Inspection on 07/12/05 for St Judes Residential Home For The Elderly

This inspection was carried out on 7th December 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 Judes Residential Home For... 28/11/08

St Judes Residential Home For... 29/11/07

St Judes Residential Home For... 19/04/06

St Judes Residential Home For... 27/04/05

St Judes Residential Home For... 09/11/04

St Judes Residential Home For... 05/05/04

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 Judes Residential Home For The Elderly Front Street Nympsfield Nr Stonehouse Glos GL10 3TY Lead Inspector Sharon Hayward-Wright Unannounced Inspection 7th December 2005 14:00 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 Judes Residential Home For The Elderly DS0000016586.V271195.R01.S.doc Version 5.0 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 Judes Residential Home For The Elderly DS0000016586.V271195.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service St Judes Residential Home For The Elderly Address Front Street Nympsfield Nr Stonehouse Glos GL10 3TY 01453 860682 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) Mr Paul Anthony Morgan Mrs Winifred Morgan Care Home 10 Category(ies) of Old age, not falling within any other category registration, with number (10) of places St Judes Residential Home For The Elderly DS0000016586.V271195.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27/04/05 Brief Description of the Service: St. Judes is a small, family run care home providing personal care for older people. The accommodation is on two floors. However, service users whose rooms are on the upper floor need to be able to climb stairs, as the home does not have a lift. All but one room is single occupancy and the majority have ensuite facilities. There are bathrooms on each floor with the ground floor bathroom offering an electric bath hoist to assist with bathing. The communal areas consist of a lounge and dining room. The outside area is accessible, however, service users who have limited mobility will require assistance from the staff in the home to access the terrace which is up some steps. St Judes Residential Home For The Elderly DS0000016586.V271195.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 3.5 hours, on one day in December. The Registered Manager and Registered Provider were spoken to. Two service users were spoken to directly to gain their views of the care they receive and the home in general. Only two were spoken with as five of the ten service users were out with staff. Care records and the management of medications were inspected, as well as the records for food, servicing of equipment and quality assurance. A tour of the home took place and the staff were observed going about their work and interacting with service users. All requirements issued at the last and previous inspection have been addressed. A few minor areas identified in the warning letters were followed up, as these remained outstanding from the follow up visit. The home has done well in reviewing their recording keeping and documentation has greatly improved. The service users spoken with all had positive comments to make about the home. The home has made vast improvements in meeting the National Minimum Standards for Older People, and the home strongly encourages service users to live as they would in their own homes. What the service does well: The home is a family run business with a very low turn over of staff resulting in continuity of care for the service users. Staff morale is high, resulting in an enthusiastic workforce that works positively with service users to improve their whole lives. A varied activities programme is available for service users should they wish to participate, otherwise they are free make their own arrangements. The home maintains strong links with the local community and many activities involve the service users from the home and residents from the village. St Judes Residential Home For The Elderly DS0000016586.V271195.R01.S.doc Version 5.0 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 Judes Residential Home For The Elderly DS0000016586.V271195.R01.S.doc Version 5.0 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 Judes Residential Home For The Elderly DS0000016586.V271195.R01.S.doc Version 5.0 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 the following standard(s): 3 The homes’ pre admission assessment is not adequate in providing information about service users’ needs therefore the home is unable to provide assurance that their needs will be met. EVIDENCE: The home has recently accepted an emergency admission. The information about this service user was gathered over the telephone from Social Services. The service user was then brought to the home with a copy of their care plans and assessment completed by Social Services. The home undertook an assessment on admission, however none of the areas identified by Social Services were listed on this form. Following the last inspection the home was issued with a warning letter to improve their pre admission format. The home is part way to addressing this but needs to include all the areas identified in Standard 3.3 of the National Minimum Standards for Older People to ensure any of the needs of the service user are recognised and documented to assist with care planning. St Judes Residential Home For The Elderly DS0000016586.V271195.R01.S.doc Version 5.0 Page 9 The Registered Provider is aware that the home needs to write to new service users detailing to them how the home can meet their needs, however as it is unsure if this service user will be staying, this has not yet been undertaken. The service user said they have only been at the home for a week and feel they will need longer to settle in. However they did say they have no complaints so far. St Judes Residential Home For The Elderly DS0000016586.V271195.R01.S.doc Version 5.0 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 the following standard(s): 7 & part of 9 There is now a clear and consistent care planning system in place to adequately provide staff with the information they need to satisfactorily meet service users’ needs. The systems for the administration of medication have improved since the last inspection but some practices potentially puts service users at risk. EVIDENCE: Case tracking was not undertaken at this inspection, however five care plans were examined. The home has reviewed their format since the last inspection and this has improved the quality of their documentation. From the care plans looked at there is a list of daily activities detailing their individual needs. Two separate daily information sheets are kept relating to personal care and activities. It is recommended that the home devise another daily record sheet to document any other changes and health professional visits. The care staff have started to write in the care plans since the new format has been introduced. Monthly reviews of the care plans were seen. The home has devised a basics risk assessment form that also includes moving and handling information. Other changes to this format include a personal information list containing the service users’ personal details and identifies their key worker. St Judes Residential Home For The Elderly DS0000016586.V271195.R01.S.doc Version 5.0 Page 11 Medication was not examined in full only the requirements issued at the last inspection. The home has reviewed how they undertake their checking systems as now a computer generated MAR (Medication Administration Record) is used. The Registered Provider checks the medication in each week and against the repeat prescription and records they have started to make. This is so they are able to identify any errors or changes in medication immediately. A lockable facility has been provided to transport any medication around the home if needed. During the tour of the home it was noticed that one service user had nonprescription medication in their room. The home must provide a lockable facility for this and monitor how much of this the service user is having and check with their GP. One member of staff was noticed putting the medication into their hand prior to giving it to the service user. The home must ensure that the medication is not touched due to infection control risks and to prevent the staff member absorbing any of the medication. The home must also ensure that the container storing medication in the fridge is lockable. St Judes Residential Home For The Elderly DS0000016586.V271195.R01.S.doc Version 5.0 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 the following standard(s): 15 The meals in this home offer service users a varied selection of foods, however it is difficult to determine the nutritional valve of the food provided. EVIDENCE: A record of food provided to service users was seen. However more detail is required when the home lists sandwiches. The records showed that the service users receive a varied diet but it was difficult to determine the nutritional value of the meals provided from the records. Service users spoken with all said they enjoyed the food provided. No service users require any assistance with eating their meals. Teatime was observed and it was noted to be a very sociable occasion. Beans or spaghetti on white toast were offered with a piece of cake for ‘afters’. A limited choice was available but service users all seemed to enjoy their meal. The Registered Provider said staff have now completed their food and hygiene training. The home has recently had an Environmental Health Officer visit them and they made several requirements and recommendations. The Registered Provider said they are working towards addressing them. The standard of hygiene in the kitchen must be improved to reduce any risks to service users. This is discussed further in the environmental standards. St Judes Residential Home For The Elderly DS0000016586.V271195.R01.S.doc Version 5.0 Page 13 However staff were seen wearing protective aprons whilst working in the kitchen. St Judes Residential Home For The Elderly DS0000016586.V271195.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 The staff have an understanding of Adult Protection issues to assist in providing service users with a safe environment. EVIDENCE: The home has the appropriate policies and procedures in place to provide staff with information about adult protection. It is recommended that the home contact the local Adults at Risk team to obtain a copy of the Gloucestershire’s Alerters guide. The Registered Provider said the staff are to receive training about abuse in January 2006 as part of their rolling programme of training. The Registered Provider is aware of the POVA list. However the other staff were out with service users but have been questioned about this at previous inspections and were aware of what to do. St Judes Residential Home For The Elderly DS0000016586.V271195.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 There has been no change to the décor or furnishings in the last 12 months and although this does not pose a risk to service users it does not create a pleasing and pleasant environment to live in. The standard of cleanliness of the home is poor in places and could pose a risk to service users. EVIDENCE: The environment provides a homely feel for service users. No decoration or changes in furniture have taken place in the last 12 months or even before. In some rooms the décor is starting to look tired and outdated and damage to the wall in the lounge/dining room was noted. Two carpets were seen as needing immediate attention as they are very worn and stained and one has a hole in it. One room is the room where the new service user is living and the other room is opposite the main lounge and dining room. The Registered Provider is looking to have the remaining windows doubleglazed. The standard of cleanliness in the home overall is poor. Visible debris was seen on all carpets in the room inspected. Dust was seen in places and the St Judes Residential Home For The Elderly DS0000016586.V271195.R01.S.doc Version 5.0 Page 16 standard of cleanliness in the kitchen needs improvement. The Registered Provider said he has spoken with the staff about the cleanliness of the home and is looking to improve it. It is strongly recommended that the home devise a redecoration and re carpeting programme to improve the environment for service users. Staff were seen wearing protective aprons whilst working in the kitchen. St Judes Residential Home For The Elderly DS0000016586.V271195.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): No standards were assessed at this inspection. EVIDENCE: A requirement issued at the last inspection for the home to obtain a CRB/POVA (Criminal Record Bureau & Protection of Vulnerable Adults) check on the volunteer to the home was not completed as this person left after the inspection as they got employment elsewhere. St Judes Residential Home For The Elderly DS0000016586.V271195.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38 The home ensures so far as is reasonably practicable the health, safety and welfare of service users and staff. EVIDENCE: The home is continuing with quality assurance procedure and monitoring systems and are planning to send questionnaires to service users’ relatives. Records were seen of maintenance of equipment to include boiler servicing, fire equipment and testing/fire drills, portable appliance testing (PAT) and water temperatures. The home is due to renew their electrical wiring certificate next January. A maintenance contract is provide for their assisted bath seat. A consultant recently reviewed one service user and they have requested this service user makes themselves hot drinks. The home must complete a risk assessment for this activity. St Judes Residential Home For The Elderly DS0000016586.V271195.R01.S.doc Version 5.0 Page 19 St Judes Residential Home For The Elderly DS0000016586.V271195.R01.S.doc Version 5.0 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 1 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 3 2 x x x x x x 2 STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x x x x 2 St Judes Residential Home For The Elderly DS0000016586.V271195.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP3 Regulation 14(1)(a) Requirement The Registered Persons must ensure that all prospective service users have a comprehensive assessment prior to admission. The Registered Persons must ensure that a lockable facility is provided in the service users room that has the nonprescription medication. Monitoring the usage of this medication must be undertaken and referred to the service users GP if needed. The Registered Persons must ensure that staff do not touch the medication for service users with their hands and use a suitable container, as this is an infection control risk. The Registered Persons must store medication in the fridge in sealed lockable container. The Registered Persons must replace the carpets in the new service users room and the room opposite the main lounge/dining room. DS0000016586.V271195.R01.S.doc Timescale for action 01/02/06 2. OP9 13(2) 31/12/05 3 OP9 13(2) 07/12/05 4. 5 OP9 OP19 13(2) 23(2)(b) 31/12/05 31/01/06 St Judes Residential Home For The Elderly Version 5.0 Page 22 6 OP26 23(2)(d.) 7 OP38 13(4)(a) The Registered Persons must 31/12/05 improve the cleanliness of the home as it potentially puts service users at risk. The Registered Persons must 31/12/05 undertake a written risk assessment to ensure the service user that makes their own hot drinks in the kitchen is not put at any undue risk. 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 4 5 Refer to Standard OP3 OP7 OP9 OP15 OP19 Good Practice Recommendations The home should ensure their pre admission format contain the areas identified in this standard. The home should devise another daily record sheet for staff to add any other changes and health professional visits. The home should devise a specimen initials and signature list for staff who administer medication. The home should obtain advice about the food provided to service users to ensure they are providing service users with a nutritious food. The home should devise a redecoration and replacement of carpets programme to improve the environment for service users. St Judes Residential Home For The Elderly DS0000016586.V271195.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB 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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