Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 08/06/05 for St Johns Court Nursing Home

Also see our care home review for St Johns Court Nursing Home for more information

This inspection was carried out on 8th June 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home is being effectively and competently managed, and staff were very caring and considerate to residents, who were very complimentary about the staff team. The rights and interests of residents is clearly promoted by staff. The proprietor, manager and staff have worked hard to maintain standards within the home.

What has improved since the last inspection?

Staff within the home are working well to ensure that care records are improved, thereby underpinning and supporting consistency in the care provided to residents.

What the care home could do better:

CARE HOMES FOR OLDER PEOPLE ST JOHNS COURT St Johns Street Bromsgrove Worcestershire B61 8QT Lead Inspector Nick Richards Unannounced 8 June 2005 - 7:15 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 JOHNS COURT E52 S4139 St Johns Court V231207 090605.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service St Johns Court Address St Johns Street Bromsgrove Bromsgrove Worcestershire B61 8QT 01527 575070 01527 576246 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) Somerset Redstone Trust CRH(N) 44 Old age Physical Disability - over 65 44 44 Category(ies) of OP registration, with number PD(E) of places ST JOHNS COURT E52 S4139 St Johns Court V231207 090605.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9 November 2004 Brief Description of the Service: St John’s Court is a care home providing nursing and personal care for up to forty-four older people. The home also provides palliative care for up to four people.It is owned by Somerset Redstone Trust, a charitable organisation. The home is located in the centre of Bromsgrove, close to shops, pubs and other community amenities. The home was extensively refurbished in 2002 and provides accommodation on three floors. There is a passenger lift providing mechanical access to all floors of the home. The home has thirty-six single and four shared bedrooms. All the bedrooms have en-suite facilities. The single rooms all measure in excess of ten square metres and the shared rooms in excess of sixteen square metres. ST JOHNS COURT E52 S4139 St Johns Court V231207 090605.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over six and a half hours, and was carried out to assess how the home was addressing the requirements from the previous inspection, and to establish how effective care was during the early morning period. A tour of the premises took place and care records were inspected. Five staff on duty and five residents were spoken to. What the service does well: What has improved since the last inspection? Staff within the home are working well to ensure that care records are improved, thereby underpinning and supporting consistency in the care provided to residents. ST JOHNS COURT E52 S4139 St Johns Court V231207 090605.doc Version 1.30 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. ST JOHNS COURT E52 S4139 St Johns Court V231207 090605.doc Version 1.30 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 JOHNS COURT E52 S4139 St Johns Court V231207 090605.doc Version 1.30 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) 1, 2, 3 and 4. There is a proper assessment prior to people moving into the home. This helps to ensure that care needs can be met. EVIDENCE: The admission procedure was satisfactory to guide staff on the actions to be taken to ensure that new residents’ needs are properly assessed and planned for. Individual records are kept for each of the residents, and inspection of the records for three residents had full assessment information recorded. Staff members on duty were spoken to, and knew about the care needs of the three residents. Residents who were interviewed all said that they felt that the home was effectively meeting care needs. The homes Statement of Purpose and Service User Guide are satisfactory – providing residents and prospective residents with details of the services the home provides, enabling an informed decision about admission to be made. ST JOHNS COURT E52 S4139 St Johns Court V231207 090605.doc Version 1.30 Page 9 ST JOHNS COURT E52 S4139 St Johns Court V231207 090605.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10. Progress has been made, but also needs to continue on improving arrangements to ensure that the health care needs of residents are identified and met. These improvements help to safeguard the health care needs of residents. EVIDENCE: Individual plans of care are available, and progress has been made to ensure that all aspects of health, personal and social care needs are identified and planned for. Most plans were detailed, up to date and had been regularly reviewed. However, some plans required further development to make sure that care needs were met correctly. This related to plans regarding people with diabetes – which were poor and failed to ensure that care staff could deliver care safely to people with diabetes. As a result of the concerns identified, an Immediate Requirement Notice was issued to ensure care plans were improved. The Trust’s Chief Executive responded in an appropriate and positive manner, confirming that (a) Care plans for people who were diabetic were not appropriate, ST JOHNS COURT E52 S4139 St Johns Court V231207 090605.doc Version 1.30 Page 11 (b) A diabetic specialist nurse had been contacted and was going to provide training for staff, and (c) The organisation’s Director of Operations would be providing on-going monitoring of care plans. Significant events in the home had been recorded, daily entries into case records had been made and entries available gave an indication of the actual care given. Residents spoken to were happy to confirm that their care needs were being met by staff within the home in a dignified and respectful way. Staff were seen providing care sensitively and discretely to residents, and discussions with staff confirmed that they were aware of residents’ care needs, and how the care was to be provided. A member of the nursing team was observed administering medication to residents. Medication was administered safely, sensitively and diligently to ensure that the right medication was administered to the right person, at the right time and in the right dose – thereby promoting the safety and well-being of residents. However, it was noted that some medication record charts had not been accurately completed by (a) the supplying pharmacy and (b) nursing staff within the home. As a result of the anomalies identified, an Immediate Requirement Notice was issued to ensure that medication systems were safe. The Trust’s Chief Executive responded in an appropriate and positive manner, confirming that (a) More care and attention will be paid to the administration of medicines, and that routine practice will be improved, (b) The Trust’s Director of Operations will meet with the supplying pharmacy to address poor accounting practices which have occurred when drugs are received into the home, and (c) The manager-designate will be monitoring staff practice and will check medication sheets on a daily basis to record anomalies and arrange supervision for staff who do not comply with the home’s medication policy. ST JOHNS COURT E52 S4139 St Johns Court V231207 090605.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13 and 15. Meals are well managed, creative and provide daily variety and flexibility for people living in the home. Contact with family and friends was openly maintained. EVIDENCE: A number of people living in the home were spoken to and everyone who commented on the food said how good it was and that they welcomed the daily choices offered. Menus were inspected and found to be balanced and interesting and meal time arrangements are also flexible enough to accommodate individual preferences. Catering staff demonstrated a detailed knowledge and understanding of individual residents’ dietary preferences and requirements. Care staff were seen providing direct assistance to people with their lunch in a sensitive and relaxed manner. During the inspection, some relatives were seen visiting people, and staff greeted visitors politely. Residents spoken to said that they could receive visitors at any time of the day, thereby maintaining links with family members. Residents confirmed that there were “no restrictions” on visiting. ST JOHNS COURT E52 S4139 St Johns Court V231207 090605.doc Version 1.30 Page 13 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) 16 and 18. Complaints are handled objectively and residents are confident that their concerns will be listened to, taken seriously and acted upon. A vulnerable adults procedure has been developed to ensure a proper response to any suspicion or allegation of abuse. EVIDENCE: The home has a simple and clear complaints procedure, and the complaint records indicated that this is followed. A copy of the complaints procedure had been given to all residents, and was available to visitors and relatives. Residents spoken to were confident that concerns could be raised with the home. A procedure for responding to allegations of abuse is available. ST JOHNS COURT E52 S4139 St Johns Court V231207 090605.doc Version 1.30 Page 14 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, 20, 21, 22, 23, 24, 25 and 26. Investment within the home continues to maintain a high environmental standard, creating a comfortable and safe environment for those living there and visiting. EVIDENCE: Each bedroom seen had been furnished with residents’ personal possessions, thereby generating ownership and a sense of autonomy for individuals. Residents confirmed that they appreciated the physical environment. Hot water temperatures have been risk assessed and had been regulated to prevent people being accidentally scalded when they have a bath, and radiators had been guarded and restricted to prevent people being accidentally burnt through intentional or unintentional contact All the windows located above first floor level had been restricted to prevent people from being injured through falling out of the windows (accidentally or deliberately). ST JOHNS COURT E52 S4139 St Johns Court V231207 090605.doc Version 1.30 Page 15 The environmental standards within the home were positive, thereby promoting a “homely” feel within the home. All areas seen were both clean and tidy. Since the time of the previous inspection, three bedrooms on the second floor of the home have been commissioned to a very high standard. ST JOHNS COURT E52 S4139 St Johns Court V231207 090605.doc Version 1.30 Page 16 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, 28 and 30. Staffing levels and competencies are suitable to ensure that residents’ needs are identified and effectively met. EVIDENCE: There were suitable nursing and care staff on duty to provide care and support for the residents. In addition to nursing and care staff, there were also ancillary staff on duty to support service provision. During the visit, call bells were activated, and staff responded speedily to them. The duty rotas confirmed that the staffing levels were stable, with little evidence of staff being absent through short-term sickness. Training has been provided to staff, and includes infection control, first aid and moving and handling. Training was identified as a result of the needs of residents, to ensure that care delivered was appropriate to and in response to the needs of residents. Residents said that staff were “very good, they look after us well” and were “very attentive”. Residents generally believed that there were sufficient staff available to meet their needs. ST JOHNS COURT E52 S4139 St Johns Court V231207 090605.doc Version 1.30 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) 31, 32 and 33. There is clear leadership, guidance and direction to staff to ensure residents receive consistent care, resulting in practices that promote and safeguard the health, safety and welfare of the people using the service. EVIDENCE: There is a manager-designate who has made application for registration to the Commission, and she is competent and appropriately qualified and experienced to manage the service. Once the application is approved, the managerdesignate will become the registered manager for the home. Staff and residents spoke very highly of her, and significant diligence and action has been undertaken to maintain the quality of the service provided by the home. Residents clearly expressed their opinion that the home was being run in their best interests. ST JOHNS COURT E52 S4139 St Johns Court V231207 090605.doc Version 1.30 Page 18 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 3 3 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 2 3 3 x x x x x ST JOHNS COURT E52 S4139 St Johns Court V231207 090605.doc Version 1.30 Page 19 yes 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 15 Requirement Care plans must be further developed in accordance with the specifications and criteria of Standard 7 and NMC (Nursing and Midwifery Council) Standards for records and record keeping. The administration of medication must be accurately recorded onto MAR charts. Handwritten medicine administration records (MAR) charts must be checked by a second person and referenced back to the original prescription. Timescale for action 31/07/05 2. 3. 9 9 13 13 Immediate and ongoing. Immediate and ongoing. 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 Good Practice Recommendations ST JOHNS COURT E52 S4139 St Johns Court V231207 090605.doc Version 1.30 Page 20 Commission for Social Care Inspection The Coach House John Comyn Drive, Perdiswell Park Droitwich Road Worcester WR3 7NW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI ST JOHNS COURT E52 S4139 St Johns Court V231207 090605.doc Version 1.30 Page 21 - 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!