Inspection on 12/12/06 for St Hilary

This inspection was carried out on 12th December 2006.

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 Hilary 21/10/08

St Hilary 13/11/07

St Hilary 18/08/05

St Hilary 18/04/05

St Hilary 18/10/04

St Hilary 14/04/04

Similar services:

Fairfields Country Rest Home

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Trevaylor Manor

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

CARE HOMES FOR OLDER PEOPLE St Hilarys Bramble Hill Bude Cornwall EX23 8DG Lead Inspector Mike Dennis Key Unannounced Inspection 12th December 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 Hilarys DS0000009068.V318547.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 Hilarys DS0000009068.V318547.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Hilarys Address Bramble Hill Bude Cornwall EX23 8DG 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) 01288 352754 01288 359077 Cornwall Care Limited Care Home 38 Category(ies) of Dementia - over 65 years of age (28), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (28), Old age, not falling within any other category (10) St Hilarys DS0000009068.V318547.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Total number of service users not to exceed a maximum of 38 Date of last inspection 10th October 2006 Brief Description of the Service: St Hilarys Care Home is run by Cornwall Care Ltd. which is a registered and charitable organisation, whose management team offer support regarding the running of the home. Members of the company visit regularly. St Hilarys Care Home provides accommodation and care for thirty-eight people in need of care due to dementia, mental disorder or old age. There is also a busy day care centre on the premises. St Hilarys is a purpose built home close to the town centre and amenities of Bude. The accommodation is offered on three floors, with wide staircases and lift access to each floor. The home is split into four units, known within the home as wings, with each wing having a personalised name. Each wing has a kitchenette - which allows simple food and drink preparation - dining area, sitting room and adequate bathing and toilet facilities. Main meals are prepared in the central main kitchen, located within the day centre, and are transported to each wing by a heated food trolley. For social events, involving all service users, the large day room situated within the day centre can be used. Activities are arranged within the home and service users can also partake of activities and functions arranged by the day centre if they choose. Service users are supported to maintain social contacts and leisure activities in the community with either the support of family and friends or staff at the home. The home has a central outside area that has been developed into a sensory garden, providing stimulation, relaxation and seating for service users to enjoy the warmer summer months. St Hilarys DS0000009068.V318547.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 12th. And 13th. December 2006 over a ten hour period. The inspector met with the Manager, assistant managers, a selection of staff and 4 service users. During the course of the inspection the inspector observed groups of service users engaged in a number of activities. Staff were observed to be tending to service user needs whilst respecting their dignity. Various records, policies and procedures were inspected. The inspector visited all parts of the building and noted a satisfactory standard of hygiene and maintenance. Service users commented favourably on the overall service received. This home also received a random inspection on the 10th. October 2006 following which a number of recommendations were made. The inspector is pleased to report that all of these recommendations have been acted upon. Cornwall Care has recently appointed a new manager at St. Hilary who demonstrated that she is aware of some of the inherent problems. She is already in the process of addressing the shortcomings listed in this report. Various members of staff commented that it is good to have a manager in post at last. The current fee level for this home starts at £399 and rises to £468 per week depending on the level of care provided. What the service does well: Service users stated that St.Hilary provides good quality care and accommodation. They made various comments about staff such as; they are ‘kind’ and ‘caring’. All service users commented that they felt that their care needs were met at all times. Cornwall Care prioritises staff training and is keen to continue to develop staff skills. Continued training is being provided to improve the quality of service. This inspection was generally positive and the inspector would comment that Cornwall Care Ltd is an organisation that wants to achieve a high standard of care to all its service users and provide appropriate training and support to its staff group. St Hilarys DS0000009068.V318547.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. St Hilarys DS0000009068.V318547.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection St Hilarys DS0000009068.V318547.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are provided with information prior to their admission which allows them to make an informed choice about choosing this home. Service users have statements of terms and conditions with the home. Service users are fully assessed prior to admission to the home. Prospective service users can and do visit the home prior to admission. This home does not provide Intermediate care EVIDENCE: Four service user files were inspected and case tracked. All contained information pertaining to pre-admission assessment. The information provided was comprehensive and included risk assessments and general details of daily St Hilarys DS0000009068.V318547.R01.S.doc Version 5.2 Page 9 care requirements, medication and health care requirements. Contracts or Statements of Terms and Conditions were also present. Service users informed the inspector that they were given the opportunity to visit the home prior to admission. Several had attended for day care or respite care before permanent admission. They also informed the inspector that written information is provided by way of the Statement of Purpose/Service User Guide and Brochure prior to admission. The Statement of Purpose should be reviewed to ensure it is up to date and fully reflects the services the home provides. In particular information as to how to make complaints and to whom needs revision. Standard 6 is not applicable as the home does not provide Intermediate Care. St Hilarys DS0000009068.V318547.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 health care needs of service users are identified planned for and met. Comprehensive policies and procedures for dealing with medicines are followed Service users are treated with dignity and respect EVIDENCE: Four Individual Plans of Care were inspected. They were seen to contain full and relevant information, to include Risk Assessments, pertaining to the health, personal and social care needs of that individual. The records indicated that these plans of care are reviewed at monthly intervals. Service users confirmed that information is gathered regarding their past life experiences and interests. This information is used to promote an Active Care programme for that individual. St Hilarys DS0000009068.V318547.R01.S.doc Version 5.2 Page 11 Appropriate professionals from other disciplines frequently visit the home to provide for general health care, ie. G.P’s, Community Nurses, Opticians, Dentists etc. The home has full medication policies and procedures. The manager and assistant managers are the nominated persons who administer medication. The majority of the medication is in ‘blister packs’. All medication including controlled drugs was recorded correctly as received, administered and disposed. Recorded evidence confirmed that medication received is now signed into the home allowing the inspector to determine who was responsible for this operation. This was a recommendation given at a random inspection of the home on 10/10/06. This recommendation has been complied with. The controlled drugs were stored to comply with drug regulations. An audit of controlled drugs was undertaken and proved to be correct. Service users informed the inspector that they were treated with dignity and respect. The inspector observed that this was the case. St Hilarys DS0000009068.V318547.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 good. This judgement has been made using available evidence including a visit to this service. The home ensures that service users social, educational and leisure needs are identified and aim to provide a variety of activities in the home. Visitors are encouraged and welcomed. Service users are helped to exercise choice A wholesome balanced diet is provided. EVIDENCE: From discussions with service users and their representatives they commented that there is ‘enough to do’ during the day. Service users recalled a variety of activities that are provided. These matched the interest and hobbies section of the care plans in respect of that individual. All service users in the home are able to participate in the day care activities, which are held in the day centre. The inspector observed a variety of activities occurring during the inspection St Hilarys DS0000009068.V318547.R01.S.doc Version 5.2 Page 13 The home’s policies and documentation demonstrate that they aim to encourage service users to pursue their hobbies and interests, and individual interests are recorded in service user care plans. Residents meetings are held and documented. Relatives were not spoken with during this inspection but the visitors book indicated that they visit frequently. The inspector met the chef and viewed the preparation of a midday meal. Menus are varied and offer choice. The service users were seen to be enjoying their lunch. St Hilarys DS0000009068.V318547.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. The complaints procedure is well publicised and used when required. Service users rights are protected. The registered persons ensure that service users are protected from all forms of abuse with staff having knowledge through training of Adult Protection issues which helps to protect service users EVIDENCE: A comprehensive complaints policy and procedure is kept within the home. This procedure includes timescales and who will deal with the complaint. The home also keeps a complaints log for ease of reference. Service users indicated that they were aware of the procedures. There has been one recorded complaint since the last inspection. The home has a comprehensive policy and procedure in place to protect service users from abuse. Staff are made aware of these procedures during the induction period. The management team is also aware of the local social services procedure within “No Secrets” to investigate any complaints regarding the suspected abuse of any service user. St Hilarys DS0000009068.V318547.R01.S.doc Version 5.2 Page 15 The information given to service users in the Statement of Purpose/Service User Guide requires amendment. It should detail the fact that complaints should be made to management of the home and/or to the purchasing authority (Dept. of Adult Social Care). Information may also be relayed to the Commission for Social Care. CRB and POVA checks are undertaken, with Cornwall Care being the umbrella body to obtain these checks. St Hilarys DS0000009068.V318547.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The location and layout of the home is suitable for it’s stated purpose and provides a safe and well maintained environment. The home was clean, hygienic and free from offensive odours providing an attractive and homely place to live EVIDENCE: The inspector toured and inspected the building. The home provides a safe and well-maintained environment for the service users. The décor is of a domestic and homely nature. The manager discusses refurbishment and development issues with the company annually or as St Hilarys DS0000009068.V318547.R01.S.doc Version 5.2 Page 17 required. She informed the inspector that she is currently working up a business plan which will list the needs for change to the premises if funds are available. This includes a new reception area, conservatory and improved lighting. Day to day maintenance is carried out as required. Bedrooms are redecorated and re-carpeted as they become empty. Service users commented that they were happy with the accommodation provided. Rooms were personalised according to the individuals taste. Bathing facilities were observed to be satisfactory with suitable aids supplied. The home has a large and attractive sensory garden with wheelchair access. The home appeared clean and hygienic on the day of inspection. No offensive odours were noted. Laundry systems are in place to promote the control of infection. Protective equipment i.e. gloves and aprons were observed to be available for all staff throughout the home. The home has policies and procedures in place that are available to all staff and in accordance with relevant legislation St Hilarys DS0000009068.V318547.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,29,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a balanced mix of skills amongst the staff team. Positive recruitment practices are followed. Staff training is given priority. EVIDENCE: The staffing structure for this consists of Manager, assistant managers, care staff, domestics, catering staff, driver/maintenance personnel, and an administrative clerk. The staff rota indicated that an assistant manager plus 6 care staff are on duty during the day followed by 3 care staff at night and an ‘on call’ manager. Recruitment policies are robust and adhered to as confirmed by some staff spoken with. References and CRB checks were evidenced. Trainees and all new staff are put through a pre-determined induction training course. The home has exceeded the target of having at least 50 of staff holding NVQ awards. St Hilarys DS0000009068.V318547.R01.S.doc Version 5.2 Page 19 St Hilarys DS0000009068.V318547.R01.S.doc Version 5.2 Page 20 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): 31,33,35,36,37,38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The newly appointed manager is suitably qualified. A quality assurance audit is due. Service users are safeguarded by the accounting and financial procedures of the home Improvement is required in staff supervision. Record keeping is generally good but improvements required in certain areas. Attention to health and safety is positive. St Hilarys DS0000009068.V318547.R01.S.doc Version 5.2 Page 21 EVIDENCE: A new manager was appointed to St. Hilary and took up her post on the 30th. October 2007. She is applying to the CSCI for Registered Manager status. She is a qualified R.M. N. with experience as a Charge Nurse and Ward Manager in various elder care psychiatric hospital settings. The inspector held an open and constructive discussion with the manager and agreement was reached concerning certain areas in need of improvement. These improvements generally relate to management oversights due to the lack of a permanent manager being in post for some considerable time. The date of the last service user quality assurance audit was not verified. It is probable that this exercise is now due and if so should be conducted in the near future. The inspector met with the administrative clerk and is pleased to record that all financial dealings relating to service users is in order. The supervision of staff has slipped in some cases and improvement is required. Record keeping, policies and procedures are generally good. There are however some areas in need of improvement. Accident records are completed and then filed collectively on a month by month basis. It is recommended that completed accident forms are filed on the personal fire of the service user they relate to, thus conforming with the Freedom of Information Act. The fire records indicate that a minority of staff (night staff) have not received their ‘in-house’ training at the required time intervals. Insurance and maintenance documentation is in order. Evidence was presented to demonstrate that health and safety issues are taken seriously and that maintenance contracts are in place. St Hilarys DS0000009068.V318547.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 3 3 2 2 3 St Hilarys DS0000009068.V318547.R01.S.doc Version 5.2 Page 23 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 2 Standard OP36 OP37 Regulation 18 Requirement Timescale for action 01/03/07 01/02/07 ALL staff must receive supervision at least 6 times per year. 17,Schedu ALL staff must receive fire le 4 training, 6 monthly for day staff and 3 monthly for night staff. 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 Refer to Standard OP1 OP16 OP33 Good Practice Recommendations The Statement of Purpose is in need of review to ensure it’s accuracy. Amend information given to service users to ensure they are aware of who they may make a complaint to. It is recommended that a quality assurance survey be conducted if the previous one is more than 12 months old. St Hilarys DS0000009068.V318547.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD 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 Hilarys DS0000009068.V318547.R01.S.doc Version 5.2 Page 25 - 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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