Inspection on 03/11/05 for St Martins

This inspection was carried out on 3rd November 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 Martins 30/11/06

St Martins 17/02/06

St Martins 30/03/05

St Martins 18/01/05

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE St Martins 80 Aldersbrook Road Manor Park London E12 5DH Lead Inspector Stanley Phipps Unannounced Inspection 03 November 2005 11:15 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 DS0000025926.V261608.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 Martins DS0000025926.V261608.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service St Martins Address 80 Aldersbrook Road Manor Park London E12 5DH 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) 020 8530 5972 020 8530 8051 Mr Patrick Bell Mrs Bridget Bell Mrs Bridget Bell Care Home 36 Category(ies) of Old age, not falling within any other category registration, with number (36) of places St Martins DS0000025926.V261608.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th March 2005 Brief Description of the Service: St Martins Rest Home is a care establishment accommodating elderly service users. It is registered to accommodate up to thirty-six (36) The home is located in local facilities and is easily accessed by local transport. It is privately owned by Mr Patrick Bell and Mrs Bridget Bell. Mrs Bell is also the registered manager for the home. The home is set on large grounds and itself is spread over two floors, almost in the shape of an ‘H’. There is a large garden located between the front and the rear buildings., Staff are on hand twenty-four hours to provide care and support to all service users to ensure that they enjoy life to its fullest potential. St Martins DS0000025926.V261608.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place in just over three hours. It was timed to observe the mid-morning activities, lunch and to monitor the overall progress of the home. An assessment was undertaken of: the health and safety records, staffing recruitment and training records, the environment, the complaints record, a random sample of service user plans, menus and policies and procedures. Two members of staff were interviewed along with the manager and discussions were held with up to twelve service users on the day of the visit. Informal discussions were also held with other members of staff regarding the care and support provided to service users at St Martins Rest Home. The inspection found a fairly relaxed group of service users pleasantly going through their mid-morning routines. In general all staff were engaged in some form of activity with the service users. The standard of care provision was satisfactory and service users were in a safe environment. There were some improvements since the last inspection and some minor areas noted for improvement in this report. What the service does well: The home has a sound record for providing good stable long-term care for elderly service users. It thrives on a management team that has been established for over twenty-two years and in that period has demonstrated dedication and commitment to the home. This stability of care is also a result of professional working relationships with GPs, social workers, district nurses, continence advisors, the local priest and the relatives of service users. The registered manager leads the way in providing care and support to the service users and thrives on maintaining a stable staff core group. Staff working at the home respects the ethos and philosophy of care and is able to carry out their duty with great pride and dignity – values that benefit every service user in the home. The home has a strong religious origin and hence each service user has opportunities to pursue their faith with the support of staff. Significant events celebrations such as Easter, Christmas, Remembrance Day and St Patrick’s Day are routinely celebrated and a very high percentage of the service users participate in them. St Martins DS0000025926.V261608.R01.S.doc Version 5.0 Page 6 The home also provides a good catering service to individuals in meeting their dietary preferences and needs and all the service users appreciate this aspect of the service. What has improved since the last inspection? What they could do better: As stated earlier the Registered Manager could do more to ensure that records required by Schedule 2 of the Care Homes Regulations (2001) are fully in place and maintained at the home. This would offer greater protection to service users in ensuring that the staff working with them are thoroughly screened, prior to employment. In protecting service users and staff it is imperative that risk assessments are carried out in relation to moving and handling, infection control, first aid and food hygiene. Please contact the provider for advice of actions taken in response to this St Martins DS0000025926.V261608.R01.S.doc Version 5.0 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. St Martins DS0000025926.V261608.R01.S.doc Version 5.0 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 DS0000025926.V261608.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): (1,2,4,5) Service users and their representatives are assured that they not only have updated information about the services at St Martins prior to admission, but they also receive a statement of their terms and conditions. Having this information determines whether the home is suitable for the individual and this is complimented by opportunities to visit the home prior to admission. EVIDENCE: An updated statement of purpose and service user guide is in place in the home and they are made available to service users and/or their representatives. Both documents were in a format that service users could understand. A random sample of service user files assessed indicated that each service user had a statement of terms that contains obligations of the registered provider in providing for their needs individually. All service users spoken expressed the view that the home is capable and was providing, adequately for their needs and from assessing service user plans and other care records, this view was substantiated. It was reported that prior to the inspection a prospective service user visited and had a look around in order to determine the suitability of the home in St Martins DS0000025926.V261608.R01.S.doc Version 5.0 Page 10 meeting their needs. This practice is a normal part of the admission’s process at St. Martins and as such is positive in promoting service user choice. St Martins DS0000025926.V261608.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): (7,8,10,11) The personal, social and health care needs of service users are not only welldocumented in individual service user files, but were satisfactorily provided for at St. Martins. Service users are assured that staff would be sensitive to their needs and wishes and hence, treat them with dignity and respect. They are also assured that their wishes regarding death are carried with due diligence. EVIDENCE: From assessing service user files, speaking with service users and their relatives it was evident that the health, social and personal care needs are recorded in their individual service user plans. At the point of admission to the home a detailed needs assessment is undertaken and this looks at the each service user as a whole. The assessments cover areas such as physical health, religion, dietary preferences, oral health, mobility, speech and language and leisure pursuits – and this is not exhaustive. An individual service user plan is then drawn up from this. There was also evidence of risk assessments that were carried out on service users and they were also linked to individual service user plans. This ensures that interventions made with service users are undertaken in manner that minimises risks to the service user and subsequently the staff working with them. St Martins DS0000025926.V261608.R01.S.doc Version 5.0 Page 12 From the case tracking of a service user who carried a leg ulcer, it was observed that she received input from the district nurse and good support from the staff in the home in enabling her to regain a healthy leg. At the time of the visit her bandage was clean, in tact and her leg was elevated to promote circulation of the lower extremity. Records seen bore evidence of this. From the interview with the service user, she was quite pleased with her progress stating that ‘the leg was definitely improved and the staff were doing a good job of it’. From assessing the staffing interventions made with service users, it was evident that they were treated with dignity and respect by the staff at all times. Positive interactions were observed on the day of the visit, as all staff were tolerant, caring and placed the service users’ needs first, in caring for them. This was particularly evident while assisting them to use the toilet, with mobilising around the home and clearly during the consumption of their lunch. The care records of service users held details of their religion as well as the wishes of service users and their relatives in relation to death and dying. There was evidence that the registered manager works very close with each service user and their relative/s in ensuring that these wishes are carried out e.g. a preference to die in their own room. The manager also conducts regular visits to service users in hospitals and maintains extremely good contact with individuals and their relatives during periods where service users were inevitably dying. There was evidence from many cards and memorabilia provided by the manager that all relatives who had a related death in the home were extremely satisfied with the support and care offered to their loved ones during their last days. On this evidence, it was clear that the personal contributions made by the management of the home exceeded that required by the minimum standards. St Martins DS0000025926.V261608.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): (13,15) Service users and their relatives are assured that opportunities for their involvement in the home would be encouraged and maximised at St. Martins. The nutritional needs of service users are also adequately provided for in terms of choice, variety, and specialist needs. EVIDENCE: The home has demonstrated a good commitment to encouraging and involving the relatives of service users in life at St. Martins. Whilst it is acknowledged that several service users were without relatives, the home still provides a place of belonging in that there is a family feel to it i.e. a caring atmosphere. All service users were settled and generally happy on the day of the visit and this was mainly due to the fact that there was a strong staff presence engaging with them. There was evidence that for service users with relatives, they were involved in various aspects of the life in the home and this was particularly noticeable during social and festive celebrations. Service users spoken indicated that they felt valued, loved and well cared for by the staff and management and as such many of the service users live to a good age at St. Martins e.g. one service user was over one hundred years old. Lunch was observed and the meals provided were varied and specific to individual service user needs, for example diabetic diets, low salt diets and soft diets. All service users were observed enjoying their lunch and on checking with them, they expressed satisfaction with the meal on the day and meals St Martins DS0000025926.V261608.R01.S.doc Version 5.0 Page 14 generally in the home. A record of meals is maintained on a daily basis and service users although agreeing to a set menu, have the option of choosing an alternative should they change their mind. Service users had the choice of eating as part of a large group or individually and staff worked sensitively with those requiring assistance with feeding. Service users were also supported to eat at their own pace and as such the meal routine was unrushed. This is very important to the service user group in question as it makes swallowing and digesting food safer. A food hygiene inspection was carried out in July 2005 and the report was presented as evidence that food hygiene in the home was satisfactory. However a recommendation was made for the registered manager to retain cooked food samples and freeze for up to seven days, should there be an outbreak of food poisoning in the home. This would enable an analysis of the food to be undertaken and hence assist with diagnostics. The manager indicated that she commenced with this process. St Martins DS0000025926.V261608.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): (18) Satisfactory adult protection guidelines and protocols are in place to provide a protective framework for all service users living at St. Martins Rest Home. EVIDENCE: Staff demonstrated a satisfactory understanding of the concept of elder abuse and there was evidence to demonstrate that training on adult protection/abuse awareness had taken place for most staff in the home. Further training was scheduled for the newly recruited staff. In addition, the process of NVQ training includes elements relating to adult protection and a most of the staff had either started their NVQ Level 2 or have completed it. There is a satisfactory policy/procedure on adult protection as well as guidance on whistle-blowing. There is no history of adult protection issues at St. Martins Rest Home. St Martins DS0000025926.V261608.R01.S.doc Version 5.0 Page 16 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): (19,20, 21,23,25,26) The home offers a safe, comfortable and clean environment to all service users living there and this gives them a positive outlook on it. Service users are encouraged and supported to determine the décor of the home in general and this promotes a greater sense of comfort for them. EVIDENCE: All service users spoken to were happy with the physical layout, décor and facilities offered by the home. Throughout the inspection visit they were observed safely manoeuvring the home either with or without staff support. The walls of the internal communal areas were adorned with picturesque items that gave the home a rich feel that was consistent with the likes of service users living there. There were adequate toilets and bathrooms that were strategically located on both floors of the building i.e. proximate to the dining, lounge and bedroom areas of the home. They were satisfactorily maintained and contained a good supply of hot and cold water along with soap for hand washing and towels for drying hands. St Martins DS0000025926.V261608.R01.S.doc Version 5.0 Page 17 The home is well ventilated and has heating facilities that provide service users with adequate warmth and comfort. A sound system is in place for identifying; reporting and undertaking areas of repair and all staff are expected to play their part in identifying and reporting. Items of repair and/or redecoration are filtered through pretty quickly and, acted upon without delay. This generally works well, as the husband and/or son of the registered manager carry out most of the work in the home. The environment is generally safe and hygienic. Both the internal and external communal spaces were generally well maintained and accessible to all service users. There were security cameras fitted in strategic parts of the home i.e. aimed at exit doors and windows, to promote service-user safety. The location of these cameras does not impinge upon the privacy of the service users living in the home and primarily resulted from attempted and unwanted intrusion in the past. Service users are therefore safer with them. St Martins DS0000025926.V261608.R01.S.doc Version 5.0 Page 18 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): (29,30) Service users are reassured that staff working with them, committed, competent, and have their interest at heart. Generally, they are protected by the recruitment procedures undertaken by the registered persons. However, by maintaining staffing records fully in line with Schedule 2 of the Care Homes Regulations 2001, service user’s safety would be further enhanced. EVIDENCE: There were improvements in relation to the protection of service users and this was with regard to the recruitment of staff in the home and the records held on them. However there was one case in which a staff member was recruited without having CRB clearance and this practice should cease. Whilst it was acknowledged that there were undue problems with the Criminal Records Bureau Agency, the registered persons must ensure that every opportunity is taken to safeguard service users living in the home. The implications were fully discussed with the registered manager/proprietor and would be marked for improvement in this report. Further improvement was also required in the maintaining staffing records in line with schedule 2 of the Care Homes Regulations 2001, as the requirements were not fulfilled for all staff. From assessing the staff training records, observing their practice and speaking with service users, it was clear that the staff received training to enhance their knowledge and competence, which benefited service users in the quality of care they received. Service users are generally safe as evidenced by the low level of incidents in the home e.g. falls and in speaking with them, they were all satisfied with the way in which staff worked with them. St Martins DS0000025926.V261608.R01.S.doc Version 5.0 Page 19 The staff team were in receipt of training that was specific to the needs of the service user group, which included; First aid, food hygiene, medicine, dementia and catheter training. Staff interviewed displayed a sound knowledge of the needs of the service user group and the ‘philosophy of care’ in the home. They were also aware of the key policies used in carrying out their daily work with service users. One of the common statements made by service users at different points of the visit was: ‘we love the staff here as they really look after us. We do not want for anything here’. On this evidence it was clear that all service users were happy with the care provided at St. Martins Rest Home. St Martins DS0000025926.V261608.R01.S.doc Version 5.0 Page 20 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): (31,33,38) Service users and their relatives are assured that the management of St. Martins Rest Home is sound, holds their interests at heart and would go all out to ensure that a good standard of care is provided to all. This is extended to promotion of their health and safety, although this needs some improvement to provide an even safer home. EVIDENCE: The registered manager has managed the service since its inception and as such knows the home and all service users quite well. She has taken the home through the various changes including that of regulation and has generally managed to provide a good standard of service at St. Martins. There was evidence that she undergoes periodic changes to update her own skills and knowledge and provides clear guidance and support to the staff team. From conversations held with staff, service users and compliments/feedback recorded from relatives and friends; the manager has their overwhelming support. They all made reference to her commitment to provide a good service, putting the needs and interests of service users first. St Martins DS0000025926.V261608.R01.S.doc Version 5.0 Page 21 Some improvement was made from the last inspection as the registered manager acquired the views of service users regarding the service provided at St. Martins Rest Home. This was undertaken with regard to monitoring the quality of the services provided at the home and was a requirement made at the last inspection visit. It was conclusive that all service users were happy with the care and support they received and most importantly that, they enjoyed living at St. Martins From assessing the health and safety practices at St. Martins, it was concluded that the registered persons are in the main, providing a safe environment from the benefit of service users, their relatives and staff. There was evidence of weekly routine health and safety checks that was satisfactory, daily fridge/freezer temperature checks, induction and training for staff in fire and health and safety with safety procedures adequately posted throughout the home. However the registered manager needs to carry out risk assessments on safe working practice topics to include moving and handling, infection control, first aid and food hygiene. This requirement was made at the last inspection. It must be noted that a continued failure to meet requirements set by the Commission impacts adversely on the welfare of service users. It is in this respect that the Commission would consider taking enforcement action against the registered persons to achieve compliance; to ensure optimum safety for all at St. Martins. St Martins DS0000025926.V261608.R01.S.doc Version 5.0 Page 22 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 3 3 X 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 4 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 3 3 X 3 3 3 3 STAFFING Standard No Score 27 X 28 X 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 X X X X 2 St Martins DS0000025926.V261608.R01.S.doc Version 5.0 Page 23 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 OP29 Regulation 19,12,13 Requirement The registered persons are required to: (i) undertake CRB checks on all staff prior to their employment and (ii) keep a record of all staff in line with Schedule 2 of the Care Homes Regulations 2001. (The latter of the requirements has been previously made). The registered manager is required to carry out risk assessments on all safe working practice topics listed in Standard 38 of this report. (This requirement was previously made). Timescale for action 28/02/06 2 OP38 12,13 28/02/06 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 DS0000025926.V261608.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU 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 Martins DS0000025926.V261608.R01.S.doc Version 5.0 Page 25 - 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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