during the day, some in their own rooms, and some in communal areas. She was also able to talk briefly with 3 relatives/friends, and was sent completed CSCI survey forms from 7 residents, and 7 relatives/friends. These were all very helpful in being able to form an overall view of the Home, and to confirm that residents were happy with the standards of care given. The Registered Manager (who is also a Provider) was available during the day, and also the General Manager, Head of Care and Assistant Manager. The Inspector was assisted by these staff, and also talked with a carer, 2 housekeepers, a restaurant assistant, and 2 chefs. Other staff were seen to be busy with their duties, or taking part in the handover after lunch time. The Home had a friendly and welcoming atmosphere, and was running calmly and efficiently. Staff combined a friendly attitude with professional behaviour, providing a secure and relaxed environment. The premises were spotlessly clean, and had a high standard of internal maintenance and décor. Work was just commencing on the exterior of the building, which includes replacing the roof with new tiles, and attending to paintwork and guttering while the scaffolding is in place. Scaffolding was being erected on the day of the inspection. Residents and relatives had been informed that this work was to be done. The Inspector viewed the premises, including most of the bedrooms and bathrooms, lounges and quiet areas, dining room, clinical room, laundry and kitchen. Some residents had chosen to lock their doors while they were out, or in the dining room for lunch. Records and documents viewed included care plans, pre-admission information, medication charts, some policies and procedures, accident records, complaints record, a number of staff files, and some servicing records. What the service does well: St. Helier’s is set in a very pleasant location near to the sea, and backing on to large private gardens. This is complemented by a well maintained interior, which is in keeping with the Victorian style of the premises, but with the addition of updated facilities (such as a passenger lift) to make it suitable for it’s purpose. The Providers have worked hard to bring the premises up to such St Heliers Residential Hotel H56-H05 S23583 ST HELIERS V231627 010805 Stage 4.doc Version 1.40 Page 6 a high standard. The housekeeping is excellent, ensuring that everywhere is kept clean and tidy. The Inspector noted that residents made very positive comments about the friendly and caring attitude of the staff. No negative comments were received about the staff from anyone spoken to, or from any written surveys. The Providers manage to keep a balance between a hotel-style residence, and giving personal care and attention to the residents. Many residents commented on the good food, the choice of menus and the presentation of the food. The dining area is regarded as a restaurant, and residents said that they are always able to have a choice of dishes, and can ask for any other specific meals if they do not feel like having those on offer. Salads and home-made soups are always available, and fresh fruit, vegetables and meat are used in preference to frozen foods wherever possible. Cakes and pastries are made on the premises. What has improved since the last inspection? What they could do better: The Inspector only received one comment during the inspection from residents/relatives about things which could be improved, and that was in respect of providing more activities. The Inspector was able to see that this was already in the process of being addressed. (see above section.) St Heliers Residential Hotel H56-H05 S23583 ST HELIERS V231627 010805 Stage 4.doc Version 1.40 Page 7 The Home ensures that daily reports are written for each resident at the end of each shift. The Inspector felt that these did not contain sufficient evidence of care given, and recommends that more details are included. Medication charts did not include staff signatures for handwritten entries, and there is a requirement to ensure that staff take accountability for any of these. There is also a recommendation to improve the procedure for any medication given in error, so that staff are fully aware of how to outwork their responsibilities if errors are made. The Home did not have paper towels in any areas, and this contravenes the infection control guidelines for Kent & Medway. There is a requirement to fit paper towel dispensers and pedal bins in communal toilets and bathrooms, the laundry room, and the clinical room. The Inspector could not see the need to fit these in other rooms of the Home. Personal laundry is carried out in the Home, and the current washing machine is not fitted with a sluice facility for dealing with any soiled linen. There is a procedure in place, but it is a requirement that the Providers reassess the infection control procedures. This may include the purchase of a washing machine with an integral sluicing facility, and ensure that any soiled items are put directly into red alginate sacks and into the machine. Items should not be soaked in a sink as this is contrary to infection control procedures. The Registered Manager is also one of the Providers; she has been assisted in fulfilling managerial responsibilities by other designated staff. There are new requirements in place for Registered Managers to have achieved/commenced NVQ 4 /Registered Managers Award training by 31.12.05, and the General Manager has completed these qualifications. There is an intention for the General Manager to apply to CSCI for the Registered Managers’ post, and there is a requirement to ensure that this is carried out in sufficient time to meet the given deadline. A further recommendation is given in respect of ensuring that Data Protection Act 1998 legislation is complied with, when accident records are completed. 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 Heliers Residential Hotel H56-H05 S23583 ST HELIERS V231627 010805 Stage 4.doc Version 1.40 Page 8 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 Heliers Residential Hotel H56-H05 S23583 ST HELIERS V231627 010805 Stage 4.doc Version 1.40 Page 9 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) 1-5 (Standard 6 does not apply in this Home.) The Home provides clear and detailed information for any prospective residents, ensuring that they can make an informed decision before moving into the Home for a trial period. Residents are fully assessed prior to admission to ensure that the Home can meet their needs. EVIDENCE: The Registered Manager and the General Manager had worked hard to update the Statement of Purpose and Service Users’ Guide. The Statement of Purpose includes all the required data, and is laid out in a straightforward format, enabling relatives, prospective residents or authorised professionals to understand the ethos and objectives of the Home. The Service Users’ Guide has been prepared in easy to read larger print, and gives a detailed overview of life in the Home, with information about the services provided, staffing, terms and conditions of residency, and residents’ rights. It includes a sample contract, menu choices, the complaints procedure, St Heliers Residential Hotel H56-H05 S23583 ST HELIERS V231627 010805 Stage 4.doc Version 1.40 Page 10 and some views of the Home expressed by residents and relatives. A number of photographs enable anyone who lives at a distance to get a flavour of the Home. The Manager has produced a more detailed Service Users’ Guide for anyone who requires additional information; this contains far more detail about the help available for giving personal care, dressing, bathing, assisting with mobility, and staff duties and training. Before coming into the Home, residents are assessed by one of the management team – either in hospital or in their own homes – to ensure that the staff will be able to meet their needs. Pre-admission assessments are kept in residents’ care plan files, and the Inspector read 5 of the completed assessments. Details included family and social history; mobility needs; physical and medical history; communication ability; nutrition needs; medication, and assistance needed with personal care. Further information had been taken at admission, and highlighted specific data such as diabetes or allergies. The allocated room was specified, and the physical condition of the resident on the day of admission. The Managers ensure that the available room is suitable for the person concerned, taking into account any additional equipment needed (eg: wheelchair, commode). All residents are given a contract, and these specify the fees, and arrangements regarding items such as hospital admission, pets, smoking, and bringing personal possessions into the Home. Contracts are arranged on an individual basis, and take into account the size of the room occupied. Residents are admitted for an initial trial period of 4 weeks, but this can be extended if required. Emergency admissions may take place if there is a suitable vacant room, and these residents would still be fully assessed prior to the Home arranging admission. St Heliers Residential Hotel H56-H05 S23583 ST HELIERS V231627 010805 Stage 4.doc Version 1.40 Page 11 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) 7-11 Detailed care plans are in place, providing staff with clear information which enables them to carry out their tasks effectively. Health needs are met, with evidence of good input from other health professionals, and evidence that residents privacy and dignity is maintained. Medication systems ensure that this aspect of health care is carried out satisfactorily. EVIDENCE: The Inspector assessed care plans for 5 residents, including the 2 most recent admissions, 2 residents who had been in the Home for several years, and 1 for a resident with mental health needs. The Manager had identified that 3 residents had developed mental health problems, and CSCI have agreed to add a condition to the registration to enable these residents to stay. The Home was able to show suitable additional support to meet the extra needs of these clients. Care plans are drawn up with the involvement of the resident, their family members, and the Care Manager (as applicable). The Inspector noted that some care plans had been signed by residents or their representatives to show St Heliers Residential Hotel H56-H05 S23583 ST HELIERS V231627 010805 Stage 4.doc Version 1.40 Page 12 agreement of the plan. These are then reviewed monthly by one of the Managers, and signed and dated accordingly. Care plans are presented in individual folders, and are based on the “Roper’s Activities of Daily Living”, which have separate plans for details such as: maintaining a safe environment; eating and drinking; continence and elimination; personal care; skin integrity and pressure area care; mobility; social interests and mental health. These plans were suitably detailed according to individual needs, and had been appropriately reviewed. Following sections included risk assessments (such as going out unaided, or self-medication); a weight chart for monthly weights; and nutrition details, including a likes and dislikes list. Visits by different health professionals are recorded, and give information regarding visits from eg: GPs, District Nurses, Occupational Therapists, dentist and optician. The Home arranges for chiropodists to visit the Home for podiatry care, and an ex-dance teacher is employed to go in and give an armchair exercise class every 2 weeks. The Inspector was able to follow a clear pathway for a resident who had been unwell and had been admitted to hospital; the records contained information about blood tests, pressure relief and doctors’ visits. Specialist needs are dealt with by professionals such as the Community and Psychiatric Team, (CAST), the Community and Rehabilitation Team (CART), and by the Kent Association for the Blind (KAB) – who provide aids and talking books for blind or partially sighted residents. The clinical room and medication administration records (MAR charts) were inspected, and were seen to be well managed. Policies and procedures are kept in a separate folder for easy access. The Inspector noted that while there was a policy for medication given in error, there was no procedure in place. A recommendation was given for this, so that staff have a clear understanding of what to do in this instance. Different locked cupboards are provided for external medications and lotions, and for stock tablets. There was no out of date medication, and no overstocking. A drugs fridge is used for storing eye-drops etc, and these had been dated on opening. The temperature of the drugs fridge is recorded daily. Controlled drugs are stored correctly and a register is kept with 2 signatures for each time these are administered. The Inspector checked the amounts for one resident, and these tallied with the records. Suitable assessments are carried out for any residents wishing to self-medicate, and the Manager ensures that they have a lockable facility in their rooms for storage. Residents confirmed that staff retain their privacy and dignity at all times. Letters from relatives showed that terminal care is given with compassion and attention to detail. St Heliers Residential Hotel H56-H05 S23583 ST HELIERS V231627 010805 Stage 4.doc Version 1.40 Page 13 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) 12-14 Residents are enabled to follow their preferred lifestyles, and are assisted with retaining links with the community. The Home has made progress with arranging some additional activities, although this could be further improved. The meals offered provide excellent choice and variety. EVIDENCE: The Home provides some entertainment opportunities, including singing afternoons, games, quizzes, videos and celebrations/parties for special events. Residents also enjoy one to one attention with manicures, individual shopping outings, and walks in the local gardens. Some residents like to attend local clubs such as the Over-60s club, and afternoons organised by the Salvation Army. Church Services are held in the Home, and residents are assisted in going out to churches of their choice. The Home has a well-stocked library, and these books are changed by the local library service every 3 months. An increase in activities had been discussed at a recent residents’ meeting, and the Home was willing to facilitate any new ideas. Some residents suggest activities which are then arranged, but may then change their minds about attending. The Inspector felt there was a commitment on the part of the Home to see activities provided according to residents wishes. St Heliers Residential Hotel H56-H05 S23583 ST HELIERS V231627 010805 Stage 4.doc Version 1.40 Page 14 Visitors are welcome at any time, and some residents told the Inspector that their relatives stayed for meals with them, or took them out. The staff recognise that this is the residents’ home, and they should be assisted to carry out their own choices as much as possible. Residents are able to bring in their own personal furniture and possessions, including their own TV sets and music centres. These are checked to ensure that they comply with electrical requirements. The Inspector visited the kitchens, and was able to chat with 2 chefs who were in the time of handover between shifts. The kitchens were well organised, clean and well equipped. Fridge, freezer and meat temperatures are recorded, and there is a systematic cleaning schedule in place. The night staff assist with some of these duties. The chefs use fresh ingredients as much as possible, and all cakes and pastries are home made. Residents said that the food is very good, well presented, and with plenty of choice. They are able to have a choice of cooked breakfasts if they wish, and have a choice of main dishes and desserts at all meal times. Additional snacks/drinks are available if requested. The dining room is set up in the same style as a restaurant, and extra serving staff are employed. Menu formats are discussed with the management, and reflect seasonal changes. St Heliers Residential Hotel H56-H05 S23583 ST HELIERS V231627 010805 Stage 4.doc Version 1.40 Page 15 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) 16-18 The Home has a satisfactory complaints procedure, and records showed that suitable action is taken in response. Residents said that the staff listen to them, and act on any concerns. The staff had recently been updated with understanding the recognition and prevention of adult abuse. EVIDENCE: The Home has a good complaints procedure in place, and this is available in the Home’s entrance hall, as well as in the Service Users’ Guide. One complaint had been recorded since the last inspection. This concerned an item of a resident’s clothing. The records showed that suitable action had been taken in response to this complaint. No complaints had been made directly to CSCI. The Home retains a list of advocacy services available to residents, and the Managers will arrange advocacy if requested. Residents are encouraged to continue to manage their own affairs for as long as possible, and some are still interested in taking part in the political processes. The General Manager had recently updated her own training regarding Adult Protection, and had been going through the “No Secrets” guidance on an individual basis with staff, during one to one supervision times. This ensures that staff know how to recognise different types of abuse, and the appropriate action to take if there is a suspicion of this. The Home has a whistle-blowing policy in place, so that staff can alert the management or CSCI in the event of needing to do so. Improved recruitment procedures ensures that new staff are properly police St Heliers Residential Hotel H56-H05 S23583 ST HELIERS V231627 010805 Stage 4.doc Version 1.40 Page 16 checked (Criminal Record Bureau), prior to confirmation of employment. New staff are not allowed to work unsupervised until satisfactory references, POVA First check (Protection of Vulnerable Adults), and CRB check have been received. St Heliers Residential Hotel H56-H05 S23583 ST HELIERS V231627 010805 Stage 4.doc Version 1.40 Page 17 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) 19-24, 26. The Home is well maintained, and has decor and furnishings of a high standard. It provides an excellent enviroment for its purpose, and is fitted with additional facilities and equipment to meet residents needs. The Home is kept spotlessly clean, but would benefit from some further attention to laundry procedures. EVIDENCE: The Home is situated near to the town of Folkestone and has pleasant sea views from some windows. It backs on to large mature gardens, and there is patio overlooking this area. The external maintenance was in the process of being improved, although visually it already appeared clean and tidy, and was enhanced by flower tubs and baskets. Scaffolding was being erected in order to replace the roof with new slates. Window frames were scheduled to be repainted while the scaffolding was in position, and guttering to be checked and replaced if indicated. St Heliers Residential Hotel H56-H05 S23583 ST HELIERS V231627 010805 Stage 4.doc Version 1.40 Page 18 The Providers intend to further enhance the appearance of the property by fitting Victorian style flooring tiles to the outside pathway; these will be nonslip tiles to promote safety. The Home was kept very clean in all areas, but the Inspector noted some concerns about the laundry procedures. The laundry has 2 domestic washing machines, neither of which has a sluicing facility. One machine is identified as being kept for dealing with soiled items, but these are first left to soak in a sink, which contravenes infection control standards. As noted in the summary of this report, soiled items should be placed into alginate bags and put directly into the washing machine, not soaked in a sink. This is the same sink identified for hand-washing in this room. Clothes are aired in a room next door which contains a hot water cylinder, and there is a tumble-dryer in the laundry room. There is a requirement for the Providers to re-assess the laundry procedures for soiled items. A few commodes are in use at night in some rooms. These are emptied and cleaned in residents’ own en-suite facilities. An unused bathroom is designated for deep cleaning of commode buckets, and clear procedures were in place to carry this out. Residents have well decorated bedrooms, and these have en-suite toilet facilities except for 2 rooms – which have their own toilet facilities adjoining the bedrooms. Most bedrooms are very large, and well over the recommended sizes. Some are large enough to be used for 2 people sharing if wished (eg: a married couple). The Home is well equipped with assisted baths of different types, shower facilities, raised toilet seats, grab rails and a mobile hoist. A passenger lift has been fitted to enable access to all floors. The Home has sufficient communal areas including lounges, dining–room and small quiet areas on different floors. The Inspector noted that there were no paper towel dispensers in the Home, and although clean hand towels are placed in bathrooms each day, this does not provide for effective infection control. There is a requirement to provide paper towels and pedal bins in communal toilet rooms, the clinical room, the laundry and staff areas. St Heliers Residential Hotel H56-H05 S23583 ST HELIERS V231627 010805 Stage 4.doc Version 1.40 Page 19 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) 27-30 The Home has a dedicated staff team, who work well together to meet different areas of responsibility. Sufficient staff are employed to provide effective care. Recruitment practices have been improved in response to a requirement given at the last inspection, and there is a satisfactory induction programme. EVIDENCE: Day care staff work in 2 shifts, from 07.30-1.30pm, and from 1.30-7.30 pm. The Home provides 3 care staff for each shift, and one of these would usually be a senior carer. This added responsibility is only given to carers who have completed NVQ 3 training. The Home has different Managers and a Head of Care in addition to the carers, and usually 2-3 of these would be on duty during weekdays, and 1 at weekends. A senior carer may take charge at weekends, but a Manager is always on call during nights and weekends. The Home employs 2 staff for night duties, - (from 7.30pm –7.30 am) - 1 waking, and 1 sleeping. Hourly checks are carried out at night for all residents, and conversation with some of the residents confirmed that they find this reassuring. The night carers complete a diary notebook for duties carried out in the night, which clearly itemises which clients are assisted in any way (eg: toileting, getting drinks). This is in addition to writing individual night reports, and this book enables management to see immediately if there is an ongoing problem with caring for any residents during the night. St Heliers Residential Hotel H56-H05 S23583 ST HELIERS V231627 010805 Stage 4.doc Version 1.40 Page 20 The Home employs 2 housekeepers each day, and they talked about the training they had received in respect of infection control, COSHH, and the initial induction process. The kitchen is staffed by 2 chefs working opposite shifts, and by Servery Assistants for the dining room. One of the Providers takes responsibility for all the Home’s maintenance – either carrying this out himself, or employing accredited tradesmen for specific tasks. Staff are assisted in studying for NVQ levels 2 or 3. The Home currently had 5 carers who had completed NVQ 2 or 3 training, and another 3 who were in the process of completing these. This will provide the Home with over 50 of care staff with NVQ 2 or 3 training. Recruitment procedures had been significantly improved, and 4 staff files examined contained all the required documentation. This includes a recent photograph, application form with details of previous employment, proof of identity, 2 written references, health data, a statement in respect of any criminal convictions, and training records. New staff are given a GSCC code of conduct as well as a staff handbook and a job description, and are required to sign a statement regarding confidentiality. Staff are not confirmed in employment until satisfactory POVA First and CRB checks have been received, and shadow other staff until they are assessed as competent to carry out different duties. The induction programme was seen to be satisfactory, but the General Manager informed the Inspector that this was in the process of being re-assessed, and would cover different items over the first 6 weeks. Core training courses are arranged with accredited training sources, and staff training records demonstrated that these were attended on an ongoing basis. St Heliers Residential Hotel H56-H05 S23583 ST HELIERS V231627 010805 Stage 4.doc Version 1.40 Page 21 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) 31-34, 36-38 The Homes management structure is in a state of change in order to meet the CSCI requirements for a Registered Manager with specific qualifications. The management team work well together to ensure that the Home runs smoothly and provides a good quality of care. Staff and Residents views are taken into account when discussing any proposed changes to the Home. Health and safety procedures are put in place to promote the well being of residents. EVIDENCE: One of the Home’s Providers is also currently the Registered Manager, but does not hold the required qualifications in management and care to continue in this post. The General Manager has completed NVQ4 and the Registered Managers’ Award, and is ready to apply for the Registered Manager’s post in accordance with the regulations. The Inspector recommends that this application is made St Heliers Residential Hotel H56-H05 S23583 ST HELIERS V231627 010805 Stage 4.doc Version 1.40 Page 22 to CSCI in sufficient time to meet the target date of 31st December 2005. The General Manager is also trained as an Assessor, and as a Moving and Handling Trainer. The Home has an Assistant Manager and a Head of Care, who have designated responsibilities, and further assist the smooth running of the Home. Staff meetings are held to ensure that staff are kept informed of proposed changes, and are able to contribute their ideas and viewpoints to the different discussions. The Home has recently achieved the Investors in People award. Planned supervision sessions are held on a one to one basis for all staff, and records of supervision and appraisals were viewed in staff files. Residents are invited to share their feelings and concerns at any time, and a Home questionnaire is provided at different times in the year, to enable residents to voice their feelings in confidence. Feedback is welcomed from relatives and visitors, and forms for “complaints and compliments” are kept available in the entrance hall. A recent residents meeting had been instigated, and residents had enjoyed talking together about different topics. Policies and procedures were all in order, and the Inspector viewed the medication policies and the whistle-blowing policy. Records are stored in a secure environment, which is also available to staff. Residents are informed that they can view their own records at any time, on request. Staff training records showed that staff were being trained in mandatory subjects such as fire awareness, first aid, moving and handling, infection control, food safety and health and safety. Courses were being booked for new staff to attend. Fire records were examined and seen to be satisfactory. These included fire drills for all staff, fire training with an Instructor, fire alarm tests, emergency lighting checks and fire equipment servicing. The NICEIC electrical certificate, and gas boiler certificates were up to date. PAT testing was carried out for all smaller electrical items on the day of the inspection. Satisfactory servicing records were also seen for the call bell system and hoist servicing. Accident records were properly completed, but were being filed in residents’ own records. This contravened Data Protection legislation, as it enables staff to find out each other’s addresses. There is a recommendation to ensure that these documents are stored correctly. Risk assessments had been carried out for each individual room. These were excellent, and contained lots of details. General risk assessments for the building were also in place. The Home is run as a Limited Company, and accounts are audited yearly. The Insurance certificate was on display and was up to date. St Heliers Residential Hotel H56-H05 S23583 ST HELIERS V231627 010805 Stage 4.doc Version 1.40 Page 23 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 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 4 3 3 3 4 4 x 1 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 Standard No 16 17 18 Score 3 3 3 2 3 3 3 x 3 3 2 St Heliers Residential Hotel H56-H05 S23583 ST HELIERS V231627 010805 Stage 4.doc Version 1.40 Page 24 NO 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 To ensure that all handwritten entries on Medication Adminisrtation Records are signed and dated for accountability. To provide paper towels and disposal bins in communal toilets, laundry, clinical room and staff areas. To review the infection control procedures regarding the laundering of soiled items. Timescale for action 1st September 2005 1st November 2005 1st October 2005 2. OP26 13 (3) 3. OP26 13 (3) 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. OP8 OP9 OP31 OP38 Refer to Standard Good Practice Recommendations For daily reports to include more detail in respect of personal care given, mood, activities etc. To draw up a clear procedure to be followed in the event of medication given in error. To apply to CSCI for registration of a new Manager within the given timescale, in order to achieve this by the target date of 31.12.05 To ensure compliance with the Data Protection Act 1998 in respect of the storage of accident records. H56-H05 S23583 ST HELIERS V231627 010805 Stage 4.doc Version 1.40 Page 25 St Heliers Residential Hotel 5. 6. St Heliers Residential Hotel H56-H05 S23583 ST HELIERS V231627 010805 Stage 4.doc Version 1.40 Page 26 Commission for Social Care Inspection 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 Heliers Residential Hotel H56-H05 S23583 ST HELIERS V231627 010805 Stage 4.doc Version 1.40 Page 27 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!