Inspection on 11/07/07 for St Martins

This inspection was carried out on 11th July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE St Martins 3 Joy Lane Whitstable Kent CT5 4LS Lead Inspector Mark Hemmings Key Unannounced Inspection 11th July 2007 09:00 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 Martins DS0000069853.V346042.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. St Martins DS0000069853.V346042.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Martins Address 3 Joy Lane Whitstable Kent CT5 4LS 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) 01227 261340 H U Investments Limited Amanda Jane Barrance Care Home 23 Category(ies) of Dementia (0), Old age, not falling within any registration, with number other category (0) of places St Martins DS0000069853.V346042.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the Service are within the following categories: Dementia (DE) Old age, not falling within any other category (OP). 2. The maximum number of service users to be accommodated is 23. Not applicable. Date of last inspection Brief Description of the Service: St Martins (the Service) is registered to provide accommodation and personal care for 23 older people who have special mental health needs. This means that they experience difficulty with recalling some events and/or with organising some of their thoughts. The premises are an older detached twostorey property. Recently, the property has been reconfigured and extended to enable additional bedrooms and various other facilities to be created. There is provision for 17 people to have their own bedroom. There are three double occupancy bedrooms. Each bedroom has a private wash hand basin. There are two stair lifts. These provide step-free access around the accommodation. The premises are fitted with a call bell system which is designed to help people who use the Service to call for assistance should it be needed. The Service is set back a little from one of the main roads into Whitstable. To the rear of the property, there is an enclosed garden. The nearest shops are about one quarter of a mile away. The Registered Provider is a private limited company. It has just been registered with respect to St Martins. The Company operates a number of other residential care services in the south east of the country. The Registered Provider is understood to supply information to prospective people who might use the Service through a variety of routes. These include the provision of a Service Users’ Guide. This is a brochure which outlines the St Martins DS0000069853.V346042.R01.S.doc Version 5.2 Page 5 principal features of the facilities and services available in the Service. Also, there is a document called a Statement of Purpose available for review in the Service. This gives a more detailed account than does the Guide. In addition, the Registered Provider ensures that a copy of the most recent Inspection Report from the Commission, is available for anyone in the Service to read. The range of fees charged currently for residence in St Martins, runs from £367.82 to 580.00 per week. St Martins DS0000069853.V346042.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This Report is based upon a number of sources of evidence. These include a review of the correspondence in relation to the Service received by the Commission since the last inspection. Another source of evidence involves any written information received from the people who use the Service, from their relatives and from care managers (social workers). Also, the Inspector completed an unannounced inspection visit to the Service. This took about six hours to complete. During this time, the Inspector spoke in some detail and/or spent time with five of the people who use the Service. Some of these discussions/periods of time were in private. The Inspector consulted with a representative of the Registered Provider. Also, he spoke with the Deputy Manager, with one of the three senior care workers, with two of the care workers, with one of the housekeepers and with the cook. The Inspector examined various parts of the accommodation and he reviewed a selection of the key records and documents. The Registered Provider operates the Service in a suitable manner, so as to enable the people who use the Service to receive the support and assistance they need. What the service does well: The people who use the Service consider that St Martins provides them with a relaxed and generally comfortable setting within which to make their home. They say that they receive all the assistance they need and that they are served with good quality meals. St Martins DS0000069853.V346042.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. St Martins DS0000069853.V346042.R01.S.doc Version 5.2 Page 8 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 Martins DS0000069853.V346042.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 2, 3 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the Service. Prospective people who might use the Service should have most of the information they need in order to establish if the Service will meet their requirements. Prospective people who might use the Service have their needs assessed. EVIDENCE: Prospective people who might use the Service are provided with a range of written information about the facilities and services available in St Martins. The St Martins DS0000069853.V346042.R01.S.doc Version 5.2 Page 10 Deputy Manager builds upon this by answering questions about points of detail. The Deputy Manager completes an assessment of each prospective service user’s needs for assistance, before a decision is made about whether or not the Service is a suitable place for the person’s residence. Previously, people who use the Service have said that their needs for assistance were identified before they moved into the Service. Also, they have indicated that the care workers were ready to respond to their needs from the point of their admission. The Deputy Manager says that all of the people who elect to move into the Service, do so with the intention of making St Martins their longer term home. St Martins DS0000069853.V346042.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the Service. The health and personal care which people who use the Service receive, is based upon their individual needs. Suitable arrangements are in place to manage medication. The principles of respect, dignity and privacy are put into practice. EVIDENCE: The people who use the Service say or indicate (by their relaxed manner) that the care workers offer them all the assistance they need and that this is provided in a reliable and consistent manner. There is a written plan of care for each service user. These are important documents. This is because they form one of the means by people who use the Service can be informed about and St Martins DS0000069853.V346042.R01.S.doc Version 5.2 Page 12 can agree to the assistance they will receive. Also, the plans constitute a source of reference information for care workers. There is an omission in an aspect of the arrangements in place in relation to two of the people who use the Service. The Registered Provider is going to address these oversights by 1 August 2007. The people who use the Service are assisted to maintain their physical health. Care workers keep a tactful eye open, so that medical attention can be sought promptly should the need arise. Since the last inspection visit, family practitioners, the local district nursing service and various other hospital-based medical services have been involved in supporting the care provided in the Service. Suitable arrangements are in place to enable medication to be stored securely and to be administered in accordance with the doctors’ instructions. The people who use the Service say or indicate that the care workers are kind and considerate. They are relaxed in the company of the care workers and there is a family atmosphere in the Service. There have been a limited number of occasions when items of clothing have not been returned from the laundry to the right person. The Registered Provider is going to look into this matter to see what needs to be done to sort out the problem. St Martins DS0000069853.V346042.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the Service. The people who use the Service have things to do and they keep in touch with members of their families. Good quality meals are served. EVIDENCE: The people who use the Service are free to choose what to do each day. The pace of daily life is relaxed. There are no unnecessary rules or routines to disrupt the experience of a normal domestic setting. The people who use the Service consider themselves to be suitably occupied. There is a calendar of social activities taking place in the Service. The Registered Provider is going to keep the adequacy of this provision under St Martins DS0000069853.V346042.R01.S.doc Version 5.2 Page 14 active review. Some of the relatives think that a greater variety of activities should be offered and that events should take place more frequently. The people who use the Service are assisted to keep in touch with family and friends. People can receive visitors at any reasonable hour. They can meet with their visitors in the privacy of their bedroom if they wish to do so. The Deputy Manager routinely consults with relatives so that they know how things are going. The people who use the Service say that they receive good quality meals and they always have enough to eat. The menu indicates that a normally varied diet is provided. The cook regularly chats with the people who use the Service. Plainly, she has a good idea of which meals are likely to be popular and she arranges for these to be served regularly. St Martins DS0000069853.V346042.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the Service. There is an effective system for dealing with complaints. The wellbeing of the people who use the Service is safeguarded. EVIDENCE: The Registered Provider is aware of the need to ensure that complaints about the Service are investigated thoroughly and resolved promptly. Since the last inspection, the Deputy Manager has appropriately resolved a complaint to the satisfaction of the relative concerned. The complaint concerned a relatively minor matter. The care workers have a sound understanding of what constitutes good care practice. As part of this, they are aware of the need to be alert to instances in which the well being of people who use the Service might become jeopardised. The people who use the Service feel safe living in St Martins. St Martins DS0000069853.V346042.R01.S.doc Version 5.2 Page 16 St Martins DS0000069853.V346042.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the Service. Most areas of the accommodation are homely. Improvements need to be made in two of the bathrooms and in the laundry. EVIDENCE: The people who use the Service consider the accommodation to be homely and welcoming. As mentioned earlier in this Report, the Registered Provider has just been registered with respect to the Service. As one of the first steps it will take in its stewardship of St Martins, the Registered Provider is preparing an action plan. This will identify a number of improvements which it intends to make to the St Martins DS0000069853.V346042.R01.S.doc Version 5.2 Page 18 premises. It is understood that the action plan will be completed by 1 September 2007. The Registered Provider anticipates that work on the several improvements can start well before the end of the year. The need for some these improvements has already been identified by the Registered Provider and these are discussed below. The Registered Provider has completed an organised assessment of the adequacy of the fire safety measures in use in the Service. This indicates that there are no significant hazards which have yet to be addressed. The assessment is going to be submitted to the Kent Fire and Rescue Service by 1 August 2007. This will be done so that the agency can confirm the adequacy of the assessment in question. It is understood that the premises comply with the principal requirements of the local Department of Environmental Health. The kitchen is equipped adequately. Also, it is clean and well organised. The cook is aware of the principles of good food hygiene practice. At the moment, there is no mechanical ventilation which means that the kitchen can become uncomfortably hot. The dishwasher is located in a room next door to the kitchen. There is no general purpose sink or water supply in this area. This means that care workers have to pre-rinse items using a washing up bowl. This is a very cumbersome arrangement. There are three bathrooms. One of these is far too small to enable it to be used in the manner intended. It would accommodate a much needed shower facility. The remaining two bathrooms are adequately sized. However, in one of them the hoist is difficult to use because of how it is positioned. All of the bathrooms are rather bare. More should now be done to make them into the welcoming spaces most people want to have when they are bathing. The accommodation is kept comfortably warm and there is an adequate supply of hot water. Suitable steps have been taken to help prevent someone being burnt or scalded. The laundry is unreasonably small. Although it has the basic items needed such as washing machine and drier, there is simply no room for care workers to move around and to organise their work. All residential care service are required to comply with new regulations which have been introduced to help prevent used water from leaking back into the main cold water supply. The Registered Provider is going to clarify with the St Martins DS0000069853.V346042.R01.S.doc Version 5.2 Page 19 water supply company what (if any) additional steps may need to be taken in relation to this matter in the Service. This will be undertaken by 1 September 2007. St Martins DS0000069853.V346042.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the Service. There are enough members of staff on duty. Security checks are completed in relation to new employees. Care workers know what they are doing. EVIDENCE: There are four care workers on duty to respond to people’s needs for assistance from early in the morning until later in the evening when the night staff arrive. The care workers are supported in their work by other people, who undertake catering and housekeeping tasks. There are enough staff on duty to enable people’s needs for assistance to be met in a timely and reliable manner. At the moment the laundry assistant is absent from work. This means that her work is having to be undertaken by her colleagues. The Registered Provider intends to address this matter, so that more suitable arrangements are made to resource the operation of the laundry. St Martins DS0000069853.V346042.R01.S.doc Version 5.2 Page 21 More than one half of the care workers employed in the Service have acquired a National Vocational Qualification (NVQ) in health and social care, or hold a nursing qualification. The Registered Provider completes a number of security checks for new members of staff. These are designed to ensure that all members of staff are suitable people to be entrusted with access to service users who may be vulnerable. There is an omission in relation to Care Worker A. The Registered Provider is going to address this matter by 1 September 2007. All new care workers receive introductory training. This is designed to ensure that they have the basic knowledge and skills they need in order to be able to work without direct supervision. This is important because the quality of care delivered in the Service, depends largely upon the adequacy of the competencies care workers have to hand. In addition to the introductory training, existing care workers undertake a number of training courses. These are designed to further develop their skills. The Deputy Manager is going to add to this system, by reviewing the adequacy of the skills and knowledge of each of the existing care workers. This is a good idea because it double-checks that each care worker has the competencies they need. This exercise will be completed by 1 February 2008. St Martins DS0000069853.V346042.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the Service. The Service is well managed. The quality assurance system needs to be developed further. Sensible measures are in place to safeguard health and safety. EVIDENCE: St Martins DS0000069853.V346042.R01.S.doc Version 5.2 Page 23 The Deputy Manager has a thorough knowledge of how the Service runs. Members of staff say that they like the way she consults with them. They think that this contributes to their being good team work. The people who use the Service are invited to comment informally to staff about how things are going. The Registered Provider says that it intends to add to this arrangement by operating a more organised quality assurance system. This means that the people who use the Service, their relatives and other relevant people will be asked their views about how the Service might be improved. Their suggestions will then be used to form part of the Registered Provider’s ongoing written development plan for the Service. The Registered Provider intends to complete the first of these annual consultation and planning exercises by 1 February 2008. Some of the people who use the Service are assisted by staff to manage their personal spending allowance. There are suitable systems in place to ensure that these funds are administered in a proper manner. The Deputy Manager says that all items of equipment in use in the Service remain in good working order. There are various service documents in place which are consistent with this account. The Registered Provider is completing a number of ongoing checks which are designed to ensure that the Service’s fire safety equipment remains in good working order. Also, there are regular fire drills and periods of fire safety training. These are intended to check that members of staff know what to do if the fire alarm sounds, or if there is a fire safety emergency. The Registered Provider monitors the premises and the accommodation so that potential hazards to health and safety can be identified and resolved. The Deputy Manager says that there are no significant hazards waiting to be addressed. The Inspector did not notice any obvious hazards. St Martins DS0000069853.V346042.R01.S.doc Version 5.2 Page 24 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 3 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 3 X 2 3 X X 3 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 Score 3 X 2 X 3 X St Martins DS0000069853.V346042.R01.S.doc Version 5.2 Page 25 17 X 37 X 18 3 38 3 St Martins DS0000069853.V346042.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? Not applicable. 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. Refer to Standard Good Practice Recommendations St Martins DS0000069853.V346042.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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