Inspection on 20/09/05 for St Ives House

This inspection was carried out on 20th September 2005.

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 Ives House 23/02/07

St Ives House 27/02/06

St Ives House 28/02/05

St Ives House 02/08/04

St Ives House 18/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE St Ives House Horton Road St Ives Ringwood BH24 2ED Lead Inspector Catherine Churches Unannounced 20 & 21 September 2005 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 Ives House D55 S26872 St Ives House V243562 200905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service St Ives House Address Horton Road, St Ives, Ringwood, Dorset, BH24 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) 01425 473822 01425 489003 The Trustees of TH Russell Charitable Trust Mrs Rowena McDermott PC Care Home only 23 Category(ies) of OP - 23 registration, with number of places St Ives House D55 S26872 St Ives House V243562 200905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28 February 2005 Brief Description of the Service: St Ives House is a large detached property, which stands in ample secluded grounds and is situated approximately one mile from Ringwood. The home was formerly owned by T H Russell and on his death was placed in trust as a home for older people. (T H Russell Charitable Trust). A group of trustees hold responsibility for the business management matters related to the home, while the registered manager Mrs McDermott attends to the day to day running of the home. Accommodation is offered on both the ground and first floors of the home, with all bedrooms being single and offering en-suite facilities. A passenger lift is available to the first floor. There is a comfortable main lounge on the ground floor, with a separate dining room that leads into a large conservatory/sunlounge. There are communal bathrooms, with assisted baths, on both floors. There is also a large, attractive conservatory leading off the main lounge and this provides another useful area for service users. In addition, the home offers six flats, which are self-contained and situated in a connected ground floor wing of the house. The service users accommodated in these flats can use the facilities of the main house, and receive varying amounts of care and support as necessary. The home is registered to provide accommodation for a maximum of 23 service users in the category OP (older people). St Ives House D55 S26872 St Ives House V243562 200905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place 20th and 21st September 2005. The inspection took place as part of the regular, programmed inspection schedule for the home. The registered Manager, Mrs McDermott was not available during the inspection. The draft report was sent to the home and then a follow up meeting was arranged on 24th October 2005 to discuss the issues raised in the report. This report reflects the situation found in the home on the day of the inspection. However, it was evident during this second visit that the majority of the issues raised in the report had either already been addressed or were in the process of being addressed. The last inspection of St Ives was satisfactory and no requirements or recommendations were made. The purpose of this visit was to check that the home continues to run in the same satisfactory manner and that the people who are living in the home are properly cared for. The premises were inspected and a number of records examined. Time was also spent time observing routines within the home and talking with residents and staff. Mrs Moran, the deputy manager, was present throughout the inspection. The Inspector spoke with the majority of staff on duty over the two days of the inspection as well as the deputy manager and seven residents. What the service does well: St Ives House provides a homely, relaxed and comfortable environment with a welcoming and friendly atmosphere. The home is very well presented and has beautifully maintained gardens that residents reported they enjoyed very much. All residents spoken with were very positive about the care and attention that they receive. There is a good range of activities both in the home and in the local area and visitors are encouraged to come to the home whenever possible. The staff group is stable and were observed to be respectful, helpful and caring. St Ives House D55 S26872 St Ives House V243562 200905 Stage 4.doc Version 1.40 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. St Ives House D55 S26872 St Ives House V243562 200905 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection St Ives House D55 S26872 St Ives House V243562 200905 Stage 4.doc Version 1.40 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 standard(s) None of these standards were assessed on this occasion. EVIDENCE: St Ives House D55 S26872 St Ives House V243562 200905 Stage 4.doc Version 1.40 Page 9 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) 7,8 and 10 The care planning system in the home is comprehensive but is not being used to the full extent for each resident, particularly those with more complex needs, therefore not all needs are clearly set out. This shortfall means that residents could be vulnerable if staff are not aware of the tasks they must undertake. Discussions with staff confirmed that they are aware of all care needs. It is the recording systems that are lacking and no lack of care was found during this inspection. Systems for resident consultation and participation in the assessment and care planning process are inconsistent. Residents are respected and their right to privacy is supported EVIDENCE: Care plans and related documentation were examined for 4 residents. It was found from these records that there is a care planning structure in place but that it does not cover all of the recommended areas as set out in the National Minimum Standards. For those residents with minimal needs documentation was found to be of an acceptable standard. Through discussion with staff and St Ives House D55 S26872 St Ives House V243562 200905 Stage 4.doc Version 1.40 Page 10 observation of/discussions with the residents whose care plans were examined it became evident that, in the case of residents with greater needs, there was a lack of detail about how needs should be met and the care that should be provided. For example, monthly reviews were either out of date or noted “no change” when recording in daily records contradicted this. There were no nutritional assessments, care plans or regular recording of weights, no psychological assessments or care plans and in some cases photographs of residents were not available. Resident’s health needs are met through visits to/by doctors and other health professionals as required. Residents spoken with confirmed that they are treated respectfully. All residents spoken with confirmed that the staff are kind and attentive. St Ives House D55 S26872 St Ives House V243562 200905 Stage 4.doc Version 1.40 Page 11 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 and 13 The social, cultural and recreational activities provided by the home or by families meet the expectations of residents. Relatives and visitors are welcome in the home at any time, with no restrictions. EVIDENCE: The activities diary showed a detailed programme of events has been planned for the year. The home has good support from a group of volunteers known as the “Friends of St Ives House” and staff also spend time organising in house activities such as card and board games. Residents confirmed that they could receive visitors whenever they wish and that the staff will also assist them to prepare for trips out to shops or to visit people and help with calling taxis etc. Examination of the visitor’s book also reflected that there is an almost constant stream of visitors to the home. St Ives House D55 S26872 St Ives House V243562 200905 Stage 4.doc Version 1.40 Page 12 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) 18 Procedures for responding to suspicions of abuse are held in accordance with Department of Health guidance. Residents can therefore feel confident that staff are aware of policy to help provide a safe environment for residents. EVIDENCE: Examination of policies and procedures confirmed that available on the actions to take if they suspect abuse. reported incidents. The Deputy manager was clear on spoken to confirmed that they had received training in Vulnerable Adults. guidance for staff is There have been no her role and those staff the Protection of St Ives House D55 S26872 St Ives House V243562 200905 Stage 4.doc Version 1.40 Page 13 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, 25 and 26 The home is very well presented: it is nicely decorated and furnished and has a homely atmosphere. The grounds are also very well maintained, providing lots of colour and interest as well as a variety of places to sit and relax. The home maintains a good standard of hygiene and all areas seen were clean and free from offensive odours. Staff training needs to be updated to ensure that staff are reminded of infection control procedures. EVIDENCE: A tour of the premises confirmed that the home is well decorated, furnished and equipped. Dorset Fire and Rescue Service has visited the home and confirmed that it complies with their requirements. Discussion with some residents, and investigation of some wash hand basins, revealed that there is an issue in some of the older parts of the building with St Ives House D55 S26872 St Ives House V243562 200905 Stage 4.doc Version 1.40 Page 14 the supply of hot water to some wash hand basins. The Deputy Manager confirmed that this is due to the age of the building and the matter was already being addressed. The home was clean and no offensive odours were detected, indicating that continence issues are well managed. Discussions with Staff confirmed that they had a good understanding of infection control procedures and the relevant protective clothing was available. However, examination of training records and further discussions evidenced that training in this area is out of date. St Ives House D55 S26872 St Ives House V243562 200905 Stage 4.doc Version 1.40 Page 15 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, 29 and 30 The home was well staffed ensuring that residents receive the care and attention they need in an unrushed manner. Staff clearly enjoyed working in the home, there was a positive atmosphere and residents had a happy, relaxed relationship with the manager and staff. Since the last inspection the standard of vetting and recruitment practices has declined with appropriate checks not being carried out and potentially leaving residents at risk. The arrangements for the induction and further basic training of staff do not comply with minimum requirements. This means that staff may not have basic competencies in the areas of care required of them. However, no evidence that staff were not competent was found on this occasion, the requirement here is to ensure that the training provided is compliant with the requirements of the standard. EVIDENCE: Examination of the staff rota and observation throughout the inspection demonstrated there was a sufficient number and skill mix of staff to meet the needs of residents. Staff and residents spoken with confirmed that they were satisfied with staffing levels. Staff records were examined for 2 newly appointed staff. These demonstrated some serious omissions. Both staff had commenced their duties without a St Ives House D55 S26872 St Ives House V243562 200905 Stage 4.doc Version 1.40 Page 16 POVA (Protection of Vulnerable Adults) or CRB (Criminal Records Bureau) check, of these 2 one CRB revealed convictions that had not originally been declared. No evidence was available of the actions taken by the manager regarding this. One member of staff had also commenced duties with no references having been taken up and no evidence of identification checks. Staff and examination of records confirmed that various in house training courses continue to take place. However, it was evident from discussions and examination of staff files that Induction and foundation training, compliant with the National Training Organisation requirements, was not being provided. St Ives House D55 S26872 St Ives House V243562 200905 Stage 4.doc Version 1.40 Page 17 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) 36, 37 and 38 The management arrangements in the home support good care practices for the residents. Organisation of some of the administrative tasks, particularly staff supervision and administration of some records could be better defined to ensure that residents therefore benefit from efficient management of staff. The health, safety and welfare of residents and staff is protected by the systems that the home has in place for staff training, maintenance and risk assessment. EVIDENCE: Examination of records revealed that staff are not receiving the required formal supervision 6 times per year. This inspection found that a number of records were out of date or incomplete. Of particular note were residents care plans and staff records. This is contrary St Ives House D55 S26872 St Ives House V243562 200905 Stage 4.doc Version 1.40 Page 18 to the 2 previous inspections and lead the Inspector to look at recent changes at the home. One notable issue was that the home had been without a full time administrator for a period of approximately three months. This meant that the manager and deputy manager have had to cover this role in addition to their own duties and has involved, amongst other duties, the logging in of all post, staff time sheets and undertaking banking duties. This has been time consuming and must clearly have contributed to the matters revealed at this inspection. Fire records, staff fire training records, accident books and risk assessments were examined and found to be up to date and detailed. St Ives House D55 S26872 St Ives House V243562 200905 Stage 4.doc Version 1.40 Page 19 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 x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x COMPLAINTS AND PROTECTION 3 x x x x x 3 2 STAFFING Standard No Score 27 3 28 x 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 x x x x x 1 1 3 St Ives House D55 S26872 St Ives House V243562 200905 Stage 4.doc Version 1.40 Page 20 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 7 Regulation 14 and 15 Requirement Timescale for action 30/11/05 2. 7 12 and 13 3. 29 19 All service users must have a plan of care that sets out in detail the action which needs to be taken by care staff to ensure that all aspects of health, personal and social care needs of the service user are met. The plan must be reviewed at least once a month and updated to reflect changing needs. The plan must be drawn up with the invovement of the service user and recorded in a style accessible service user; agreed and signed by the service user whenever capable and/or representative (if any). Risk assessments, nutritional 30/11/05 and psychological assessments must be undertaken and kept up-to-date. ny identified issues must be addressed via a care plan. The registered person must 30/11/05 operate a thorough recruitment procedure based on equal opportunities and ensuring the protection of service users.Evidence of a new emplyees identification must be held on file, 2 written references Version 1.40 St Ives House D55 S26872 St Ives House V243562 200905 Stage 4.doc Page 21 4. 30 12 and 18 5. 36 18 and 19 6. 37 17 and a Criminal Records Bureau/POVA check must be obtained prior to an employee commencing duties or being confirmed in post. All staff must receive induction 30/12/05 and foundation training to NTO specification within 6 weeks of appointment to their posts. Care staff must receive formal 30/12/05 supervision which covers all aspects of practice, philosophy of care in the home and career development needs, at least six times a year. The registered person must 31/12/05 ensure that the records required by regulation for the protection of service users and for the effective and efficient running of the home are maintained, up to date and accurate. 7. 8. 9. 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. Refer to Standard 26 Good Practice Recommendations Staff should receive regualr training in arrangements to prevent infection, toxic conditions and the spread of infection at the care home. St Ives House D55 S26872 St Ives House V243562 200905 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Unit 4, New Fields Business Park Stinsford Road Poole BH17 0NF 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. 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