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Inspection on 31/07/07 for St Michael`s View

Also see our care home review for St Michael`s View for more information

This inspection was carried out on 31st July 2007.

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

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

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

The home provides good clinical care and there is good liaison with clinical specialist and other health professionals. Service users feel that they are well looked after by the staff and speak highly of the care they receive. Staff members engage service users in conversation when carrying out care and staff members put elderly service users at their ease. The manager and her staff are flexible in relation to service user`s individual needs and wishes and try to ensure the service responds to the individual`s needs and wishes. Lifestyles are tailored to service users preferences as well as possible taking into account the service users capacity and abilities. The activities available to service users are tailored to individuals requirements and staff work hard to provide a wide ranging social and activities programme.

What has improved since the last inspection?

Staff moral and motivation has continued to improve since the ownership changed to Southern Cross. More imaginative decoration has been used to provide an interesting and stimulating environment for service users. Staff now receive regular supervision.

What the care home could do better:

A loop induction system should be installed to help service users who have hearing aids. Better access to transport would make it easier to provide more activities outside the home.

CARE HOMES FOR OLDER PEOPLE St Michael`s View St. Michaels Avenue North South Shields Tyne And Wear NE33 3BP Lead Inspector Mr Tom Moody Key Unannounced Inspection 10:00 31st July 2007 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 Michael`s View DS0000000270.V346172.R02.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. St Michael`s View DS0000000270.V346172.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Michael`s View Address St. Michaels Avenue North South Shields Tyne And Wear NE33 3BP 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) 0191 455 1215 0191 455 1238 st.michaels@ashbourne.co.uk Ashbourne Homes Limited Sonia Pharoah Care Home 64 Category(ies) of Dementia (32), Dementia - over 65 years of age registration, with number (32), Old age, not falling within any other of places category (33), Physical disability (2), Physical disability over 65 years of age (16) St Michael`s View DS0000000270.V346172.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The additional 1 OP service user category relates to one service user and is specific to the duration of the placement. 16th June 2006 Date of last inspection Brief Description of the Service: St Michaels View Care home is owned by the Souther Cross, which was first registered in November 1994 and now accommodates 32 older people of mix gender for general nursing care and another 32 persons with mental ill health, 16 of who may also have a physical disability. The home does not provide intermediate care services. It is situated in a residential area and convenient for the town centre of South Shields. It is close to local train and bus transport. The seaside, shopping outlets, local theatres and social amenities are close by. The local shops and a post office are within easy walking distance of the care home. St Michaels View is a modern single storey care home, custom designed and built to provide facilities and services in 2 distinct separate units. There are in total 4 lounges, 2 dining areas and bedrooms with en-suite facilities. There are 2 internal courtyards both with wheel-chair access. The home is decorated and furnished to a good standard, and in keeping with the age, character and style of the building. St Michael`s View DS0000000270.V346172.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The site visit for this inspection took place over one day on 24 July 2007. One inspector carried out the inspection. The manager of the service was present during the site visit. The views of people living at the home were gathered during the day of inspection, by talking to them, their visitors and by reading documents. Positive feedback was received from all of those whom the inspector spoke to. The manager was interviewed and documents were examined, including care plans. A tour of the home took place. A mealtime was observed but the inspector did not sample the food at this inspection What the service does well: What has improved since the last inspection? Staff moral and motivation has continued to improve since the ownership changed to Southern Cross. St Michael`s View DS0000000270.V346172.R02.S.doc Version 5.2 Page 6 More imaginative decoration has been used to provide an interesting and stimulating environment for service users. Staff now receive regular supervision. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. St Michael`s View DS0000000270.V346172.R02.S.doc Version 5.2 Page 7 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 Michael`s View DS0000000270.V346172.R02.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. All service users entering the home have their needs accurately assessed by social care and health service staff. The home makes it’s own assessment in addition to this. Most service users and their family have the opportunity to visit the home before they come to stay, unless there are exceptional circumstances. This allows them to make an informed choice about staying in the home. EVIDENCE: Care plans show that an assessment is made by specialist nurses and socialwork staff, as well as the home manager. Assessments are in the Southern Cross style and are very comprehensive, covering social and recreational needs as well as physical requirements. St Michael`s View DS0000000270.V346172.R02.S.doc Version 5.2 Page 9 The home also produces a newsletter that informs relatives of current events. Discussions with service users confirmed that they receive information about the home. Service users relatives were happy with the information they recieved. St Michael`s View DS0000000270.V346172.R02.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Service users health care needs met. Service users have access to all healthcare services that they need. The home has appropriate policies and procedures to ensure service users receive their medication in a safe way. EVIDENCE: The staff, who were spoken to have a good awareness of service users social recreational and clinical needs. The manager spoke of contact and training being given by the Community Matron. Medication is stored safely. A monitored dosage system is in use and recording is good. Controlled drugs are safely stored and stock balances are correctly kept. St Michael`s View DS0000000270.V346172.R02.S.doc Version 5.2 Page 11 Care plans are comprehensive and well written. The format of these has change in line with Southern Cross policy. The new format is well laid out and the examples seen were completed to a good standard. Pressure damage risk was approriately assessed and all risk assessments being reviewed monthly. Service user’s care plans contain much useful clinical information. Some of the life histories were well recorded and detailed in most cases. Reviews are recorded and relatives views on the care are contained in these. All of these comments were positive about their relatives care experience. The home has appropriate equipment and suitable adaptions to meet service user,s needs. Discussions with staff revealled that they have a high commitment to the service user’s several spoke of staff coming in on rest days to support them in going to social events. The atmosphere on the Mental Health unit is very calm. St Michael`s View DS0000000270.V346172.R02.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The home endeavours to provide a lifestyle that matches service users needs and preferences. Meals are of good quality and the timing and choice can be varied to meet service users needs EVIDENCE: The unit caring for dementia has been refurbished to provide corridors that look like old streets, complete with shops, a pub and a café. Cream teas are provided in the café on two days during the week. The was seen during the site visit and was much enjoyd by staff, visitors and service users. Corridors have wall hangings that are sensory (they can be touched) based on differing themes. The care workers now have responsibilities for some social programmes and activities although there is a very pro-active, and enthusiastic activities co-ordinator. St Michael`s View DS0000000270.V346172.R02.S.doc Version 5.2 Page 13 The previus night various members fo staff had provided an entertainment based on “Songs From The Shows” photo graphs were on display and this was evidenlty enjoyed by those who took part as well as those who participated. This is an exellent initiative. Staff deal with relatives, in person, and in telephone enquiries, appropriately. The cook and the manager plan the meals using the Nutmeg programme to ensure good, balanced nutrition. A number of service users and their relatives commented on the good quality of the meals, saying, “The meals are very good now”, and “I always compliment the chef.” Menus are satisfactory and show a choice for both evening and midday meals. Service users are aware of alternative choices. The kitchen is clean and and well organised. The quality and presentation of food was good. Visiting is unrestricted and visitors were seen coming and going throughout the day. The home does not have a dedicated bus and Southern Cross’ pool bus is charged to the home. Staff indicated this was prohibitive and there seemed to be fewer outings here than in homes that had a dedicated bus. Service users spoke of using the garden if the weather was suitable and were observed moving in and out of the sheltered patio areas. The home also has a quiet room, with low lighting, that provides a degree of seclusion for anyone requiring this. St Michael`s View DS0000000270.V346172.R02.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The homes policy on adult protection reflects the multi-agency approach to adult protection, and local procedures and staff know how to use it. This should ensure the protection of service users. Service users and relatives are confident that the process and the staff will act in the service user’s best interests. EVIDENCE: The homes management has dealt with the issues of adult protection issues appropriately. Complaints are recorded well, ooutcomes are recorded and audited. The Manager stated she had an open door policy and was seen greeting visitors as they entered the home. Visitors and staff displayed a relaxed and friendly attitude towards each other. All of the relatives that were spoken to confirmed that they found the staff helpful and felt that the Manager was approachable. Service users and relative expressed confidence that staff would deal with any problems they had. One said, “If I ask for anything, it gets done”, another said, “I’d be happy to complain but it never comes to that.” St Michael`s View DS0000000270.V346172.R02.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The environment is well maintained and safe. The home has most of the equipment it needs to meet service users needs. Rooms are comfortable, furnished to service users tastes, and the home is kept clean. EVIDENCE: All fire precautions were being observed during the time of the inspection. Regular maintenance takes place and this is certificated. The home was pleasantly heated and lighting was at appropriate levels. Moving and handling equipment was available and there were fixed handrails in toilets, bathrooms and showers. The home still does not have an induction loop system for hearing aid users. St Michael`s View DS0000000270.V346172.R02.S.doc Version 5.2 Page 16 There was no appreciable odour in either unit other than when the sluice was being used. The home is clean and tidy in all areas used by service users. The Cleadon unit has beend transformed by a series of murals and pictures depicting varoious themes. The entrance area is a conservatory and this now has a mural depicting tropical plants. Other corridors have been named after local streets and shop fronts have been created to enhance this idea. Staff have produced a brick” effect that is very convinving and would do credit to a professional stage designer. The activities co-ordinator now puts on cream teas from the “tea shop” areas. There is a wide variety of communal space including wide corridors and rest areas. One lounge in the Cleadon unit has been transformed into a period public house and this now hosts a “luncheon club” to provide an alternative dining venue. There is open access to a sheltered courtyard that has raised beds thatcontain a variety of plants. Rooms were well furnished and clean. Many had personal items and usefull prompts such as wall mounted clocks. A variety of wall decorations are displayed and these have differing textured surfaces to encourage tactile exploration by service users. St Michael`s View DS0000000270.V346172.R02.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The manager ensures that the home operates safely and sufficient numbers of staff, who are appropriately trained, are available to meet service users needs. EVIDENCE: The manager confirmed that good level of induction take place records confirm this. There is a well laid out matrix indicating a what stage staff are in training. The manager also confirmed that the Community Matron was providing training for staff in assessment of pressure damage risk. Earlier conversations with the Matron had indicated this was to take place. Duty rotas indicated an appropriate level of staff. The call system was answered promptly. The home has an activities co-ordinator who is extremely enthusiastic and is a key member of staff. St Michael`s View DS0000000270.V346172.R02.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The Manager is professional in her approach and has a positive vision of how the home should be run. Service users and staff benefit from the way she carries out her duties. EVIDENCE: The home continues to introduce positive changes, such as the newsletter, and a varied social programme. The activities of all grades of staff, to provide entertainment to service users, also fosters teamwork and this is a commendable effort. The Manager is an experienced nurse and the staff respond well to her leadership style. St Michael`s View DS0000000270.V346172.R02.S.doc Version 5.2 Page 19 The Manager confirmed that they operate the Southern Cross Quality assurance system and that customer satisfaction surveys are carried out. The results are fed back to each home. The Manager is aware of her statutory responsibilities, including health and safety, and record keeping is good. She stated that supervision takes place. Records confirm they have regular supervision sessions. The home keeps service user’s personal allowance and has a good and secure system to account for any expenditure. Discussions with staff indicate the moral in the home is good and staff feel motivated and enthusiastic. They confirm the Manager is approachable and they have confidence in her. Service users and relatives say that The Manager is approachable. The Manager confirmed she felt well supported in her role by the senior management team. St Michael`s View DS0000000270.V346172.R02.S.doc Version 5.2 Page 20 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 X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 3 3 St Michael`s View DS0000000270.V346172.R02.S.doc Version 5.2 Page 21 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 OP22 Regulation 16, 23 Requirement The home must provide equipment suitable for service users with physical or sensory deficit. Timescale for action 30/09/07 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. Refer to Standard OP14 Good Practice Recommendations The home should have reasonable access to suitable transport to enable service users to use community facilities. St Michael`s View DS0000000270.V346172.R02.S.doc Version 5.2 Page 22 Commission for Social Care Inspection South Shields Area Office 4th Floor St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI St Michael`s View DS0000000270.V346172.R02.S.doc Version 5.2 Page 23 - 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. 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