Inspection on 09/08/05 for St Nectans Residential Care Home

This inspection was carried out on 9th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

St Nectans Residential Care Home 30/07/08

St Nectans Residential Care Home 14/08/07

St Nectans Residential Care Home 24/05/06

St Nectans Residential Care Home 13/02/06

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE St Nectans 3 Cantelupe Road Bexhill-on-Sea East Sussex TN40 1JG Lead Inspector Andy Denness Unannounced 9th August 2005 14:00 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 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 Nectans H59-H10 S63996 St Nectans V237257 090805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service St Nectans Address 3 Cantelupe Road Bexhill-on-Sea TN40 1JG Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01634 727422 St Nectans Residential Care Home Ltd Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (OP), 33 of places St Nectans H59-H10 S63996 St Nectans V237257 090805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. That the number of registered places may not exceed thirty three (33) 2. That the category of registration be old age, not falling within any other category 3. Service users must be older people aged sixty-five (65) years or over on admission Date of last inspection First inspection Brief Description of the Service: St Nectans is situated on a residential street a short level walk from Bexhill town centre and railway station. The building has been adapted from four adjacent properties which are now interlinked. Accommodation is provided on four floors which are served by a shaft lift. The home is registered to accommodate up to 33 older people and has recently been purchased by new owners, St Nectans Residential Care Home Ltd. St Nectans H59-H10 S63996 St Nectans V237257 090805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over an afternoon and evening in August and lasted 4 ½ hours. To help gather evidence on how the home is performing the Inspector sat with service users during their evening meal, met with one of the home’s owners and some staff, examined a range of records and written information and undertook a short tour of the premises. In depth discussions took place with 8 service users. This was the first inspection under the new owners who took over earlier this year. What the service does well: What has improved since the last inspection? 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 Nectans H59-H10 S63996 St Nectans V237257 090805 Stage 4.doc Version 1.40 Page 6 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 Standards Statutory Requirements Identified During the Inspection St Nectans H59-H10 S63996 St Nectans V237257 090805 Stage 4.doc Version 1.40 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 & 5 Appropriate steps are taken to ensure that service users are admitted to a home that is suitable to meet their assessed needs. EVIDENCE: Assessments of service users needs are undertaken prior to them moving in to St Nectans; a selection was examined, they were of a satisfactory standard. Service users spoken to said that they had the opportunity to look around prior to moving in to ensure that the home was suitable for them. The home’s contract states that the first two months of a service user’s stay is a trial period and hence only one weeks notice to leave need be given. St Nectans H59-H10 S63996 St Nectans V237257 090805 Stage 4.doc Version 1.40 Page 8 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 & 9 Improvements are required to current systems to ensure that service users health and personal care needs are met appropriately. EVIDENCE: Using the initial assessment of need as a starting point individual plans of care are compiled for each service user; these identify amongst other things what support they require from staff to meet their day to day needs in relation to health, personal and social care needs. A selection of these plans was examined. The new owners are changing existing care plans to a new format; whilst the format itself is good the plans have not been completed in enough detail, this could result in needs being overlooked. From discussions with service users and an examination of records it was evident that a range of healthcare professionals is accessed when and if required. It was noted that in the instance of one frail service user an assessment had not been undertaken regarding the risk of developing pressure sores or the dangers of falling. It has been required that care plans are appropriately completed and that pressure sore and falls risk assessments are completed. Some service users look after their own medication, procedures are followed to ensure that they can do this safely. Most medication however is managed for service users by staff; the system used is one that is easy to monitor, storage and records were examined and were found to be in order. St Nectans H59-H10 S63996 St Nectans V237257 090805 Stage 4.doc Version 1.40 Page 9 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 14 & 15 Service users are ensured choices in all areas of their daily lives. Arrangements regarding meals were satisfactory. EVIDENCE: Discussions with service users confirmed that they have choices in all areas of their daily living including what time to get and go to bed, whether to stay in their rooms and how to spend their day. The Inspector sat with service users during their evening meal, they obviously enjoyed their meal and said that if they did not like the meal on offer then they would be offered an alternative. One service user said that “the food is lovely” and Records examined confirmed that service users are encouraged to make complaints or compliments regarding the quality of the meals provided. St Nectans H59-H10 S63996 St Nectans V237257 090805 Stage 4.doc Version 1.40 Page 10 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 Complaints are managed well with service users being confident that any concerns they raise will be acted on. EVIDENCE: The home has a written complaints procedure in place for service users to follow should they be unhappy with any aspect of the care provided at St Nectans. Service users spoken to said that they felt able to complain and were confident that their concerns would be acted upon. One service user said that the new owner had acted very quickly to address concerns that they had recently raised. St Nectans H59-H10 S63996 St Nectans V237257 090805 Stage 4.doc Version 1.40 Page 11 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,22,23,24,25 & 26. Service users live a pleasant well-maintained environment which is suitable to meet their needs. Physical standards throughout were very high. Some work has been required to ensure that the environment is safe for service users. EVIDENCE: An inspection of most areas of the home was undertaken. All areas were furnished and decorated to a high standard. Standards of hygiene and cleanliness were good. Accommodation is provided on four floors, a shaft lift is fitted to ensure level access to all areas. Bedroom accommodation is provided in 31 single and one double rooms; those rooms inspected were furnished and decorated to a satisfactory standard. Service users are able to bring their own furniture with them and many have done so, this has resulted in pleasant personalised rooms. All bedrooms have ensuite facilities and are fitted with emergency call points. Communal accommodation is provided by a lounge and dining room and two smaller lounge areas, these were furnished and decorated to a satisfactory standard. It was noted that in the windows in the lounge are not fitted with a restrictor and present a risk of falling to service users, action has been required to address this matter. St Nectans H59-H10 S63996 St Nectans V237257 090805 Stage 4.doc Version 1.40 Page 12 Heating is provided by a gas central heating system with radiators in all areas, the majority of radiators are not guarded. It was noted that a guard is not fitted in one room where the occupant has a history of falls. To ensure the safety of the service user it has been required that a guard is fitted as a matter of urgency. A sufficient number of bathrooms and WCs are available, these are suitably equipped. Hot water delivered to baths was extremely hot, to protect service users from the dangers of scalding it has been required that individual thermostatic controls are fitted. St Nectans H59-H10 S63996 St Nectans V237257 090805 Stage 4.doc Version 1.40 Page 13 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, & 28 Staffing arrangements are satisfactory with support for service users being provided by a sufficient number of appropriately trained staff. EVIDENCE: Staffing levels on the day of the inspection were satisfactory to meet the needs of service users. Records examined confirmed that this is the case at all other times, service users also said that there are always enough staff to help them when required. Service users spoke very positively of the qualities of staff, their comments included “ staff are wonderful, helpful and caring” and staff are “really nice”. Observations made indicated that staff were hardworking and caring in their interactions with service users. From discussions with staff and records examined it was evident that the requisite number of staff are trained to the national required level. At the last inspection, when the home was owned by the previous proprietors, requirements were made regarding improvements to recruitment procedures. The Inspector was told that since the new owners took over only two new staff have been employed; it was not possible to check if correct procedures had been followed, as records were not kept on site. One of the new owners, who was present during the inspection, said that he would ensure that records will now be kept on site, a further visit will take place to check these. St Nectans H59-H10 S63996 St Nectans V237257 090805 Stage 4.doc Version 1.40 Page 14 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 34, 35, 36 37 & 38. Administrative systems were generally good and help ensure the required support for staff. To ensure the safety of staff and service users some improvements to health and safety checks are required. EVIDENCE: The previous owner of the home had stayed on in the post of manager under the new owners; he only spent limited time on the premises. It has been required that the new owners submit an application to register a new manager as a matter of urgency. Records examined confirmed that the home have recently issued a questionnaire to service users to ascertain their views of the home and what improvements they would like to see. The insurance certificate for the home was examined; this was set at the required level. Staff manage some personal spending money for three service users, records and balances were examined, they were in order. Staff spoken to confirmed that they receive the required one to one support meetings from the management team. St Nectans H59-H10 S63996 St Nectans V237257 090805 Stage 4.doc Version 1.40 Page 15 A selection of the records required by regulation were examined, these were in order and stored securely. A selection of health and safety records was examined; it was noted that the home’s environmental risk assessments required reviewing. Also records indicated that the emergency lights are not tested regularly as is required and that a fire drill is overdue, action has been required to address these matters. St Nectans H59-H10 S63996 St Nectans V237257 090805 Stage 4.doc Version 1.40 Page 16 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 3 COMPLAINTS AND PROTECTION 1 3 3 x 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 1 x 3 3 3 3 3 2 St Nectans H59-H10 S63996 St Nectans V237257 090805 Stage 4.doc Version 1.40 Page 17 Yes 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 7 Regulation 15 Requirement That care plans are expanded to include full details of service users needs and the support they need from staff. Plans should include pressure sore risk assessments and falls risk assessments. That a radiator guard is fitted in the room disucssed. That a restrictor is fitted to the lounge window. That individual thermostatic mixer valves are fitted to hot water outlets on baths. That emergency lighting is tested on a regular basis and the results records and that a fire drill is arranged. That the environmental risk assessments are reviewed. That an application to register a new manager of St Nectans is submitted to the Commission for Social Care Inspection. Timescale for action 9/9/05 2. 3. 4. 5. 19 19 19 38 13(4)(a) 12(1)(a) 12(1)(a) 23(4) 9/9/05 9/9/05 9/11/05 9/8/05 6. 7. 38 31 12(1)(a) 18(1)(a) 9/9/05 9/11/05 St Nectans H59-H10 S63996 St Nectans V237257 090805 Stage 4.doc Version 1.40 Page 18 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 Good Practice Recommendations St Nectans H59-H10 S63996 St Nectans V237257 090805 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Ivy House 3 Ivy Terrace Eastbourne East Susssex BN21 4QT 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. 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