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Inspection on 09/02/10 for St Michael`s Care Home for the Elderly

Also see our care home review for St Michael`s Care Home for the Elderly for more information

This inspection was carried out on 9th February 2010.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

St Michael`s is a small home which provides a family environment due to the small number of people who live there. Most residents have their own rooms. Visitors are made welcome. Staff working at St Michael`s have been there for a number of inspections and there is a low turn over of staff.

What the care home could do better:

Activities is an area that has been brought up in a number of inspections and requirements have been made. Each time the home has been inspected there has been changes to the activites offered to the residents, but this still needs to be developed further. Activities offered should be both individual and group and take into consideration the present residents past hobbies and interests. The home is beginning to look tired and in need of some redecoration and new furnishings.

Random inspection report Care homes for older people Name: Address: St Michael`s Care Home for the Elderly 20 Meteor Road Westcliff On Sea Essex SS0 8DG one star adequate service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Sharon Lacey Date: 0 9 0 2 2 0 1 0 Information about the care home Name of care home: Address: St Michael`s Care Home for the Elderly 20 Meteor Road Westcliff On Sea Essex SS0 8DG 01702354735 01702301060 Kennethmgshpd@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Dr Kenneth Ihuoma care home 8 Number of places (if applicable): Under 65 Over 65 8 8 dementia old age, not falling within any other category Conditions of registration: Date of last inspection Brief description of the care home 0 0 St Michaels Care Home provides accomodation and care for eight older people with dementia. It is a small family style home. The lounge is situated at the front of the house and dining room overlooks the garden. Toilet and bathroom facilities are on both floors. The home offers six single bedrooms and one double, which has been separated to ensure privacy. Rooms vary in size, but none have ensuite facilites and some would be too small for wheelchair use. A shaft lift provides access to both floors where residents accomodation is provided. St Michaels Care Home is close to local amenities, including transport facilites. There is limited parking on site, but additional parking is available on Meteor Road. Care Homes for Older People Page 2 of 11 Brief description of the care home The fees for St. Michaels range from £373 to £446, with an average of £424 per week. Care Homes for Older People Page 3 of 11 What we found: The last Key inspection to St Michaels Care Home took place on the 8th October 2009. There had been a number of improvements to the home and it was assessed that the new quality rating for this service was 1 star, which meant that people who used this service experienced adequate outcomes. A random inspection was arranged to assess whether the service had sustained the improvements. The Choice of Home, Health and Personal Care, Daily Life and Social Activities, Complaints and Protection and the Environment Standards were assessed. The findings for each assessed section are as follows: CHOICE OF HOME: The Service User Guide and Statement of Purpose were found in the hallway of the home and both visitors and residents would be able to gain access to these. On reading these documents it was found that they contained the information required, although it was considered that the information and statements did not always reflect the services on offer at the home. It also stated the CQC visits the home twice yearly, but this is not routine practice and needs to be changed. The Service User Guide had been reviewed on 13 October 2009, after the last inspection, but the Statement of Purpose did not have a review date on it. The last inspection report was on the wall in the hallway, enabling residents and visitors to gain access to this. Of the two files viewed, both contained a fully completed written contract/statement of terms and conditions of the home. The staff member in charge supplied a copy of an Assessment Pack, which contained documentation that would be used during this process. On viewing the assessment form this contained all the areas listed in Standard 3.3 the National Minimum Standards. It was confirmed that no new admissions had been admitted to the home. All new residents would need to have a full needs assessment before moving into St Michaels, to ensure they are able to meet their individuals needs. Prospective residents and their relatives and friends should have an opportunity to visit St Michaels to assess the quality, facilities and suitability of the home. Guidance on trial visits needs to be added to the Service User Guide. HEALTH AND PERSONAL CARE: All four residents have separate folders with details of their health and personal care needs. The care plans seen included details of the date of admission to the home, photos of the residents, a document called All About Me, details of the individuals daily routine including breakfast, lunch, tea and bedtime and general risk assessments. The care plans seen contained details of the care required and how the individual wanted that care to be provided. It was noted that the care plans had been reviewed, but when changes to care had occurred these had not always been clearly recorded. The importance of recording information and keeping the care plans updated was discussed with both staff on duty and examples given were this had not occurred. It was also found that staff had not routinely updated information regarding contact and visits from health care professionals. Care Homes for Older People Page 4 of 11 One file had details of an optician visit, but this had not been recorded on the appropriate form. Another did not have any information on it with regards to staff contacting the individuals GP for a prescription. Documentation showed that nutritional records had been kept and provided detail of the meals provided and the amount eaten. All four residents had been weighed. Medication was not fully inspected, but the paperwork and systems for recording was viewed. MAR sheets had been correctly completed and were medication had been refused this had been clearly recorded. The medication folder contained a photo of each resident to assist staff with identification. The folder also had examples of staff signatures to assist with any auditing completed. On viewing the MAR sheets there were no anomalies seen. The staff member in charge was heard contacting the GP surgery to chase a prescription that was requested the day before. All four residents were washed and dressed and in the front lounge when the inspection started. One resident was doing her knitting, another was a sleep in the office and the remaining two were in the lounge sleeping under blankets. During general observation it was felt that the care provided to the four residents is much more individual and the staff members involve the resident in making choices were possible. This was seen in connection to needing the toilet, what drinks they would like with their lunch, what flavour yogurt they would like for their dessert, whether they wanted their meals later etc. It was noted during the observation that there was a good atmosphere in the home and staff are working to meet the individual residents care needs rather that meeting the routine of the home. One resident was heard saying lovely lady to a staff member and kissing her hand. A relative spoken with stated that the staff knew her mother and what care she needed and she was happy with the care provided. DAILY LIFE AND SOCIAL ACTIVITIES: As previously stated there is now more evidence that staff are offering choice and control to the residents over the care they receive. The care does not seem so task orientated and choice was seen to be offered were possible. The home has a four week menu, which offers a variety of meals to the residents. The menu stated that the meal on the day of the Inspection was egg, bacon, chips and beans and this was confirmed by the staff member who was going to cook lunch. The dining area is small but pleasant and tables had clean table clothes, place mats, salt and pepper and silk flowers. Residents were offered a choice of juice with their meal and one resident chose to have a cup of tea. Sauces were available, but these had not been placed on the table for residents to use independently. Once these had been placed on the table one resident then helped herself. Another resident requested a piece of bread with her meal and this was provided. When asked if the meal was nice, those residents who were able to respond stated yes thank you. One staff member was observed holding a residents hand during lunch and talking to the resident, who then smiled back. There was a good relaxed atmosphere and staff offered residents assistance as required. Nutritional records had been made, which included details of what was eaten and the amount. When looking at the issues of what activities had been introduced to St Michaels since the last inspection, the person in charge stated that they now had group activities, which included toss a ball, folding clothes, singing old songs, reading magazines and newspapers, counting money, dancing to old songs, card playing and hoopla. There were Care Homes for Older People Page 5 of 11 also photographs on the wall in the dining room, which showed the residents on Christmas day having their lunch and also carol singing with the staff. The issue of activities was discussed in depth with both members of staff on duty and examples given, which may enhance what they have already introduced. Although there has been some improvement in the activities now being provided to the present residents, it is felt that further development can still be made in this area. The Hairdresser had not been for a few weeks and this was noticeable in the appearance of the residents. The staff member in charge stated they were in the process of trying to arrange another one. They are also looking to arrange to take one of the residents to a shop to have their hair permed. There was a visitors book to sign when entering the home, but this had been torn and the details could not be fully completed. The member of staff in charge was advised that a new sheet needed to be put in place, to ensure there is an audit of those visiting and leaving, due to Health and Safety. Visitors are made welcome to the home and it was established that most of the residents have regular visitors. Family and friends were also invited to the Christmas festivities at the home. COMPLAINTS AND PROTECTION: The complaints procedure could be found in the foyer of the home. This document contained details of the process and also timescales in which the home will deal with complaints. Details of the complaints procedure could also be found in the Service User Guide and Statement of Purpose. It was confirmed that no complaints had been received. Staff had attended safeguarding training and those on duty had an understanding of the issues around whistle blowing and the protection of vulnerable adults. There were also written guidance for staff on safeguarding on the wall of the office. Details of the Southend Advocacy service could be found in the foyer of the home. ENVIRONMENT: St Michaels is generally clean, but the furnishings and fittings are beginning to look tired and in need of redecoration. Some carpets around the home need to be replaced, due to being worn in places. It was noted that the wall paper in the dining area was beginning to come off the walls under the window and needed to stuck. Skirting boards and door frames were in need of repainting due to being scuffed. Some wardrobes and furniture in the bedrooms needed to be replaced before new residents are admitted, due to being insecure or not shutting properly. Not all radiators have been covered and new risk assessments would need to be completed when new residents are admitted to ensure their safety Generally it was found that the service now offers residents a more person centered form of care and the residents are offered more choice in the way their care is provided. A further random inspection will be completed to assess the last two sections of the National Minimum Standards; staffing and management and administration, before the next Key inspection. Care Homes for Older People Page 6 of 11 What the care home does well: 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 2. Care Homes for Older People Page 7 of 11 Are there any outstanding requirements from the last inspection? Yes R No £ 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 33 Regulation 24 The registered provider shall 18/01/2010 (1)(a)(b)(2)(3 appoint an individual to ) manager the care home. This is to ensure that residents live in a home that 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. They should be qualified, competent and experienced to run the home and meets its stated purpose, aims and objectives. This is a repeat requirement, previous timescales of 30/09/09 have not been met. New timescale set. 2 36 18(2)(a) Persons at the home must be 18/10/2010 appropriately supervised to ensure they receive the support required in their role as a care worker. Care Homes for Older People Page 8 of 11 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 1 19 23 The premises must be of a good state of repair externally and internally. All parts of the home must be kept clean and reasonably decorated. This is to ensure that residents live in a safe, well maintained environment. 29/10/2010 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 1 The Service User Guide and Statement of Purpose should be reviewed to ensure it reflects the home and also the services it offers. It should also be updated with regard to the inspection frequency of CQC. The Service User Guide needs to be updated to reflect guidance on trial visits to the home. Ensure care plans are updated when visits or contact with health care professionals take place. Ensure any changes to care plans are clearly recorded, so that staff can easily identify what changes have occurred and which are the most up to date. Page 9 of 11 2 3 4 5 8 8 Care Homes for Older People 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 5 6 13 19 Ensure the visitors book is updated so that there is an audit of who visited and left the home. Ensure risk assessment are updated on bedrooms if any new residents are admitted. Care Homes for Older People Page 10 of 11 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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