Inspection on 27/07/05 for St Leonards Rest Home

This inspection was carried out on 27th July 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 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 Leonards Rest Home 06/06/08

St Leonards Rest Home 08/06/06

St Leonards Rest Home 16/12/05

St Leonards Rest Home 04/02/05

St Leonards Rest Home 08/10/04

St Leonards Rest Home 04/03/04

St Leonards Rest Home 06/01/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE St Leonards Rest Home 38 St Leonards Avenue, Hayling Island Portsmouth Hampshire Lead Inspector Martin Bayne Unannounced 13 June 2005, 10:00 th 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 Leonards Rest Home H54 S11859 St Leonards V233579 130605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service St Leonards Rest Home Address 38 St Leonards Avenue, Hayling Island, Portsmouth, Hampshire, PO11 9BW 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) 02392 463077 Mrs M Barlett Mrs M Barlett CRH 15 Category(ies) of DE- Dementia: 15 registration, with number DE(E)- Dementia over the age of 65 years: 15 of places MD- Mental Disorder: 15 MD(E)- Mental Disorder over the age of 65 years: 15 OP- Old Age: 15 St Leonards Rest Home H54 S11859 St Leonards V233579 130605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1- Service users in the categories DE and MD are not to be admitted under the age of 60 years. Date of last inspection 4/02/2005 Brief Description of the Service: St Leonards is registered to provide care and accommodation to fifteen people with frailty as a result of old age or who have mental health disorders relating to old age, above the age of sixty. The home is located in a residential area of Hayling Island within easy reach of local shops, amenities and the sea front. The accommodation is provided on two floors, with access to the first floor by means of stairs or stair lift. The home has been extended and converted from two houses and has eleven single rooms and two shared rooms. The communal areas consist of a large lounge with patio doors that lead to an enclosed garden, a dining room and conservatory area. St Leonards Rest Home H54 S11859 St Leonards V233579 130605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first visit made to the home by the inspector. A tour of the building was made with introductions to the staff team and residents. The criteria for admission to the home and the general aims and objectives were discussed with Mr & Mrs Bartlett. The admissions and care planning procedures were also discussed before residents were then spoken with individually and in small groups about their experience of living in the home. All of the feedback from residents was positive and there were no negative opinions expressed about the home. The inspector was invited for lunch and had the opportunity to speak with a different group of residents. In the afternoon the home was evaluated against more of the standards. There were no requirements made at this inspection. What the service does well: What has improved since the last inspection? Since the last inspection the home has attended to the requirements made at an environmental health inspection in respect of the kitchen. Staff are now provided with uniforms and hats for use in the kitchen and improved cleaning schedules have been put in place. Hand towels have been provided in the kitchen and plastic containers provided for foodstuffs. St Leonards Rest Home H54 S11859 St Leonards V233579 130605 Stage 4.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 Leonards Rest Home H54 S11859 St Leonards V233579 130605 Stage 4.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 Leonards Rest Home H54 S11859 St Leonards V233579 130605 Stage 4.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) 2, 3, 4 & 5 Residents’ needs are met through good assessment procedures. Prospective residents have access to information about the home. EVIDENCE: Residents and relatives are involved in choosing the home prior to admission. One person spoken with who was staying at the home for respite care informed that she wished to move to the home for long term care. Another resident spoke of how his son had helped him choose to move to St Leonards. Mrs Bartlett discussed how she assessed residents referred to the home. An assessment as to whether the home would be suitable to meet the person’s needs is made usually in the persons home or in hospital. Residents and relatives are encouraged to visit the home prior to admissions. Once a person is admitted a more detailed assessment is carried out covering all the person’s needs in relation to their care. The recording format was discussed for this assessment process and it was agreed that the new form being piloted in the home would be ideally suited as this covered all the topics required in the St Leonards Rest Home H54 S11859 St Leonards V233579 130605 Stage 4.doc Version 1.30 Page 9 standards. Residents are offered a trial period before deciding to move permanently into the home. The majority of the residents receive funding through Social Services and copies of these contracts are held in the home. The home also has a contract that residents enter into with the home that detail the terms and conditions of residence at the home. Copies of these were in place for all residents save two residents. In the case of one person they were on respite and deciding whether to move into the home permanently and in the other case the contract had been sent to a relative to sign as the resident did not have capacity to sign this document. It was agreed that contracts would put in place for these residents as soon as possible. The residents spoken with all said that their needs were met at the home and this was verified by tracking the recording of care and health needs for two resident through the inspection. St Leonards Rest Home H54 S11859 St Leonards V233579 130605 Stage 4.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 & 10 Residents’ health needs are met through monitoring by the staff using welldeveloped recording systems. EVIDENCE: The health and care needs of two residents were discussed with them and with Mr & Mrs Bartlett. The recording and paperwork in relation to these residents’ needs were then looked at and these demonstrated that there were good systems in place. A full care plan that had been drawn up from the assessment and the residents sign a document that they had been involved. There was also evidence that care plans were being monitored each month as to whether they were up to date. Risk assessments were carried out in respect of the risk of falls. Monitoring of weight and diet are monitored. Each resident is registered with a local GP and visits made by the GP are recorded as well as visits from opticians, chiropodist and dentists. The home also receives visits from a liaison nurse employed by the Primary Care Trust to follow up health needs that do not necessitate visits from the GP. St Leonards Rest Home H54 S11859 St Leonards V233579 130605 Stage 4.doc Version 1.30 Page 11 The medication policies and procedures were discussed with Mr & Mrs Bartlett. A new training package on safe administration of medication is soon to be introduced to all staff who administer medication in the home. It was also reported that in the previous week two members of staff had attended a day course on medication administration. The home has a recording system that can allow an audit trail for all medication that enters the home. The homes procedure is for two staff to administer medication. The home uses a unit dosage system. Medication is taken from the unit dosage container and put into a lidded pot and then taken to the resident. They are observed taking their medication, a record of this is then made. The medication administration records for all of the residents were inspected and it was found that there were no gaps within the records. The home has an arrangement with a local pharmacist and records were seen of the visits and inspections made through this arrangement. It was agreed that a risk assessment for the homes procedure would be undertaken and this will be followed up at the next inspection. St Leonards Rest Home H54 S11859 St Leonards V233579 130605 Stage 4.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, 14 &15 Residents benefit from a range of activities and a good standard of food. EVIDENCE: On the day of this visit to the home an exercise class was being taken from an instructor who visits the home. The residents spoken with said that there were activities of some kind on most mornings, quizzes and bingo currently being very popular. Mr & Mrs Bartlett reported that the current resident group was active and able and it was their intention to deploy an additional member of staff who will be able to take groups of resident out into the community more often. Residents spoken with said that they had autonomy to exercise choice. Examples given were the right to get up and go to bed when they choose. They are able to lock their doors if they choose and have meals within their rooms and to receive visitors when they choose. All of the residents spoken with said that the food was of a good standard and that there was always plenty to eat. One resident also spoken with said that St Leonards Rest Home H54 S11859 St Leonards V233579 130605 Stage 4.doc Version 1.30 Page 13 they enjoyed the vegetarian diet provided at their request. It was noted that specialised diets for diabetics were catered for. St Leonards Rest Home H54 S11859 St Leonards V233579 130605 Stage 4.doc Version 1.30 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 standard(s) These standards were not inspected. EVIDENCE: Since the last inspection there has been one complaint made against the home that was investigated by CSCI and found to be unsubstantiated. St Leonards Rest Home H54 S11859 St Leonards V233579 130605 Stage 4.doc Version 1.30 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 standard(s) 19, 20 & 24 The residents have the benefit of a homely, well-maintained environment with suitable facilities and an enclosed garden. EVIDENCE: The home has been converted from two houses with an extension also put onto the home. There is a patio area leading from the lounge and a wellmaintained garden enclosed garden. The home is provided on two floors and a stair lift accesses the first floor. In addition to the lounge, a dining area and conservatory make up the communal areas. The home has eleven single rooms and two shared rooms. Four of the bedrooms have ensuite WC facility. The home has sufficient numbers of bathroom and WC facilities. On the day of inspection the home was found to be clean and in reasonable decorative order. St Leonards Rest Home H54 S11859 St Leonards V233579 130605 Stage 4.doc Version 1.30 Page 16 There was evidence that residents were able to personalise their rooms and bring their own furniture. Bedrooms have door locks and residents are able to lock their doors if they wish. Residents said that their call bells were answered in good time if they rang for assistance. Residents reported that the home was kept warm in the winter and there was good ventilation in summer. St Leonards Rest Home H54 S11859 St Leonards V233579 130605 Stage 4.doc Version 1.30 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 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 The home has a well-trained and supported long-serving staff team, from which the residents benefit. EVIDENCE: The overall staffing structure and levels of staffing were discussed. Mrs Bartlett is the registered manager and supervises the care in the home whilst Mr Bartlett deals with administration, maintenance and some night shifts. Mrs Bartlett is a registered nurse and also has a NVQ level in management and care. Mrs Bartlett has a deputy, who is trained to NVQ level 3 and there are two senior carers, one for night care and one for day care. The home also employs a cook and cleaner. It was reported that in general there are two members of staff on duty throughout the day however a third member of staff is often deployed for particular events or if needs of residents dictate. During the night time period there is one awake and one asleep member of staff on duty. The residents spoken with said that there were sufficient members of staff to meet their needs. The home has a core of long serving staff and it was reported that there was little staff turnover. Two members of staff were spoken with who said that they were supported through supervision and appraisals. It was reported that they also received good levels of training. St Leonards Rest Home H54 S11859 St Leonards V233579 130605 Stage 4.doc Version 1.30 Page 18 The staffing recruitment records for two members of staff were viewed, one for a long-standing member and one for the last member of staff recruited. It was found that the required checks and information had been obtained such as CRB and two references. It was agreed that the staff application form be reviewed so as to obtain the information now required under Schedule 2 of the Regulations. St Leonards Rest Home H54 S11859 St Leonards V233579 130605 Stage 4.doc Version 1.30 Page 19 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) 32, 35 & 37 The home is well managed with staff supported to carry out their role. Good record keeping is maintained. EVIDENCE: The home was well managed with the staff team seeming to be motivated and supported. Mr & Mrs Bartlett maintain a high profile in the home and residents spoke warmly of them. The records viewed during the inspection were found to be up to date and accurate. Staff receive supervision and have annual appraisals. The financial records maintained on behalf of one resident who is unable to manage their finances was inspected and found to be a complete and accurate record with the balance tallying to money held. Mr Barlett, who is also St Leonards Rest Home H54 S11859 St Leonards V233579 130605 Stage 4.doc Version 1.30 Page 20 appointee for this resident was able to demonstrate that he had acted and involved Social Services as appropriate. St Leonards Rest Home H54 S11859 St Leonards V233579 130605 Stage 4.doc Version 1.30 Page 21 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 3 3 3 3 x 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 x 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 x x x 3 x x STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x 3 x x 3 x 3 x St Leonards Rest Home H54 S11859 St Leonards V233579 130605 Stage 4.doc Version 1.30 Page 22 na 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 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. Refer to Standard Good Practice Recommendations St Leonards Rest Home H54 S11859 St Leonards V233579 130605 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection 4th Floor- Overline House Blechynden Terrace Southampton Hampshire SO15 1GW 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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