Inspection on 19/07/05 for St Paul`s Care Home

This inspection was carried out on 19th July 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 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 Paul`s Care Home 20/11/08

St Paul`s Care Home 23/11/07

St Paul`s Care Home 28/06/06

St Paul`s Care Home 27/10/05

St Paul`s Care Home 12/10/04

St Paul`s Care Home 13/05/04

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

Thorndene

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

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

CARE HOMES FOR OLDER PEOPLE St Pauls 65 Albany Road St Leonards on Sea East Sussex TN38 0LJ Lead Inspector Caroline Johnson Unannounced 19th July 2005 10:00 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 Pauls H59-H10 S14047 St Pauls V231739 190705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service St Pauls Address 65 Albany Road St Leonards on Sea East Sussex TN38 0LJ 01424 425798 01424 428885 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) New Century Care (Hastings) Limited Ms Margaret Law Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (OP) of places Physical disability (PD), 25 St Pauls H59-H10 S14047 St Pauls V231739 190705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. That there is adherence to the staffing levels set down Date of last inspection 12 October 2004 Brief Description of the Service: St. Paul’s is a care home with nursing provision. In order to provide nursing care, the owners employ Registered Nurses to manage nursing care, and care staff to support the residents with their personal care needs. The care home is registered for 25 older people, or those with physical disabilities.The home is owned by New Century Care Limited (NCC Ltd) and is part of a group of homes situated in East Sussex. The Care Home is situated in a residential area of St. Leonards-On-Sea and is on the bus route for the shopping area of Silverhill in one direction, Kings Road, St. Leonards in the other, and into the town of Hastings a little further. The Care Home has assisted bathing equipment, lifting and moving aids, and a passenger lift to the upper floors to assist those who are less mobile. St Pauls H59-H10 S14047 St Pauls V231739 190705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the first in the year running from April 1 2005 to March 31 2006. The inspection lasted from 09.30am until 3.30pm. During the inspection there was an opportunity to meet with five residents in private. Two members of staff were interviewed individually. A number of records were examined and plans for the care to be provided for two residents and the pre admission documentation held in respect of one recently admitted resident were seen on this occasion. A full tour of the building was not undertaken. However, five bedrooms, communal areas and some of the bathrooms were seen. The manager although not on duty arrived at the home an hour after the inspection began. In addition the home’s area manager arrived at the home half way through the inspection. During the inspection there was also an opportunity to meet with the relative of a resident and with a visiting professional. What the service does well: What has improved since the last inspection? The quality of care planning has improved since the last inspection and care plans seen during this inspection were detailed and had been reviewed at regular intervals. The arrangements in place for the storage and handling of medication have been reviewed and updated and they are now satisfactory with one exception (see below). A requirement was made at the last inspection to encourage care staff to train to NVQ level two and now there are well over half of the care staff trained to level two and some staff have progressed on to level three. Since the last inspection an administrator has been appointed to work in the home on a part-time basis. In addition a senior sister has also been appointed. This will be of benefit to the manager who has been able to delegate some areas of responsibility allowing her extra time to attend to management tasks. St Pauls H59-H10 S14047 St Pauls V231739 190705 Stage 4.doc Version 1.40 Page 6 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 Pauls H59-H10 S14047 St Pauls V231739 190705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection St Pauls H59-H10 S14047 St Pauls V231739 190705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3, The home ensures that they carry out an assessment of prospective service users’ needs prior to making a decision about offering accommodation. EVIDENCE: A pre-admission assessment was seen in respect of one resident recently admitted to the home. As the resident was fairly independent in most areas, limited information was recorded. However, following admission to the home a much more detailed assessment of needs was carried out. This included the resident completing a choice of lifestyle questionnaire indicating choices in relation to times for getting up and going to bed, hobbies and interests and likes and dislikes in relation to food. In addition information was obtained in respect of the resident’s personal history. A full plan of the care to be provided was introduced and this had been reviewed and updated at regular intervals. St Pauls H59-H10 S14047 St Pauls V231739 190705 Stage 4.doc Version 1.40 Page 9 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 In respect of the care plans seen the quality of care planning was good and had improved since the last inspection. In respect of one of the plans seen the advice included needs to be more specific so that staff can communicate more effectively with the resident. The arrangements in place for the storage and handling of medication have improved since the last inspection. However it is recommended that the home cease the practice of double dispensing medication. The home works well in conjunction with the with the Tissue Viability Consultant to provide the best care possible for residents in relation to wound management and pressure care. EVIDENCE: Plans for the care to be provided to three residents were seen on this occasion. Generally there was detailed information provided to assist staff in meeting each individual’s assessed needs. Care plans seen were kept up to date and included detailed risk assessments advising staff of the action to be taken to minimise the risk of accidents/incidents occurring. In respect of one resident’s needs there was a care plan in place in relation to communication but the information provided was not very explicit. It was difficult to determine how best to communicate with the resident due to their hearing impairment. Daily records held in relation to this resident did not include any reference to St Pauls H59-H10 S14047 St Pauls V231739 190705 Stage 4.doc Version 1.40 Page 10 communication. In addition daily records included limited reference to how residents’ emotional needs are being met. Staff advised that as far as it is possible to, residents are involved in the care planning process. In respect of the care plans seen either residents or a representative on their behalf had signed the care plans. Where cot sides are used then residents or their representatives sign to say they have been involved in the decision to use them. Nutritional assessments are also carried out. A Tissue Viability Consultant visits the home regularly to provide advice and support. At the time of inspection there was an opportunity to meet with her. She spoke very positively of the home and stated that they have a good record of success in this area. She also provides regular training for staff on tissue viability. The manager advised that the home’s procedure on administration of medication was made available to all staff. The arrangements in place for the storage of medication were satisfactory. There is a monitored dosage system in place for medication. However, for some of the lighter drug rounds, staff dispense medication into named pots prior to administering them to the residents. The home’s pharmacist provides training annually for staff. St Pauls H59-H10 S14047 St Pauls V231739 190705 Stage 4.doc Version 1.40 Page 11 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) 12,14,15 There are good opportunities provided for residents to participate in activities both within the home and within the wider community. EVIDENCE: An activity person is employed to work three afternoons a week. She has responsibility for organising entertainment and arranging day trips. Staff advised that in recent weeks there had been a trip to Michelham Priory. There were photos of this trip displayed in the entrance to the home. Regular trips are also arranged to the White Rock for theatre outings and to Alexandra Park to see bands playing. On the day of inspection one resident was taken out shopping. In-house activities include manicures, dominoes and reminiscence. One of the residents spoken with stated that she enjoys spending time in the garden and depending on the weather she likes to have her meals outside. Clothes parties arranged periodically. Another resident described St Pauls as `home-from-home’. She said that she has her paper delivered daily and she enjoys writing poetry. At the time of visiting residents, they were having tea and biscuits. It was noted that tea was served in plastic cups and that the biscuits were not served on plates. This was raised with the home’s manager and it was agreed that biscuits should be served on plates. In addition it was agreed that an assessment would be carried out to determine the most appropriate type of drinking cup to be St Pauls H59-H10 S14047 St Pauls V231739 190705 Stage 4.doc Version 1.40 Page 12 provided for individual residents. Residents spoken with stated that the food served in the home is very good and that if they do not want what is on the menu an alternative would always be provided. St Pauls H59-H10 S14047 St Pauls V231739 190705 Stage 4.doc Version 1.40 Page 13 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) 18 Staff spoken with during the inspection were aware of the procedure to be followed should they suspect abuse. EVIDENCE: There is a detailed procedure in place in respect of adult protection and prevention of abuse. A staff member spoken with stated that three staff have recently undertaken a course on adult protection and that they will in turn cascade this training to the rest of the staff team. St Pauls H59-H10 S14047 St Pauls V231739 190705 Stage 4.doc Version 1.40 Page 14 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) 19,22 All areas of the home seen were well decorated to a good standard and accommodation provided is homely in design. Testing of fire alarms should be kept separate to fire drills. More detailed records should be kept of fire drills in terms of the time taken to carry out the drill and records of staff performance. The current gravel driveway means that staff have to pull wheelchairs in reverse to get to the end of the driveway. The addition of a pathway would allow easier access. EVIDENCE: A full tour of the building was not undertaken on this occasion. At least seven bedrooms were seen. Each was decorated to a good standard. Bedrooms had been personalised and residents have photos and ornaments that are special to them on display. At the last inspection of the home a good practice recommendation was made to install a pathway from the front door to the end of the driveway. The manager advised that this has been raised with the management team for further discussion. Staff spoken with during the St Pauls H59-H10 S14047 St Pauls V231739 190705 Stage 4.doc Version 1.40 Page 15 inspection confirmed that a pathway would make it easier to push wheelchairs. At present there is a gravel driveway. There is a detailed fire risk assessment in place. The home has addressed most of the requirements and recommendations made as a result of this process. However details of the specific action taken, is not recorded. Emergency lights are serviced quarterly. The manager advised that fire alarms are tested weekly but not always recorded. The last recorded test was 20 June 2005. Each time the alarms are tested staff treat this as a fire drill. Door guards have been fitted where assessed as necessary. A small number of self-closing devices were still to be fitted but during the inspection the maintenance man was completing this task. All of the residents spoken with during the inspection raised concerns regarding the call bell system. The system had failed a couple of weeks earlier. However, workmen were in the home at the time of inspection. They advised that they had tried on a few occasions to correct the fault but that each time another problem had occurred. The manager stated that that when the system is out of action, staff on night duty carry out rounds every half-hour. The call bell system was in working order by the end of the inspection. All areas of the home seen were clean. St Pauls H59-H10 S14047 St Pauls V231739 190705 Stage 4.doc Version 1.40 Page 16 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) 27,28,29,30 Staff receive training appropriate to the work that they perform. Well over 50 of care staff are trained to NVQ level 2. There are regular opportunities provided for trained staff to increase their knowledge and skills. EVIDENCE: The staff rota available for inspection indicated that there were satisfactory staffing levels in the home. It was recommended at the last inspection of the home that the manager’s designated management hours be clearly documented on the staff rota. The area manager advised that this is not always possible to predict. Since the last inspection an administrator has been appointed to support the manager and in addition there is now a senior sister in post. It was agreed that management hours could be documented retrospectively. A branch of the company has been registered to provide NVQ training. The company has employed a staff member to visit each of the homes within the area to provide training for all care staff to achieve NVQ level two. In addition this member of staff also oversees induction and foundation training for new staff. All new care staff are expected to study for NVQ level two. Both of the staff spoken with during the inspection had completed NVQ level two and one of the staff had almost completed level three. This member of staff had also completed the assessor’s course and was completing the internal verifier’s course privately. Nine of the fourteen care staff are currently trained to NVQ level two. A member of staff advised that she had recently attended a course on adult protection and was due to attend a course on dementia. She had also St Pauls H59-H10 S14047 St Pauls V231739 190705 Stage 4.doc Version 1.40 Page 17 provided in-house training for care staff recently on infection control, and MRSA. Recruitment procedures were not examined in detail but it was noted that when new staff were appointed a small number brought recently obtained CRB checks with them. The home still needs to apply for new CRBs in respect of these staff and it should be noted that photocopies of CRBs are not acceptable. St Pauls H59-H10 S14047 St Pauls V231739 190705 Stage 4.doc Version 1.40 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 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) 31,32 The manager is well qualified to manage the home and it is well run. EVIDENCE: The registered manager is a Registered General Nurse and in addition she has completed the Registered Manager’s Award. Staff spoken with described the manager as `very supportive’ and stated that she was particularly skilled in the area of teaching and encouraging other’s to develop their skills. They also stated that the manager provides regular supervision. During the inspection there was an opportunity to meet with the relative of a resident. The relative spoke highly of the care provided to their spouse. They said that `nothing was to much trouble’ and they also spoke positively of the support provided to them by staff. St Pauls H59-H10 S14047 St Pauls V231739 190705 Stage 4.doc Version 1.40 Page 19 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 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 2 15 3 COMPLAINTS AND PROTECTION 2 x x 2 x 3 3 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 3 3 x x x x x x St Pauls H59-H10 S14047 St Pauls V231739 190705 Stage 4.doc Version 1.40 Page 20 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(1) Requirement Timescale for action 30 September 2005 2. 14 3. 19 4. 19 5. St Pauls 27 In respect of one residents care plan in relation to communication, advice to staff must be more specific in detailing how best to communicate with this resident. 12(3)(4)( An assessment must be carrried a) out of each residents wishes/needs in relation to the type of cups they would like to use. 23(4)(c)(v In relation to fire safety, records )(e) must show that fire alarms are tested weekly in line with the homes policy. In addition fire drills must be held separately and records must show the time and length of each drill and each drill must be evaluated in relation to staff performance. 23(4) Action taken to address the requirements and recommendations made in respect of the home’s fire risk assessment must be documented. [This was a requirement of the previous inspection - timescale given was 30/11/05]. 17(2) Hours devoted to management Schedule tasks must be clearly shown on H59-H10 S14047 St Pauls V231739 190705 Stage 4.doc 30 September 2005 31October 2005 15 September 2005 15 September Page 21 Version 1.40 4 para. 7 6. 29 19 Schedule 2 para. (7-9) the rota. [This was a requirement of the previous inspection - timescale given was 15/11/05]. Where the home has been given a copy of a CRB obtained form a staff members previous employment, a fresh application must be made for a new CRB. 2005 31 October 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard 7 9 22 Good Practice Recommendations Staff should place more emphasis,when writing daily records, on how they are meeting the emotional needs of the residents. The home should avoid the practice of double dispensing medication. The owners should consider having a pathway installed from the front door of the property to the end of the driveway. This would make it easier for service users who use wheelchairs to come and go more easily.[This was a recommendation of the previous inspection]. St Pauls H59-H10 S14047 St Pauls V231739 190705 Stage 4.doc Version 1.40 Page 22 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. Extracts may not be used or reproduced without the express permission of CSCI St Pauls H59-H10 S14047 St Pauls V231739 190705 Stage 4.doc Version 1.40 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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