Inspection on 29/10/08 for St Maur

This inspection was carried out on 29th October 2008.

CSCI found this care home to be providing an Adequate service.

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 02/11/06

St Maur 12/10/05

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 15/11/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: St Maur St Maur 8 Knowles Hill Road Newton Abbot Devon TQ12 2PW     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Andrea East     Date: 2 9 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: St Maur 8 Knowles Hill Road St Maur Newton Abbot Devon TQ12 2PW 01626335560 01626363313 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Community Care Trust (South Devon) Limited Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 8 Number of places (if applicable): Under 65 Over 65 0 mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home 8 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 subsequently provided is a client self management and recovery programme. Care Homes for Adults (18-65 years) Page 4 of 29 Brief description of the care home The home can also provide 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. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is one star. This means that people who use this service experience adequate quality outcomes. The Inspection site visit was unannounced and carried out over one day. People were spoken with regarding their lifestyle in the home and the care services they received. Staff including the manager were spoken with and a range of information, including care and assessment records, staff personnel files and policies and procedures were examined. Care Homes for Adults (18-65 years) Page 6 of 29 A tour of the premises was also completed and information gathered from the homes annual quality assessment audit. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Adults (18-65 years) Page 8 of 29 The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 29 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The individual needs and aspirations of anyone planning to live at home were assessed and agreed prior to the person moving in to the home on a permanent basis. Evidence: Two files were examined, they held a range of assessment information about peoples individual health, personal care, social and educational needs and goals. Assessments had been completed with discussion, with the person planning to move into the home. Assessments also included input from health and social care professionals, who had knowledge and background information on that persons needs. People said that they had the opportunity to visit the home prior to moving in. One person said they had planned to move into the home after discussion with staff who had visited them in hospital. Six out of six surveys completed by the people living at home said that they had Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: received enough information about the home before they had moved in. The homes annual quality assurance assessment said that people referred to St Maur were encouraged to express their full aspiration fears and needs in relation to their recovery to well-being. It also said it is seen as essential that people visit and revisit including overnight until they are confident as possible about their stay at the home. Care Homes for Adults (18-65 years) Page 12 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People knew there assessed and changing needs and personal goals were detailed in individual plans. People were supported in making decisions about their lives and to take risks as part of an independent lifestyle. Evidence: People said that they worked alongside an unnamed member of staff to try and follow a recovery action plan. The plan details areas that person wishes to develop extend or relearn such as budgeting skills, more links with the community, or building social skills. People said that their personal goals were discussed with them and reviewed with them, with support from staff in the home and their health care professionals. Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: Documents examined showed detailed care and assessment documents that had been reviewed and updated with a person living at the home. Assessments included potential risks to peoples mental health and well-being and how risks could be minimized. There were a range of supporting documents such as diaries, daily evaluations, assessment is from health care professionals, but also gave information on peoples goals and needs. This meant that staff had all the information they needed to support people safely. Some assessments and recovery plans had not been fully completed. Some had been reviewed but this had not been fully recorded. The annual quality assurance assessment said that each person living in the home had a recovery action plan, which identified common goals and a plan of action to achieve them. It also said that each person develops a wellness recovery action plan which details what the person needs to do every day to keep well. Care Homes for Adults (18-65 years) Page 14 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were able to participate in a range of appropriate activities in the local community, attending leisure activities and in building positive relationships. Peoples rights and responsibilities were recognized and respected. People were offered a healthy diet and enjoy their meals and mealtimes, taking an active part in planning, cooking and budgeting for meals. Evidence: People said that they had an opportunity to take part in activities in the home and local community that suited them. Some people chose very active waste of their time, while others preferred slower more paced activities. All activities centered around individuals choices and needs and supporting people in making informed choices about Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: how they spent their time. The kitchen area and mealtimes were part of peoples individual plans. So that people took an active part, in planning, shopping and cooking meals. Staff said menus and meals were discussed at group meetings, in which people raised what the preferred to eat or what they disliked. Meals and special diets were also part of assessment and care planning records, for some people, if this was part of their care needs. The annual quality assurance assessment said people are encouraged to make full use of community resources and join activities where a cross-section of the community may be engaged in the same activity, for example at college, at evening classes, or using local sporting facilities. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People received sensitive and flexible personal support and care to maximize their rights to privacy, dignity, independence and choices. People were supported to retain and administer their own medication where appropriate. People were protected by the homes policies and procedures for dealing with medication. The storage and recording of medication could be improved. Evidence: People said that they were encouraged and supported to manage their own health care and take personal responsibility for their own welfare as far as they were able. Care and assessment records gave information on how peoples health care needs and personal care needs were met. Overall there was a good system of medication administration storage and recording in place. However this could be further improved as on several occasions some medications has not been recorded as either given to the person, refused or not taken. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: This meant that staff could not be sure what medication people had taken, or explore why medication had not been taken. For some people medication was key to their continued good mental health, so it is important to ensure that all medication is accounted for. There was no system in place for the receiving and storage of medications in one place. This meant potentially staff having to search for medications, reordering medications un necessarily or medication not being given. Five surveys completed by people living in the home said that they always make decisions about what to do each day. One said that they usually make decisions each day. The annual quality assurance assessment stated that each person is file contains details of individuals goals action plans and progress notes. The annual quality assurance assessment stated that as part of induction, all staff receive instruction about the safe administration of medication. This is done by qualified staff and supplemented by guidance from other experienced members of the staff team. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People felt that they were listened to and any concerns or complaints would be acted on. People were protected from abuse and neglect and self harm. Evidence: People said that they knew how to make a complaint, raise concerns and talk to staff about anything they were concerned about. A complaints procedure was available to staff and the people living in the home. The complaints procedure included an opportunity to record complaints and the outcome of the complaint. The complaints book has not been completed, so that there were no complaints recorded. Poor recording of complaints makes it difficult for the manager to assess how complaints have been addressed, to ensure that peoples needs and expectations have been met. Six surveys completed by the people living in the home said that they knew who to speak to if they were unhappy. Five surveys said that people knew how to make a complaint. Six surveys said that carers listened and acted on what people said. One survey said that they did not know how to make a complaint. The homes annual quality assurance assessment states that each person has a copy of the complaints policy in their own file, to which they have access at least once daily Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: and more often on request. The homes annual quality assurance assessment stated that the policy and procedure for reporting incidents is robust. staff received regular training and updates on the protection of vulnerable adults and the reporting of abuse or potential abuse. Since the last inspection and there had been one safeguarding concern which was addressed appropriately by the home working alongside outside professionals. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People lived in a comfortable and safe environment, that was clean and hygienic. Peoples individual rooms could be improved by additional furnishings and updating decor. Bathrooms and toilet areas could be improved by modernization, replacing dated decor fittings and fixtures. Evidence: On touring the premises the home appeared clean tidy and personalised to individuals tastes. Some peoples individual rooms did not have all of the furniture suggested in the care standards act guidance. In discussion with staff there appeared no clear reason for this and the people living at the home had got used to not having a lot of furniture. The manager agreed to review this and shortly after inspection site visit an action plan including the environment furniture and fittings were submitted to us. Bathroom and toilet facilities although clean were old-fashioned in decor. One bathroom was old-fashioned and in need of updating as it was dark in color worn and tired in appearance. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: Five surveys from people living at the home said that the home was fresh and clean. One survey said that the home was usually fresh and clean. There were a range of policies and procedures in relation to health and safety in the building that staff were aware off. This included risk assessments of the building, staff training covering a range of health and safety issues and guidance information to staff. Staff training included fire safety, food hygiene, health and safety, and first aid. Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were supported and their needs met, by competent and qualified staff that had been subject to rigorous recruitment policies and practices. Evidence: Staff said that they had received training in a range of topics. Staff were very positive about working at home, participating in training events and supporting people to meet their full potential. There was a good system of recruitment of staff in the home, which included a good induction system for new staff. The recruitment system included reference and police checks to ensure that all staff were suitable to work with vulnerable people. Since the last inspection new staff had been recruited as staff had retired or chosen to work at another home in the group of homes that St Maur is linked to. Staff supervision and appraisals had not been consistently completed, this appeared to be due to the change over from the previous manager to a new manager. Six surveys from people living at the home said that staff always treated them well. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: The homes annual quality assurance assessment said that staff attended statutory training such as food handling, first aid, fire awareness, moving and handling and the protection of vulnerable adults. Other training staff included topics such as homelessness, domestic violence and anxiety management. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefited from a well-managed home, that took into consideration peoples views on the review and development of the service. Peoples health safety and welfare was promoted and protected. Evidence: Since the last inspection the well-established manager had left the employment of the home. The new manager has not yet registered with us. This meant that we were able to confirm that the person in charge has had the reference and police checks to ensure that they are suitable to work with vulnerable people. Shortly after the site visit the manager had begun the application process to register with us. The manager said that he had a range of qualifications skills knowledge and experience in providing care services. Staff were very positive about the new manager of the home and had no concerns at Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: the changeover in management. The manager was also supported by senior staff from other homes in the group of homes and services that St Maur is linked with. The new manager, working alongside staff had plans to review and update care plan and assessment records, ensure supervision and appraisals for staff were updated and to review and update policies and procedures in the home. The homes annual quality assurance assessment said that the trust policies and procedures are known to all and understanding them is part of the induction procedure. The homes annual quality assurance assessment said that health and safety risk assessments are carried out regularly and appropriate records kept. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 6 20 review and update care and assessment records to ensure that they are fully completed. medication storage and recording should be updated to ensure that medications are stored to minimize errors and all medications should be accounted for. Concerns and complaints should be fully recorded and should include details of how concerns and complaints are addressed. Recommence as planned supervision and appraisals for all staff Register the manager with us, so that checks can be made that they are suitable to work with vulnerable people. 3 22 4 5 34 43 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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