CARE HOMES FOR OLDER PEOPLE
St Heliers Residential Hotel 25/26 Clifton Gardens Folkestone Kent CT20 2ED Lead Inspector
Lois Tozer Unannounced Inspection 3rd January 2007 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.V303618.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. St Heliers Residential Hotel DS0000023583.V303618.R01.S.doc Version 5.2 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.V303618.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 15th February 2006 Brief Description of the Service: St.Heliers is made up of two large Victorian style terrace properties, which have been linked internally. It is situated in a quiet residential area of Folkestone, close to The Leas, the sea front, and the town centre. 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 (e.g. partners). 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 access to shared gardens at the rear of the property, featuring beautiful trees and shrubs. Staffing is provided in sufficient numbers to meet service users needs. Over 50 of staff hold an NVQ certificate. 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. The company has a team of three dedicated managers. One, Liz Burton, has worked with the providers since 2000, and has recently taken on the role of responsible individual as acknowledgement of her contribution to improvement. All previous inspection reports are available from the home. The fee for this home starts from £303.00 rising to £550.00. St Heliers Residential Hotel DS0000023583.V303618.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This key site visit took place on 3rd January 2007 between 09.45 am and 3.30 pm. The manager, Ms Vanessa Simpson, service users and staff assisted with the process. Twenty-five people live at the home at the moment. Five people gave verbal feedback. Questionnaires were sent to 10 residents and their relatives, but (because of the Christmas holiday) had not been received back before the report was written. Four care plans were ‘tracked’ and these formed the basis of the inspection. All communal areas of the home and some private rooms were seen. Residents were happy to discuss their experience of living at St Heliers. All were very happy and made it clear that they would not choose to live elsewhere. The inspection process consisted of information collected before and during the visit to the home. Other information seen included assessment and care plans, medication records, duty rota and complaints logs. What the service does well:
The management team involve the residents in the planning and development of the home. When changes are planned, residents are fully consulted. Residents can see that their suggestions are put into action. The care planning system is very good. It is written from the pre-admission assessment, which is conducted in consultation with the potential service user. Independence and enjoyment of life are encouraged. People living at the home choose to get involved in activities if they wish. Many choose not to do so. The majority of people have really large, semi-self contained apartment style rooms. This gives a real ‘home from home’ feeling, as they are able to furnish the rooms with chairs, dining furniture, and items of hobbies and interests. The communal areas are extensive and very well decorated and furnished. The home is warm and comfortable. Alcoves have been used creatively to make quiet areas and libraries. The home is licensed to sell alcohol, as it retains the status of a hotel. St Heliers Residential Hotel DS0000023583.V303618.R01.S.doc Version 5.2 Page 6 There are activities available within the home. Staff offer the opportunity to all residents to join in. In warm weather, staff support picnics and outings. The Leas Bandstand is within sight of the home too. Residents can walk round to see the bands, or open a window to listen. Every resident spoken to during this visit complemented the home and said they would never choose to leave. One resident said ‘I wrote to the owners a little while ago to say the home is always tip top and it’s a wonder they keep it up all year round!’ Residents know that they can complain and feel confident to speak to staff about any issues. What has improved since the last inspection? What they could do better:
The management and staff team are conscientious and try to identify issues needing improvement on a regular basis. As such, many problems are nipped in bud as they arise. Service users are encouraged to say what they think the home could do better. The manager has been in post for several years, but registration with CSCI has still not taken place. This has recently been started with the manager submitting the form for the police check. From this visit, the management team need to review the way medication is stored. This includes controlled drugs, refrigerated items and the storage of oxygen.
St Heliers Residential Hotel DS0000023583.V303618.R01.S.doc Version 5.2 Page 7 Whilst training is provided competency assessments in medication management, adult protection etc would protect service users and better monitor staff ability. Full feedback was given to the manager during the visit. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. St Heliers Residential Hotel DS0000023583.V303618.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection St Heliers Residential Hotel DS0000023583.V303618.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from an assessment before moving into the home. Intermediate care is not currently offered. EVIDENCE: Each service user has a detailed pre admission assessment. Service users, care managers and / or family members have had full input. The manager is qualified and competent to do this task. This leads onto the service user plan, which makes clear the individuals lifestyle and support needs. St Heliers Residential Hotel DS0000023583.V303618.R01.S.doc Version 5.2 Page 10 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The plans are clearly written. They express how each person needs and wishes to be supported in all aspects of social and health care. Self administration of medication is encouraged. Centrally administered medication is generally well managed, but some improvements would be beneficial. People are treated with dignity at all times. EVIDENCE: Service users plans are detailed and have been written with the individuals input. They express how to support each person and have been regularly reviewed. Staff are able to use these on a daily basis. St Heliers Residential Hotel DS0000023583.V303618.R01.S.doc Version 5.2 Page 11 Health care is very well supported; the home has excellent relationships with the various GP’s. Full and detailed notes are kept and changes are incorporated into the support plans. The attention to changing health needs is excellent. Service users are assessed to administer their own medication. This is risk assessed and reviewed. This area is generally safe and well managed, but improvements to storage of controlled drugs, oxygen and refrigerated medication are needed. Staff must take more care when signing off medication as given on the MAR when it has not – accuracy of recording needs to improve. The majority of medication is administered centrally by staff who have had some training. There is no competency assessment for staff; having such a system would safeguard service users further. Service users said that staff treat them with dignity. Observations during the visit showed that this was the case. Care plans make clear how individuals wish to be treated, and amenities, such as private telephones, are installed into bedrooms as required. Special arrangements have been made to protect service user dignity during mealtimes. St Heliers Residential Hotel DS0000023583.V303618.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home meets the lifestyle expectations of service users. Family and friends are very welcome and, along with staff, support service users remain in control of their lives. Meals are prepared to meet individual needs and to a consistently high standard. EVIDENCE: Service users are asked what they would like to have by way of activities. All are offered the chance to be involved. Many people choose not to be involved, finding that they have happily self-contained lives in their personal rooms. Many rooms are very large, and have room for TV, seating area, dining table and space for hobbies, such as music or painting. People socialise with each St Heliers Residential Hotel DS0000023583.V303618.R01.S.doc Version 5.2 Page 13 other in their own rooms. During the summer, trips out for picnics and local events are encouraged. Some people attend clubs and Church. Family and friends are very welcome. A visitor said they could not be more happy with the home and the knowledgeable staff team. Families are, by prior arrangement, offered a meal and can be accommodated to stay overnight. Long term relationships are well supported. The home only holds small amounts of cash on service users behalf, if this is requested. Service users are in control of their finances, and family or appointees help people who need additional support. The majority of residents furnish their own rooms, and this is encouraged. Dedicated cooks make sure that the menu reflects service users particular tastes. Individual dietary needs are catered for. People are consulted to review their tastes and preferences. Food is home cooked to a high standard. People can have their meals in the dining area or in their rooms. There are quiet dining areas for people who find groups difficult. St Heliers Residential Hotel DS0000023583.V303618.R01.S.doc Version 5.2 Page 14 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints are taken seriously and acted upon. Staff ensure service users are protected from abuse. EVIDENCE: Staff are clear on the action that must be taken should a service user or family member make a complaint or if a matter of protection arises. The internal log shows that all matters are taken seriously and resolved. Observations during the visit showed that residents had no hesitation to ask for help, or make a problem known. Staff are clearly open and approachable, ensuring that complaints will be heard. Adult protection training is given, but there is no competency assessment to check that this knowledge is still fresh and being applied. This type of ongoing quality check is recommended. St Heliers Residential Hotel DS0000023583.V303618.R01.S.doc Version 5.2 Page 15 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 23, 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The premises are safe, homely, hygienic and well maintained. Service users have spacious rooms that meet individual needs. EVIDENCE: The home is right for the service user group. It has been maintained to an excellent standard and has a homely feel throughout. Many service users have apartment style rooms that are so large, much of their own furniture fits in with ease. Twenty-seven rooms have en-suite facilities. There is a passenger lift that runs to all floors. The extensive communal areas are very well decorated and comfortable. Security cameras are fitted to the entrance areas only.
St Heliers Residential Hotel DS0000023583.V303618.R01.S.doc Version 5.2 Page 16 The domestic staff ensure that the home is clean and odour free at all times. A new laundry facility has improved the service and care taken with service user clothes. A dedicated sluice room is planned, but most service users have ensuite facilities in their bedrooms, limiting the use of commodes to a minimum. St Heliers Residential Hotel DS0000023583.V303618.R01.S.doc Version 5.2 Page 17 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Competent and qualified staff support the service users at all times. Recruitment procedures offer protections. EVIDENCE: Service users say that their needs are met quickly, and never with much delay. Staffing is provided based on the assessed needs of the service users. The mixture of staff on duty reflects a good balance between new and established members. Domestic and catering staff provide additional support. There is always a manager on duty during the day. A sleep-in staff member, who is on call, supports wake night staff. There is a senior on call system for staff to use in the evenings and through the night. Recruitment follows the correct procedure and staff benefit from a skills for care induction. Staff training is provided to meet service user needs. Over 50 of staff hold an NVQ2 or above qualification. The manager is a training facilitator for many courses, and is currently providing training courses to close identified gaps. St Heliers Residential Hotel DS0000023583.V303618.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a very well run home where they have a real say in the service provided. The manager is not registered with CSCI. Individuals’ finances are safeguarded. Health and safety is well supported. EVIDENCE: The manager has been in post for several years, but registration with CSCI has still not taken place. Recently, the manager submitted the form for the police St Heliers Residential Hotel DS0000023583.V303618.R01.S.doc Version 5.2 Page 19 check through CSCI. Once the police check is received, this application must be submitted without further delay. Nevertheless, the home is well run, and very much in consultation with the service users. The manager focuses on the achievement of excellence and works with Investors in People to make sure staff hold the same values. The manager has appropriate qualifications and keeps up to date with current good practice. There is significant liaison with healthcare professionals, and this advice and support is incorporated into the day-to-day running of the home. There is a well-developed quality assurance programme in place. Staff, service users and their families have formal input by way of meetings and questionnaires. Service users views are taken seriously, and recent suggestions made were put into action a few days later. Any small amount of money held on behalf of service users is clearly documented and accountable. No person working for the home has control of service user finances. Individual possession lists are in place for each service user at the point of taking up residence. All domestic service certificates are up to date. The fire fighting equipment was being serviced at the time of the visit. Staff have up to date health and safety training and the gaps in the team skills are being sorted out at the moment. The manager has up to date information regarding fire risk assessing and will be implementing the new procedures shortly. Storage of oxygen needs to improve, and this was discussed, as this may need to be included within the fire risk assessment too. Accident and injuries are recorded and monitored. St Heliers Residential Hotel DS0000023583.V303618.R01.S.doc Version 5.2 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 3 8 3 9 2 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X 4 X X 3 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 3 X 3 X 3 X X 3 St Heliers Residential Hotel DS0000023583.V303618.R01.S.doc Version 5.2 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 Requirement Standards 9 & 38 Storage of controlled drugs, oxygen and refrigerated medication be reviewed and improved. Medication administration records must be accurate Timescale for action 01/02/07 2 OP9 13 01/02/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP9 Good Practice Recommendations Standards 9 & 18. Develop and use competency assessments in areas such as medication management and administration and adult protection. St Heliers Residential Hotel DS0000023583.V303618.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
© This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI St Heliers Residential Hotel DS0000023583.V303618.R01.S.doc Version 5.2 Page 23 - 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!
