Inspection on 16/01/07 for St John`s Nursing Home

This inspection was carried out on 16th January 2007.

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 John`s Nursing Home 01/02/06

St John`s Nursing Home 27/09/05

St John`s Nursing Home 05/02/05

St John`s Nursing Home 15/07/04

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

CARE HOMES FOR OLDER PEOPLE St John`s Nursing Home White House Lane Fishtoft Boston Lincs PE21 0BE Lead Inspector Julie Western Key Unannounced Inspection 16th 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 John`s Nursing Home DS0000002568.V325356.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 John`s Nursing Home DS0000002568.V325356.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St John`s Nursing Home Address White House Lane Fishtoft Boston Lincs PE21 0BE 01205 366059 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) Lifeline Nursing Services Limited Mr Roy Riseborough Care Home 31 Category(ies) of Dementia (31), Dementia - over 65 years of age registration, with number (31) of places St John`s Nursing Home DS0000002568.V325356.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Category DE is for persons aged 50 years and over. Date of last inspection 1st February 2006 Brief Description of the Service: St John’s Nursing home is situated on the outskirts of the town of Boston in the suburb of Fishtoft. The home has a registration for 31 beds, providing longterm personal and/or nursing care for residents of both sexes over the age of fifty, who have been diagnosed as having a dementia. On the day of the inspection 29 residents were being accommodated. The purpose-built single storey building was originally owned by the Local Health Authority and was built and managed by Lifeline Nursing Services Ltd., a company owning two other homes in Lincolnshire. Accommodation is offered in nine single and ten twin-bedded rooms. There are enclosed gardens and a patio area for residents to sit out in good weather. Car parking is available at the front of the home and a regular bus service passes the home to and from the centre of Boston. St John`s Nursing Home DS0000002568.V325356.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced, was carried out over three hours and took into account any previous information held by CSCI including the home’s previous inspection reports, its service history, pre-inspection questionnaires completed by the Manager and residents’ questionnaires sent to the home by the Commission prior to the inspection. The site inspection consisted of case tracking a sample of residents’ records and assessing the care given. Some policies and procedures were examined and some records concerning the safety of the home were also seen. Three residents, three care and ancillary staff and two visitors were spoken with. The Manager was present throughout the inspection. At the time of the inspection the home confirmed that the weekly fees ranged from £379 - £552, depending on the assessed needs of the resident. Additional charges are made for services such as chiropody and hairdressing. Information about these costs as well as the day-to-day operation of the home, including a copy of the last inspection report is available in the reception area or the manager’s office. What the service does well: What has improved since the last inspection? St John`s Nursing Home DS0000002568.V325356.R01.S.doc Version 5.2 Page 6 Since the last inspection a new set of sit-on scales and a new hoist with scales have been purchased. Building work has started on an extension for an extra five single en-suite rooms. 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 John`s Nursing Home DS0000002568.V325356.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 John`s Nursing Home DS0000002568.V325356.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): 3, 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home clearly sets out what it intends to do for its residents. This information is extensive and freely available to residents. Prospective residents are encouraged to take time before making the decision to move into the home on a permanent basis. EVIDENCE: The statement of purpose was examined and was comprehensive. The residents’ handbook contained appropriate information. The Manager confirmed that either she or the Deputy Manager carried out the pre-admission assessments of residents, either in their own homes or in a hospital or care setting. Some residents were admitted from outside the county. Following the assessment, a letter was sent to advise that the home could or could not meet St John`s Nursing Home DS0000002568.V325356.R01.S.doc Version 5.2 Page 9 the reeds of the prospective resident. The Manager said that if required, visits by prospective residents would be made to the home before admission and a visitor described how relatives were invited for lunch and evening meals, which helped the residents in settling into the home. The home does not provide intermediate care. St John`s Nursing Home DS0000002568.V325356.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): 7-10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s records give a clear indication of the needs of residents and enable staff to meet their needs with sensitivity and regard for their privacy and dignity. EVIDENCE: The four care plans looked at in depth, contained assessments that were reviewed regularly and were signed where possible by the service user or relatives/advocates. They were, however, not person-centred. The Manager was aware of this and had plans to review all care plans once she was established in post. There was a clear medication policy and the pharmacist visited regularly. The last visit was 04/12/06 and there were no issues from this. Residents said they felt safe and well looked after; one described how she went abroad for several weeks and on return found her relative well cared for. St John`s Nursing Home DS0000002568.V325356.R01.S.doc Version 5.2 Page 11 Another said ‘I feel very involved in the care of my relative. The staff team were observed carrying out their duties with kindness and sensitivity towards the residents, especially when attending to their personal needs. St John`s Nursing Home DS0000002568.V325356.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): 12-15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Social activities are extensive and well promoted, creating a variety of events and activities which residents are informed about. The residents exercise choice about which activities, if any, they wish to participate in and what meals they want to eat. EVIDENCE: Twenty-five hours are allocated weekly for an activities co-ordinator, who is responsible for producing a programme of events. Activities for each resident were now recorded and there was a timetable of events, which was displayed in the entrance area. On the day of the inspection one resident was celebrating her 95th birthday and there was to be a party. Visitors to the home said that the participation in any events organised was limited due to the residents’ abilities, but that there was ‘usually something going on’. They confirmed that they were able to visit at any time and several visited daily and assisted their relatives with eating at lunchtimes. A visitor said St John`s Nursing Home DS0000002568.V325356.R01.S.doc Version 5.2 Page 13 relatives she regularly ate the meals at the home and said they were very good. The mid-day meal was observed being served; it was well presented and balanced. Several service users had pureed food and were assisted with eating. The Environmental Health Officers had visited the home and given it a Gold Award in their food safety award scheme. All kitchen staff had the basic food hygiene award. St John`s Nursing Home DS0000002568.V325356.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 home’s complaints procedure is clear and gives residents and their relatives the confidence that comments and concerns will be listened to; there is a robust adult protection procedure. EVIDENCE: Residents and visitors to the home all said they did not wish to complain but knew how to make a complaint. The complaints records showed that the home had received no complaints in the last twelve months. The complaints procedure was displayed on the wall in the entrance foyer St John`s Nursing Home DS0000002568.V325356.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): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents live in a comfortable and safe environment, with both private and communal space being generally suitable for their needs. EVIDENCE: The home has a rolling maintenance rota and risk assessments are carried out on the premises to ensure that residents are safe from any potential hazards. Recent improvements to the home have included the purchase of a set of seated scales and a new hoist with scales. All rooms are en-suite and the home has three separate bathrooms and one separate shower. There are ten shared rooms; this is a high ratio of double to single rooms. St John`s Nursing Home DS0000002568.V325356.R01.S.doc Version 5.2 Page 16 Work was being commenced on an extension to the home, which would include 5 extra en-suite bedrooms. Overall, the standard of decoration was generally good and afforded residents a satisfactory degree of comfort. One of the bathrooms is institutional in appearance and need upgrading. St John`s Nursing Home DS0000002568.V325356.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): 27-30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff numbers are in sufficient quantity for them to be able to care for the residents. Staff members are suitably trained, qualified and competent; they undergo an induction programme before commencing their duties. EVIDENCE: The rota showed that there were two trained and five care staff on duty on the early shift and two trained plus four care staff on the late shift with 3 night staff. In addition there were adaptation nurses from overseas. Residents and staff spoken with confirmed that there were enough staff members to attend to their needs. There is a full training programme and an individual training record form for all staff. Training records showed that nine care staff had achieved the National Vocational Qualification at Level 2 with four working towards it and two had achieved Level 3. All statutory training had been completed with each staff member having a skill matrix. The Manager said that all staff should have the Alzheimer’s Society’s certificate in dementia awareness. Minutes of regular staff meetings were seen. Staff records were well documented but one folder seen needed a more clear and up to date photograph of the staff member. St John`s Nursing Home DS0000002568.V325356.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. The home is managed competently and the staff are supported and supervised in carrying out their respective roles. The views of residents and their supporters are listened to and they are involved in decisions affecting them. EVIDENCE: The Manager, who was previously the deputy manager for four years, has been in post for one day. She is a qualified RGN with 32 years’ experience in nursing. Staff spoken with said that the Manager was available for guidance and direction and there was an ‘open door’ policy whereby she was available to discuss issues at any time with residents, relatives or staff. One resident St John`s Nursing Home DS0000002568.V325356.R01.S.doc Version 5.2 Page 19 described the new manager as ‘a lovely person who will always take the time to listen to you’. Residents’ finances were safeguarded but five residents had a ‘pooled’ account. It was recommended that this was looked into as those residents were not accruing any interest by having their monies pooled. The home acquired the Investors in People award in November 2005. Comments from residents’ relatives showed that they felt very much a part of the home and a recent questionnaire showed that their views were sought and acted upon. St John`s Nursing Home DS0000002568.V325356.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 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 X X X X 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 John`s Nursing Home DS0000002568.V325356.R01.S.doc Version 5.2 Page 21 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. Standard Regulation Requirement Timescale for action 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 OP7 OP35 OP35 Good Practice Recommendations Care plans would be improved by being more personcentred; they are currently all-purpose plans. Staff photographs should be clear and up to date. Service users’ finances should be kept separately. St John`s Nursing Home DS0000002568.V325356.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 John`s Nursing Home DS0000002568.V325356.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. 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