Inspection on 12/10/05 for St Maur

This inspection was carried out on 12th October 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 Maur 29/10/08

St Maur 02/11/06

St Maur 10/01/05

St Maur 16/11/04

St Maur 07/04/04

Similar services:

Trevaylor Manor

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

Claremont Nursing Home

Althea Park House

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

CARE HOME ADULTS 18-65 St Maur St Maur 8 Knowles Hill Road Newton Abbot Devon TQ12 2PW Lead Inspector Judy Cooper Announced Inspection 12th October 2005 10:00 St Maur DS0000003813.V257097.R01.S.doc Version 5.0 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 Maur DS0000003813.V257097.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 Adults 18-65. 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 Maur DS0000003813.V257097.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service St Maur Address St Maur 8 Knowles Hill Road Newton Abbot Devon TQ12 2PW 01626 335560 01626 363313 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) Community Care Trust (South Devon) Limited Mrs Jacqueline Taryn Murch Care Home 8 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (8) of places St Maur DS0000003813.V257097.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th November 2004 Brief Description of the Service: St Maur is a detached house in a quiet residential area. It is less than half a mile from Newton Abbot town centre,therefore near to shops and the other usual town facilities. The house is located up a steep drive in a secluded position, and there is a large garden and a small car parking area. There is a lounge, separate dining room (which also has a small office facility sited within it) and a communal lounge. There are six single bedrooms and one double. The home caters for younger adults with a mental health problem, its main aim being to provide a needs-led, person centred care package, based on thorough assessment and care planning which is undertaken with the client. The care and support then provided is a client self management and recovery programme. The manager also provides a small day care service for up to two clients on a daily basis, although this service is not used on a regular basis, but rather as needed. St Maur DS0000003813.V257097.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over one day. Several standard written feedback forms were received at the inspection from clients. Opportunity was taken to tour the premises, examine appropriate records and policies and talk with the manager and, for part of the inspection, her line manager, clients and staff. Staff on duty were also observed, whilst supporting and interacting with the clients, in their day to day work. What the service does well: What has improved since the last inspection? St Maur DS0000003813.V257097.R01.S.doc Version 5.0 Page 6 The dining room has been fitted with some two new large double glazed windows as required by the fire authority to therefore ensure client safety. The home’s communal bathroom has been redecorated and the home’s lounge has been upgraded with a new double glazed window and some new furniture, which allows clients to benefit from a more attractive environment. The home’s garden has been made easier to look after and is generally more accessible to clients and staff. Additional specialised staff training has been provided which helps staff be able to better understand the needs of clients with mental health problems and so offer the correct level of care and support. 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 Maur DS0000003813.V257097.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection St Maur DS0000003813.V257097.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The individual needs and aspirations of any prospective client are assessed and well known by both the manager and staff prior to any client’s admission. EVIDENCE: By looking at the records for one client, who had recently been admitted to the home, it was noted that a full and detailed admission procedure was undertaken which had ensured that St Maur was an appropriate placement for the client. It was also noted that the client, themselves, had wanted to come and stay and undergo the treatment/support programme on offer at the home, having been given all information regarding what the home could offer, prior to admission. St Maur DS0000003813.V257097.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Staff are skilled at ensuring that the clients are involved in planning for all aspects of their overall needs and personal goals. There is a lack of recorded details, regarding what action should be taken to minimise any identified risk. This could place clients at risk as staff may not be aware of any new agreed procedures, which have been put in place to protect clients. EVIDENCE: A written plan, named a “Recovery Action Plan”, was available for each client. It had been drawn up with each client and their key worker. The plan covers all daily aspects of daily living and is easy to understand and contained very realistic goals for each individual client. The client owns the plan and has daily input into it in the form of writing his or her own daily notes and any subsequent changes to the plan. Incorporated within the plan are risk assessments and it was noted that risk taking , in various forms, is a big part of an individual client’s recovery programme. However it was noted that although risks were clearly identified, necessary actions needed to minimise any potentially harmful risks were not documented. St Maur DS0000003813.V257097.R01.S.doc Version 5.0 Page 10 Residents continue to have access to some holistic therapies (currently reflexology), which has proved popular and effective. During the inspection the daily feedback group took place where staff meet with the clients at lunchtime, to discuss the clients’ morning in a group setting, and by doing so address any individual anxiety/ problem any client may be having by offering group support/counselling. Clients spoken with were articulate as to their illness/needs. The clients confirmed that the management and staff are able to meet these as well as provide support in every day living tasks. All were able to confirm that their individual choices were upheld, and that the staff respected them and treated them with dignity. St Maur DS0000003813.V257097.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16,17 The staff remain committed to ensuring all aspects of daily living within St Maur, is determined by client choice, which allows clients to maintain control over their own lives within a supportive environment. EVIDENCE: St Maur DS0000003813.V257097.R01.S.doc Version 5.0 Page 12 Clients have the opportunity of a full recreational programme. Excellent use is made of the local community with clients using all local facilities including educational placements. Clients are supported as necessary to participate in any activity that they feel may benefit them. Essential training has also been made available to the clients that may be of use to them, both at the home and after, including such things as food hygiene training. Meals are planned with client involvement and during the inspection the weekly cookery group was taking place. One client (on a weekly rotational basis) chooses a whole three course evening meal which all other clients then shop for and help prepare. This is a popular activity and allows clients to use lots of life skills such as planning, shopping, budgeting, cooking and working together as a team. Individual choice is always upheld within the home and an example of this is a client was able to choose their own colour scheme for the room they are currently occupying and the manager then bought the paint and the staff redecorated the room according to the client’s wishes. St Maur DS0000003813.V257097.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Clients are supported in all aspects of life as needed and sensitive support is made available from a skilled staff group. Clients’ healthcare needs are supported appropriately however the absence of an up-to-date risk assessment, for any client that self medicates, could mean that a newly identified risk is not recorded and therefore not known by staff. This could place a client at risk. EVIDENCE: Care provided is tailored to each individual client’s needs. Clients’ written records contained full details of all care provided. Clients spoken with stated that they felt that their stay at St Maur had helped and enabled them, with such comments received as the home had “ allowed them to progress and the staff are very good and I am treated like a real human being”. Another stated that “It’s been a great help and learning experience for me. It’s helped me get my life on track.” Clients are encouraged and supported to manage their own health care and take personal responsibility for their own welfare as far as they are able. Experienced staff undertake any required administration of medication and there were detailed records of the medication held, and given out, by the home’s staff, as well as appropriate medication policies and procedures which helps ensure that clients are protected in this area. However it was noted that St Maur DS0000003813.V257097.R01.S.doc Version 5.0 Page 14 there were not up to date risk assessments in place, in relation to the clients who self medicate, although a clinical review had taken place. However the information obtained from the clinical review in relation to self medication had not been recorded appropriately which may place a client at risk if there were any conditions/precautions staff should be aware of. Access to other usual health services is available, with clients attending at local community facilities, however most clients have few physical needs with their needs being mostly connected to their mental health problems/illnesses. St Maur DS0000003813.V257097.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 The home has a satisfactory complaints procedure. Clients would feel able to approach the management or staff with any concerns they may have. EVIDENCE: The complaints procedure is satisfactory. An individual copy is given to clients. The home has satisfactory adult protection policies and procedures in place, with additional training being made available within the near future for a new member of staff. This ensures that clients are well protected from any form of abuse. The manager is currently not holding any money for any clients but will hold personal valuables, if requested, in a safe within the home. St Maur DS0000003813.V257097.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 St Maur is comfortable, clean, and mostly well maintained, however the residents’ living environment could be improved upon by general upgrading of the environment and the upgrading of some furniture and fittings that have now become worn. The home provides a safe place for clients to live in. EVIDENCE: Since the last inspection some upgrading has already taken place including the installation of new windows in the dining room and the replacement of an old type window in the lounge with a new double glazed unit. A new settee has also been provided in the lounge and the home’s garden has been made more attractive and accessible. The result of this is that both these areas in the home and the garden are pleasant and well maintained. However there were still some areas of the home that need to be further upgraded, to ensure that clients benefit from a pleasant environment and these have been fully detailed within the summary of this report. The home was clean and hygienic. St Maur DS0000003813.V257097.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 The clients’ needs are fully met and supported by an experienced, well trained staff team which helps clients achieve their personal goals. It was not possible to confirm that all staff working at the home had undergone a robust recruitment procedure, which ensures that the clients are fully protected, as not all staff records were available within the home. EVIDENCE: Staffing levels were seen to be in sufficient numbers to ensure that clients’ needs could be met at all times. Staff were noted as interacting positively with the clients. Two comments received from clients stated “The staff are great here and very supportive. Staff and clients are very friendly and it’s a good atmosphere to be in” and “During my time here I have progressed a lot. This is due to my confidence growing which has been aided by the tremendous support I receive from the staff”. Training continues to be well planned and supports the staff in providing support for the clients. Currently two staff are undertaking a Certificate in Community and Mental Health with other statutory and relevant training also provided. Regular staff supervision is provided. This ensures that the staff are able to both understand and work with clients suffering with mental health problems. St Maur DS0000003813.V257097.R01.S.doc Version 5.0 Page 18 The staff spoken with during the inspection stated that they felt supported in their role and that they felt they made a difference to the clients’ lives and got job satisfaction from this. The manager was able to state that the staff recruitment programme was in order and it is to the organisation’s credit that clients are now invited to be a member of the interview panel for new staff. However the staff file inspected at this inspection was incomplete as the written references and application form were being held at the Trust’s head office and so could not be verified as being satisfactory. St Maur DS0000003813.V257097.R01.S.doc Version 5.0 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 The registered manager is professionally qualified and very experienced with working with this client group. The home has a clear management structure. The home’s quality assurance systems were in order with clients encouraged to offer their views as to how the home is performing and meeting their needs. EVIDENCE: The home is managed in such a way that clients’ needs are known and met by a supported and well informed staff group. The management of the home helps create a welcoming, open and positive place to live and work. Clients were seen to be relaxed with the management and staff. Suitable quality monitoring takes so that clients’ needs continue to be met appropriately, however the Trust has chosen not to maintain its “Investors in People” award this year The manager and staff continue to maintain a safe environment with appropriate and required checks in place to ensure that clients’ health and safety is not compromised. St Maur DS0000003813.V257097.R01.S.doc Version 5.0 Page 20 The home’s annual report was made available which identified what progress (or shortfalls) the home has made and what plans the senior management has for the future of St Maur. St Maur DS0000003813.V257097.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x 3 x x Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 4 4 x 2 x Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 LIFESTYLES Standard No Score 11 x 12 4 13 4 14 4 15 4 16 4 17 Standard No 31 32 33 34 35 36 Score x 3 x 2 3 x CONDUCT AND MANAGEMENT OF THE HOME 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 St Maur Score 4 4 2 x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x x 3 x DS0000003813.V257097.R01.S.doc Version 5.0 Page 22 NO 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 2 3 4 5 Refer to Standard YA9 YA20 YA25 YA34 YA37 Good Practice Recommendations A written record should be kept of any action needing to be taken to minimise any identified risk appertaining to clients’ daily living. The registered manager should ensure that there are up to date risk assessments undertaken for any client that self medicates. The registered provider should continue to upgrade the home’s accommodation as required. The registered provider should ensure that all staff records are availabale within the home for inspection purposes. The registered manager should, as part of her continuing professional development, consider undertaking the Registered Manager’s Award. St Maur DS0000003813.V257097.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Maur DS0000003813.V257097.R01.S.doc Version 5.0 Page 24 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!