Inspection on 08/06/06 for St Leonards Rest Home

This inspection was carried out on 8th June 2006.

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 16/12/05

St Leonards Rest Home 27/07/05

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 PO11 9BW Lead Inspector Nick Morrison Unannounced Inspection 8th June 2006 10:30 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 Leonards Rest Home DS0000011859.V290851.R01.S.doc Version 5.1 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 Leonards Rest Home DS0000011859.V290851.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service St Leonards Rest Home Address 38 St Leonards Avenue Hayling Island Portsmouth Hampshire PO11 9BW 023 9246 3077 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 F W Bartlett Mrs M Barlettt Mrs M Bartlett Care Home 15 Category(ies) of Dementia (15), Dementia - over 65 years of age registration, with number (15), Mental disorder, excluding learning of places disability or dementia (15), Mental Disorder, excluding learning disability or dementia - over 65 years of age (15), Old age, not falling within any other category (15) St Leonards Rest Home DS0000011859.V290851.R01.S.doc Version 5.1 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 16th December 2005 Date of last inspection Brief Description of the Service: The home provides a service for up to fifteen older people (over the age of 60) who may also have dementia or a mental disorder. There are 11 single bedrooms and 2 shared bedrooms (located on the ground and first floors). Communal areas comprise of the lounge, conservatory and dining room. There is a garden at the side/rear. Car parking is available at the front. Local amenities (including access to the beach) are nearby. Twenty-four hour care is provided [including 2 members of staff (one awake and one asleep) on duty at night]. St Leonards Rest Home DS0000011859.V290851.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection on 8th June 2006 during which the Inspector toured the premises, looked at a sample of three service users’ files and met with those same people. All records and relevant documentation referred to in the report was seen on the day of inspection. The Inspector spoke with the Proprietors, as well as a sample of staff, service users and relatives. The current range of fees within the home is between £385 and £420 per week. What the service does well: What has improved since the last inspection? What they could do better: The service provided to people living at the home is good, but the quality assurance system needs to be clearer and information needs to be made available to those people who have an interest in the development of the service. Please contact the provider for advice of actions taken in response to this St Leonards Rest Home DS0000011859.V290851.R01.S.doc Version 5.1 Page 6 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 DS0000011859.V290851.R01.S.doc Version 5.1 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 Leonards Rest Home DS0000011859.V290851.R01.S.doc Version 5.1 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 and 6 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. Service users benefit from having their needs assessed prior to admission. EVIDENCE: Service users’ files showed that each service user had had an assessment of need undertaken prior to admission to the home. The assessments were comprehensive and were completed with the service user and their family or representative where possible. A relative spoken to confirmed this and said that when he was looking for homes for his father he was impressed by the fact that manager of St Leonards was the only manager who insisted on meeting his father to do a complete assessment before offering a place to him. The home does not provide intermediate care. St Leonards Rest Home DS0000011859.V290851.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. Service users benefited from having their needs recorded in a care plan and from having their health needs met. They were protected by the home’s medication policies and practices and were treated with respect. EVIDENCE: Each service user had care plans in plans that adequately described their needs and provided information for staff on how thee should be addressed. One service user spoken with was aware of care planning and felt he was involved in the process. The Manager had reviewed all care plans on a monthly basis. Correspondence in service user files demonstrated they were supported to access relevant healthcare services as necessary. Files showed that their healthcare needs were regularly assessed and monitored. Records were kept of all medical appointments and the Manager had a system in place for ensuring that needs were continually monitored and that healthcare appointments were kept. Service users spoken with were confident that staff in the home monitored their healthcare needs effectively and that appointments were made St Leonards Rest Home DS0000011859.V290851.R01.S.doc Version 5.1 Page 10 where necessary. The medication system in the home was well managed. Clear records were kept of all medication coming into and going out of the home as well as all medication received by service users. Staff involved in administering medication had received training and all medication was stored appropriately. The home has regular input and support from the chemist and the Manager demonstrated a good understanding of medication issues. There was a Medication Policy in place and staff spoken with were clear about their responsibilities. Staff spoken with were clear about they maintain the privacy and dignity of service users and staff observed on the day of inspection demonstrated an ability to interact with service users in a supportive and sympathetic manner. Service users spoken with said staff treated them with respect and felt that they had sufficient privacy when they needed it. St Leonards Rest Home DS0000011859.V290851.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. Service users benefited from having a range of activities on offer within and outside of the home and from being able to see friends and relatives as they wished. They benefited from a healthy, balanced diet and were able to exercise control over their own lives. EVIDENCE: The home has a planned programme of activities available to service users. Service users could choose whether or not to be involved in activities and staff were clear that some people did not want to join-in with group activities. Activities included singing, arts & crafts, games, history videos, reminiscence games, recitals, crosswords and bingo. On the day of inspection some service users were taking part in a “chairobics” session which was designed to help them exercise as many muscles as possible and to keep physically active. The session was well attended and appeared to be enjoyable for those involved. There are also occasional activities planned outside of the home including visits to local places of interest such as the zoo, cathedrals, boat trips and pantomimes. The home has a visitors policy in place that states when service users may receive visitors. It encouraged visitors to come at any time during the day until late evening. Relatives spoken with understood the policy and felt that, if St Leonards Rest Home DS0000011859.V290851.R01.S.doc Version 5.1 Page 12 necessary, the Manager would be receptive to them visiting outside of the suggested hours. Service users said their visitors were encouraged and made to feel welcome in the home. Relatives said that the home was always welcoming and that staff and the Manager were always available to assist them and answer questions if necessary. Service users were encouraged to bring their own personal items into the home, subject to safety requirements. Information was available on local advocacy services. Staff observed on the day of inspection were able to demonstrate an understanding of the need for service users to make choices and remain in control of their lives as far as possible. Food in the home was of good quality. Menus showed that there was a variety of food on offer and that meals were balanced and were based on the known preferences of service users. The special dietary requirements of individual service users were recorded and, where necessary, diabetic needs were considered and met. Service users spoken with on the day of inspection were aware of what they were having that day and confirmed that different options were always available if they did not want what was on the menu. Food seen on the day of inspection was well presented and sufficient staff were available to provide support for people who needed it at mealtimes. Service users and relatives spoken with said the food at the home was very good. One service user described the food as being “proper food, like my mum used to make.” New and different kinds of food were offered on a regular basis for service users to try and different service users had the opportunity to choose the menu for specific days during each month. St Leonards Rest Home DS0000011859.V290851.R01.S.doc Version 5.1 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 the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. Service users were protected by the home’s complaints and abuse policies and practices. EVIDENCE: The home had an adequate Complaints Procedure in place that was made available to all service users and their families on admission. Copies of the policy were also placed around the building on notice boards. A clear procedure was in place for recording and responding to complaints although the hmoe had had very few in the last five years. The Manager was aware of issues of abuse and how to respond to them, although there had been none in the home. The home has a copy of the local procedure for dealing with suspected abuse and this is complimented by in-house policies to protect service users. Staff spoken with were aware of these and understood them. St Leonards Rest Home DS0000011859.V290851.R01.S.doc Version 5.1 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 the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. Service users benefited from living in a safe, comfortable and clean home. EVIDENCE: The home was suitable for its purpose and the Proprietors kept good, clear records of routine maintenance demonstrating that this was planned and monitored. All areas of the home, including the garden areas, were kept safe and secure. A cleaning schedule was in place and the home employed a member of staff specifically for cleaning. Procedures were in place for maintaining hygiene and staff spoken with were clear about these. Service users and relatives spoken with were happy with the standard of cleanliness in the home and some had chosen the home on the basis that it had a comfortable rather than clinical ambiance. St Leonards Rest Home DS0000011859.V290851.R01.S.doc Version 5.1 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. EVIDENCE: A clear rota was in place that showed that staffing levels were maintained according to the needs of service users. Staff spoken with confirmed that staffing levels were maintained according to the rota. The fact that the home had a cleaner meant that care staff were able to concentrate on the needs of service users. The Manager kept good training records that showed training was ongoing and given a high priority. Staff certificates were kept in the home. A comprehensive Induction Training package was used and all staff were encouraged to undertake National Vocational Qualifications. Staff files contained recruitment records that demonstrated the recruitment procedure had been followed and that all relevant checks were made on staff before they began working in the home. Service users and relatives spoken with felt that the staff in the home were competent and that people living in the home were supported safely and in a very caring manner. St Leonards Rest Home DS0000011859.V290851.R01.S.doc Version 5.1 Page 16 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): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. Service users benefited from a well run home where their health and safety is protected. EVIDENCE: The Proprietors manage the home very effectively between themselves; one is the Registered Manager and is responsible for the care in the home and the other is responsible for managing the other aspects of the service. Between them they have the skills and experience to run the home well and they are both focussed on the needs of people living in the home. There are quality assurance processes within the home. There was some evidence of satisfaction surveys from service users and their families and the Proprietors explained that they acted upon the results of these. The satisfaction surveys may be more useful if service users and their families were St Leonards Rest Home DS0000011859.V290851.R01.S.doc Version 5.1 Page 17 able to complete them anonymously. The Proprietors have recently acquired a format for managing quality assurance within the home and, when implemented fully, this should contribute them being able to meet this standard. In order to fully meet the standard the Proprietors need to record and analyse the views of service users and other stakeholders and develop a written annual improvement plan for the home based on identifying and improving outcomes for service users. The plan should be made available to and shared with those people who have an interest in the service. Records showed that all staff had regular supervision from the manager and staff spoken with confirmed this. Supervision covered all aspects of care workers’ roles and ensured that their practice reflected the philosophy of the home. Sessions were based on observation of practice and support and direction from the Manager. The home does not manage the finances of service users. They are involved in looking after small amounts of money for service users and their families and the families oversee this. All money kept for service users was kept individually and was locked away safely and access was restricted. Records were kept of all expenditure and those seen on the day of inspection matched exactly with the amount of money the home had for each service user. All staff had up-to-date training in Health and Safety issues and the Manager ensured that environment was safe for all staff, service users and visitors. Risk assessments were in place where potential risks had been highlighted and these were monitored and regularly reviewed. All equipment was regularly serviced and good records were kept. All accidents were recorded appropriately. St Leonards Rest Home DS0000011859.V290851.R01.S.doc Version 5.1 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 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 2 X 3 X X 3 St Leonards Rest Home DS0000011859.V290851.R01.S.doc Version 5.1 Page 19 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. 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 OP33 Good Practice Recommendations The home needs to improve its quality assurance system so that it links clearly to the development of the service and can be shared with relevant people. St Leonards Rest Home DS0000011859.V290851.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton 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. Extracts may not be used or reproduced without the express permission of CSCI St Leonards Rest Home DS0000011859.V290851.R01.S.doc Version 5.1 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. 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