Inspection on 15/02/06 for St Helier`s Residential Hotel

This inspection was carried out on 15th 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 Helier`s Residential Hotel 03/01/07

St Helier`s Residential Hotel 01/08/05

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 June Davies Unannounced Inspection 15th February 2006 09:30 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 Heliers Residential Hotel DS0000023583.V272055.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 Heliers Residential Hotel DS0000023583.V272055.R01.S.doc Version 5.1 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 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) 01303 254980 hotel@st-heliers.net Fraser Residential Ltd Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places St Heliers Residential Hotel DS0000023583.V272055.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Three (3) OP beds should be designated for the Three (3) residents MD(E) whose dates of birth are 26/04/1927; 19/07/1921 and 25/08/1919. 1st August 2005 Date of last inspection 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 DS0000023583.V272055.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out on the 15th February 2006 at 11.00 a.m. over a period of 5.5 hours. At the beginning of the visit some of the residents were in the ground floor communal lounge taking part in a talking book activity. The unannounced inspection covered, talking to the head of care, meeting with a provider, a brief discussion with a resident, looking at supporting documentary evidence, and a tour of the building. During conversation with one of the residents, the inspector was told, that the ‘care staff are very good to me’, ‘all my needs are met’, ‘the food is very good’. What the service does well: What has improved since the last inspection? A sluicing facility has been made from one of the communal bathrooms on the first floor, this bathroom was too small to safely use as a communal bathroom and is more suited to its present use. Further maintenance will provide for the laundry room to be re-sited, and this is due to take place once the present external maintenance has been completed. St Heliers Residential Hotel DS0000023583.V272055.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 Heliers Residential Hotel DS0000023583.V272055.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 Heliers Residential Hotel DS0000023583.V272055.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): 2, 3, Residents are provided with sufficient information within the contract/statement of terms and conditions, for their stay in St Heliers. Pre admission assessments need to be carried out on every resident admitted to the home, and should contain sufficient information on which to base a care plan. EVIDENCE: The inspector was able to view resident’s contracts/statements of terms and conditions and noted that these documents conformed to the standard, confirming the number of the room to be occupied and fees payable, and were signed by the residents and the home manager. Three care plans were viewed, while two care plans contained pre admission assessments, these were not detailed enough to give sufficient information on which to base a care plan. One care plan did not have a pre admission assessment, and the head of care explained that this resident was admitted into the home in a rush. The inspector has therefore made a requirement that St Heliers Residential Hotel DS0000023583.V272055.R01.S.doc Version 5.1 Page 9 pre admission assessments contain the information as required by standard 3.3, and that all residents have a pre admission assessment carried out prior to admission into the home. St Heliers Residential Hotel DS0000023583.V272055.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): 7, 8, 9, 10 Care planning is not consistent to adequately provide staff with the information and risk assessments they need to satisfactorily meet the residents needs. Systems of medication need to improve to prevent placing residents at risk. Care staff respect the privacy and dignity of the residents in the home. EVIDENCE: Three care plans were viewed during the course of this visit, the information contained within the care plans was not consistent, in one care plan there were no likes and dislikes recorded, there was no evidence of regular weight checks being carried out in another care plan, and in all the care plans viewed the risk assessments had not always been fully completed, and there was no evidence to give the staff clear guidelines as to how the risk could be reduced. In the daily report on each resident there were referrals to G.P.’s visits, but this had not been entered onto the professional visits chart within the care plan. There was however evidence that the care plans had been reviewed on a monthly basis. A requirement has been made relating to consistent information being St Heliers Residential Hotel DS0000023583.V272055.R01.S.doc Version 5.1 Page 11 contained within each residents care plan, and that risk assessments are fully completed. On viewing three residents daily report records, personal care was described as ‘full care given’, there was no reference to personal hygiene care, and what personal hygiene assistance had been given to each resident. No evidence was available to show, that attention had been paid to: - dental care, hair care, nail care, observance of tissue viability etc. While there was evidence within each resident’s daily report professional health care visits were not accurately recorded within the care plan. Evidence was available within the residents daily reports that district nurses support the home regarding the tissue viability of the residents as and when required, that those residents who need assessment from the continence nurse receive this service, and that CPN visits can be arranged when required via referral from the G.P. The head of care was able to confirm that residents are able to see opticians, dentists and chiropodists of their choice, but again this needs to be recorded within the care plan. The inspector carried out a check of the medication. Some residents are selfmedicating, with some or all of their medication, and permission letters were available within the care plans to confirm this. The head of care also reported that self-medicating residents do have their medication checked on a regular basis to ensure that they are still able to cope. For medication that was administered by the trained staff, some initials were missing on the MAR sheets, and it was not clear whether this medication had been administered or not. Where medication had been received into the home, this was not always clearly recorded on the MAR sheet. The inspector also noted that on one MAR sheet two analgesic had been prescribed, only one analgesic should be prescribed to prevent confusion and the possibility of overdosing. It was also noted that where eye drops are administered, the date of opening was marked on the box and should be marked on the bottle. On checking the controlled drugs, while C.D’s are appropriately stored within a double locked facility, the inspector noted for the one controlled drug that was kept in the home, the actual drugs remaining did not match with the controlled drugs book, although two members of staff had signed to state the number of tablets left. Requirements have been made, for the home to meet with the NMS in regard to medication. Evidence was available to show that staff who administer medication had received medication training. The home has an up to date policy and procedure on the administration of medication, and the inspector witnessed that that the home has an up to date copy of administering staff’s initials and signatures. While touring the building the inspector noted that staff, were respecting the privacy and dignity of the residents, by knocking on doors before entering residents bedrooms, conversations between staff and residents was discreet. St Heliers Residential Hotel DS0000023583.V272055.R01.S.doc Version 5.1 Page 12 Residents are able to have their own telephone lines in their rooms if they wish to. Staff are willing to take residents clothes shopping, in some cases relatives make purchases of clothing for their own residents in the home. Of the three care plans viewed by the inspector it was noted that only one care plan stated the residents preferred term of address, and a recommendation has been made that care plans state the residents preferred term of address. St Heliers Residential Hotel DS0000023583.V272055.R01.S.doc Version 5.1 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 the following standard(s): 12, 13, 15 The home needs to develop a diverse activities plan, to ensure that the social and cultural needs of the residents are met. For some residents links with the local community are good. The meals in this home are good offering both choice and variety and catering for special diets. EVIDENCE: The home has an activities book, which records activities taking place within the home. The inspector noted that since the 1st January 2006 there were only 12 recorded activities taking place. Some of these activities were: talking books, arts and crafts, beanbag game, nail care, video afternoons. The head of care stated that activities do take place but are not always recorded, and some residents choose not to be involved in activities at all. The inspector has made a requirement that activities organised by the home and of interest to the residents are accurately recorded, and that a structured plan of activities is compiled and made available to residents, to ensure what activities are available to the residents on a daily basis. Evidence was available in the care plans viewed to show that some residents are escorted into the town by members of care staff, or are able to go along the ‘the Leas’ and sea front for a walk when the weather is nice. One or two residents like to visit the theatre, when there is a show that interests them. St Heliers Residential Hotel DS0000023583.V272055.R01.S.doc Version 5.1 Page 14 Two residents are able to visit the church of their choice. The home has regular visits and communion from the local Church of England and Roman Catholic churches. The communal dining room was seen to be attractive and homely. All tables were laid attractively, and residents are able to choose where they sit. The menu showed that residents are offered choice and variety of nutritious home cooked food. Some of the residents choose to eat their meals in their own bedrooms. One care plan stated that a resident likes to have a cooked breakfast once a week. Drinks are available to the residents throughout the day. The home caters for special diets on request or as directed by the G.P. or district nurse. The chef is able to cater for the likes and dislikes of all the residents in the home. St Heliers Residential Hotel DS0000023583.V272055.R01.S.doc Version 5.1 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 the following standard(s): 16 Residents know their complaints will be listened to and acted on. EVIDENCE: The home has had no complaints since the last inspection. There is an up to date complaints policy and procedure in place, it was confirmed by the head of care that residents would know how to complain, should the need arise. St Heliers Residential Hotel DS0000023583.V272055.R01.S.doc Version 5.1 Page 16 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): 19, 21, 23, and 26 The standard of the environment within the home is good providing the residents with an attractive and homely place to live. EVIDENCE: St Heliers is suitable for its stated purpose. At the time of the inspection the exterior of the building had scaffolding erected for essential maintenance, repair to the main roof, guttering and replacement of some windows. The home has a programme of routine maintenance, with further maintenance taking place in the near future. The courtyard at the rear of the building is due to be tidied up in time for the summer months, and once the scaffolding has been removed. All exterior doors to the home are covered by CCTV cameras to ensure security of the building and for the residents in the home. Most of the bedrooms in the home offer en-suite facilities, and there are communal bathrooms and toilets on each floor. Some of the bathrooms have specialised baths fitted to ensure ease of use for the residents in the home. The inspector did note that one communal bathroom on the first floor needed St Heliers Residential Hotel DS0000023583.V272055.R01.S.doc Version 5.1 Page 17 attention to the seal around the bath area, and a requirement has been made in relation to this seal. One bathroom has been put out of service as a communal bathroom, and is now being used as a sluicing facility. The inspector noted that the door had the appropriate sign in place and that the door is kept locked while not in use. At the time of the tour of the building, most residents were in their rooms resting, and did not wish to be disturbed. The inspector did view some of the of the vacant bedrooms in the home and found these to be sufficiently large enough to meet the needs of prospective residents.. All resident’s bedrooms are carpeted and domestically furnished. Residents are able to bring items of furniture, personal ornaments and pictures into the home with them if they wish to. All residents are able to lock their own bedroom doors, but staff are able to access these bedrooms with a skeleton key if an emergency arises. Residents have a lockable space within their bedrooms in which they can keep items of value, or medication if self medicating. On the day of the visit the home was clean, tidy and free from offensive odours. The home has policies and procedures in place to prevent cross infection, and the inspector noted that communal hand washing facilities were provided with paper towels, liquid soap, and pedal bins. The inspector noted that the home has a domestic type washing machine, and through discussion with the head of care and one of the providers, there are plans once the present refurbishment has finished, that a new laundry area is going to be provided, and this will then have a industrial washing machine, which meets the sluicing and disinfecting requirement of standard 26. St Heliers Residential Hotel DS0000023583.V272055.R01.S.doc Version 5.1 Page 18 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): These standards were not inspected on this occasion. EVIDENCE: These standards were met at the announced inspection in August 2005. St Heliers Residential Hotel DS0000023583.V272055.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 and 38 The home’s management structure is in a state of change in order to meet CSCI requirements for a registered manager. Health and safety procedures are in place to maintain the well being of the residents. EVIDENCE: The general manager has just completed her NVQ level 4 and RMA qualification, and is in the process of applying to be the registered manager of St Helier’s. An application form has not yet been received by CSCI and therefore a recommendation has been made that a registration application is made. The inspector noted that during a tour of building all the relevant Health and Safety signs were displayed in the appropriate places. The home has up to St Heliers Residential Hotel DS0000023583.V272055.R01.S.doc Version 5.1 Page 20 date policies and procedures in relation to health and safety for both residents and staff. The inspector did note that in some care plans, there was evidence of accident forms, these should be kept separately from the care plans in an accident record file and a recommendation has been made to comply with this. St Heliers Residential Hotel DS0000023583.V272055.R01.S.doc Version 5.1 Page 21 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 3 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X 2 X 3 3 X 2 STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X X X X 2 St Heliers Residential Hotel DS0000023583.V272055.R01.S.doc Version 5.1 Page 22 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 OP3 Regulation 14 Sch.3 (1)(a) Requirement Pre admission assessment is carried out for each resident prior to moving into the home. Pre-admission assessments contain sufficient information on which to base the care plan. Care plans contain sufficient information on which to base individual care for each resident and are consistent. Care plans contain risk assessments, which have been fully completed, and provide good guidelines to staff as to how the risk can be minimised. Care staff record details of assisted personal hygiene tasks and checks carried out with residents. Care plans accurately reflect visits carried out by health care professionals. Visits noted on daily report are accurately reflected within the care plan. St Heliers Residential Hotel DS0000023583.V272055.R01.S.doc Version 5.1 Page 23 Timescale for action 31/03/06 2. OP7 15 Sch.3 (1)(b) 28/04/06 3. OP8 12 (1) 28/04/06 4 5 OP9 OP9 17(1)(a) Sch.3(3)(i ) 17(1)(a) Sch.3 (3)(i) 6 OP12 16 (2) (m)(n) Accurate records are kept of all 17/03/06 medicines received, administered and leaving the home. 13(2) Designated and 17/03/06 appropriately trained staff administers controlled drugs. Another designated, appropriately trained member of staff accurately witnesses the administration of controlled drugs. Accurate records are kept of 31/03/06 activities taking place in the home. That organised activities are the choice of the residents in the home. That resident’s have a daily record of activities taking place, so they are able to choose activities of their choice. Seals around bath areas are kept 31/03/06 in a good state of repair to prevent cross infection. 7 OP26 13(3)(4) (a)(c) RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard OP10 OP26 OP31 OP38 Good Practice Recommendations Residents preferred term of address should be entered into the care plan. That the domestic washing machine is replaced with an industrial washing machine, which meets the sluicing and disinfecting standard, when the laundry room is relocated. To apply to CSCI for registration of a new manager within a timescale of by the target date of 31/03/06 To ensure compliance with the Data Protection Act 1998 in respect of accident records. St Heliers Residential Hotel DS0000023583.V272055.R01.S.doc Version 5.1 Page 24 St Heliers Residential Hotel DS0000023583.V272055.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Kent and Medway Area Office 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 DS0000023583.V272055.R01.S.doc Version 5.1 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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