Inspection on 05/10/06 for St Paul`s Residential Home

This inspection was carried out on 5th October 2006.

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.

Other inspections for this house

St Paul`s Residential Home 23/03/06

St Paul`s Residential Home 12/05/05

St Paul`s Residential Home 23/12/04

St Paul`s Residential Home 10/05/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE St Paul`s Residential Home 127-131 Stroud Road Gloucester Glos GL1 5JL Lead Inspector Mr Adam Parker Key Unannounced Inspection 09:30 5th & 6th October 2006 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 Paul`s Residential Home DS0000031351.V311899.R01.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 Paul`s Residential Home DS0000031351.V311899.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Paul`s Residential Home Address 127-131 Stroud Road Gloucester Glos GL1 5JL 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) 01452 505485 Mrs Mobina Sayani Mrs Mobina Sayani Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places St Paul`s Residential Home DS0000031351.V311899.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Room 8 must not be used as a bedroom. This can only be used as a sitting room for Bedroom 7 if this is occupied by two service users that have a relationship with each other and have made a positive choice to share rooms. Bedroom 9 must not be used to accommodate service users until the ensuite facilities are fully installed and operational. 23rd March 2006 2. Date of last inspection Brief Description of the Service: St. Pauls Residential Home is registered to provide personal care for 21 older people. The accommodation is in a busy area of the city comprising three older style houses that have been joined and adapted for their purpose. Service users accommodation is situated on the ground and first floors in and is all single accommodation, though one of the rooms can provide shared accommodation for a couple if required. The home has recently been extended into a third house and new bedrooms are provided with en-suite facilities. Further work is planned to provide new bedrooms, communal space and to upgrade some of the existing rooms. Current fees are £330 to £450.Hairdressing, chiropody and toiletries are charged extra. The home makes information about the service, including CSCI reports available to service users through a service user guide and statement of purpose available in the home. St Paul`s Residential Home DS0000031351.V311899.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit was carried out by one inspector over two days in October 2006. The registered manager of the home was not present for the first day of the inspection visit being at a care provider’s conference, although she was present in the home for the second day of the inspection visit and had input into the inspection process. Three service users were spoken to during the inspection visit. The inspection visit consisted of a tour of the premises and examination of service users care files. In addition staff recruitment and training was looked at as well as documents relating to the management and safe running of the home. A number of comment cards were received from service users, their relatives, and staff working in the home. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. What the service does well: What has improved since the last inspection? St Paul`s Residential Home DS0000031351.V311899.R01.S.doc Version 5.2 Page 6 The home has made improvements to the systems of medication administration, recording and storage. Staff have now received training on adult protection procedures and improvements have been made to staff recruitment. Fire safety has been improved through checks on equipment and staff fire drills. The recording of service users financial transactions now includes deductions such as contributions to care costs. The building work though incomplete has improved some areas of the home. 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 Paul`s Residential Home DS0000031351.V311899.R01.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 Paul`s Residential Home DS0000031351.V311899.R01.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home’s admission procedure ensures that all service users are admitted to the home on the basis of a full assessment of their needs, so that they can receive the care that they require. EVIDENCE: The documentation for the most recent admission to the home was looked at. The home had obtained a copy of the assessment completed by the funding authority and had completed their own needs assessment for the service user. This included detailed information relating to the cultural linguistic and religious needs of the service user and a statement on how these needs would be met. In respect of this the home has employed a member of staff who speaks the same language to meet the needs of the service user. The documentation for a previous admission was looked at and this included a detailed assessment of the service users needs completed by the home. The home does not provide intermediate care and so Standard 6 does not apply. St Paul`s Residential Home DS0000031351.V311899.R01.S.doc Version 5.2 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 the following standard(s): 7,8,9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. There is a care planning system in place which provides staff with the information they need to meet service users’ needs. The home meets service users health needs through liaison between the staff at the home, service users and health care professionals. There has been an improvement in medication systems to safeguard service users. Care is given in such a way as to promote the privacy and dignity of service users. EVIDENCE: Care plans were sufficiently detailed to give care staff the information required to meet service users needs and had been reviewed on a monthly basis. There are records of personal care given to service users and when baths are given. The registered manager confirmed that some of the service users are aware of the contents of their care plans and with others there has be consultation with St Paul`s Residential Home DS0000031351.V311899.R01.S.doc Version 5.2 Page 10 relatives. One service user had particular views on what information was put into care plans and the home have respected this. Evidence was seen of service users receiving input from health care professionals such as community nurses and GPs including specialist healthcare provision in order that their needs were met. There was good documentation regarding liaison between the home and a service user’ GP about medication changes. Risk assessments had been completed for moving and handling and a general risk assessment had been completed for each service user in relation to their safety in the room they occupy, this is good practice. Improvements have been made to medication systems since the previous inspection. The registered manager had issued clear written instructions to staff following the inspection and these were attached to the administration charts. The home’s medication policy outlined the respective roles of different members of staff in the home in relation to medication ordering, administration, storage and disposal. The home has a homely remedies list and evidence of consultation about this with one of the GPs. Medication administration charts are now completed during the medication round and a trolley is used, in addition staff are now recording the correct codes for administration on the charts. Some liquid medication had been dated on opening but other bottles had not. Some handwritten entries in administration charts had been signed by two members of staff which is good practice and it is recommended that this should be extended to all entries. The monitoring of storage temperatures for medication had not taken place and it is recommended that this practice should begin. The home has plans to provide a larger storage cupboard for medication once the building work is completed. Staff were seen to uphold the privacy and dignity of service users in giving care and in how they were spoken to. Service users spoken to confirmed that staff were polite and knock on doors before entering their rooms. The home has a policy on privacy and dignity that is included in the service users’ guide. St Paul`s Residential Home DS0000031351.V311899.R01.S.doc Version 5.2 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 the following standard(s): 12,13,14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users lifestyle in the home matches their preferences and meets their social, cultural and religious needs. Service users maintain some control and choice over their lives through meetings and information available in the home. Service users’ dietary needs are well catered for taking into account choice and cultural needs. EVIDENCE: The home has a policy on social contact and in addition service users have information recorded in relation to their family, social contacts and their hobbies and interests. It was reported by the registered manager that the home used to have a programme of organised activities however service users had expressed a preference not to have this and some service users follow their own interests St Paul`s Residential Home DS0000031351.V311899.R01.S.doc Version 5.2 Page 12 or prefer to watch television, although bingo is organised and enjoyed by service users in the home. Birthdays are celebrated in the home with a party held for the particular service user. Two service users attend a local church. Another service user is able to receive input from a staff member from the Islamic faith to assist with prayers. The home does not place restrictions on visitors except to ask that if they visit the home at mealtimes and wish to eat with the service user they are visiting then they let the home know in advance. One service user has a care plan relating to their preferences in relation to receiving certain visitors. Service users confirmed that they are able to receive visitors in the privacy of their rooms although one service user did not feel that there was enough space in her current room to comfortably receive visitors. A number of service users in the home handle their own financial affairs. The home has information available about advocacy services. Service users are able to bring personal possessions into the home and evidence of this was seen in bedrooms. Service users are able to have access to their personal records when this has been requested. Meetings are held for service users to discus issues about the home, the last being held in June 2006. Very detailed information was seen in one service user’s care file relating to diet in line with cultural and religious needs. This was the case with another service user who also had information recorded in relation to following a diabetic diet. Advice had been sought by the home regarding diabetic diets from a dietician; service users were involved in this where it was relevant to their needs. Apart from those following special diets, service users are offered a choice of meals and this was confirmed by service users. The cook consults with service users regarding their individual preferences. Over half of the service users who completed surveys said that they always liked the meals at the home. The serving of lunch was observed on the first day of the inspection visit. Some service users took lunch in the dining room others in their own rooms. It was noted that staff wore aprons to serve meals which were served individually to service users with the plates covered. A choice of drinks was available to service users and choice was also seen to be respected for one service user who did not wish to take their main meal at that time. A number of care staff in the home have completed training in food hygiene and the cook and registered manager have undertaken training in nutrition. St Paul`s Residential Home DS0000031351.V311899.R01.S.doc Version 5.2 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 the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The homes has policies and procedures which linked with staff training should ensure that service users feel that they know how to complain about the service and are protected from abuse. EVIDENCE: The home has a complaints procedure that is displayed on a notice board in the home. When asked if they knew about how to make a complaint one service user said, “It’s all on the notice board”. In addition meetings are held for service users where they can raise any issues about the home. The registered manager reported that there had been no complaints received about the home. Information from the local authority adult protection unit is displayed and is available in the home. The majority of staff in the home have undergone training in preventing abuse to service users and certificates relating to this were seen during the inspection visit. A discussion with staff about adult protection issues was held in the home in April 2006 and a record of this was made. There have been no incidents of abuse reported in the home. St Paul`s Residential Home DS0000031351.V311899.R01.S.doc Version 5.2 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 the following standard(s): 19 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Despite the current building work, service users have the benefit of living in a well-maintained and generally clean, environment. EVIDENCE: At the time of the inspection visit the home was in middle of major building work. A number of extra rooms have been registered following the home extending into a third adjoining house. Two large communal rooms have also been added. Further work is planned to create more bedrooms and refurbish and upgrade existing rooms. Unfortunately the building work has come to a halt after the builders had stopped work. Some service users had been able to benefit from moving into the newly registered bedrooms and a new laundry is functioning. The communal areas were still unused and a new kitchen had not been completed. The registered provider was in the process of engaging a new builder to complete the work. St Paul`s Residential Home DS0000031351.V311899.R01.S.doc Version 5.2 Page 15 Outside space to the rear of the home is currently unavailable to service users but there are plans to reinstate the garden once the work has been completed. Despite the current situation the home was generally well maintained and clean. The laundry was equipped with hand disinfection, suitable wall and floor finishes and had a washing machine with the appropriate programming for infection control. A notice in the laundry advised staff of their responsibilities in relation to infection control and handling laundry. The registered manager had plans to improve the hand washing facilities in the toilets in the newly registered part of the home and the items were currently on order. A statement on a comment card received from a relative of a service user read, “Homely Atmosphere, always appears clean and residents comfortable even on unannounced visits” The home was complying with conditions of registration in respect of bedrooms eight and nine. St Paul`s Residential Home DS0000031351.V311899.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The numbers of care staff ensure that service users needs are met. The level of staff with NVQ training ensures that service users are in safe hands. Induction training should ensure that staff are trained and competent to meet service users’ needs. EVIDENCE: The home is staffed by 2 care staff in the morning plus the manager or the deputy manager. An additional member of care staff works for 3 hours per day to meet the particular needs of one service user from a minority ethnic background and provide input to others. The team of care staff are supported by a cook and a cleaner. The home employs 14 care staff and 8 of these have achieved training to NVQ level 2. This means that the home has exceeded the standard for 50 of care staff to be trained to this level. In addition a further 3 care staff are currently undergoing the NVQ training. St Paul`s Residential Home DS0000031351.V311899.R01.S.doc Version 5.2 Page 17 Recruitment practices have improved in the home since the previous inspection. The file for the latest member of care staff to be recruited was looked at and all the required information and documentation had been obtained with correct checks made or in the process of being made. The home has commenced induction training for new staff using a local learning centre and has obtained a guide to the Common Induction Standards. In response to a question about the staff on a survey form, a service users stated, “ I find staff to be caring and helpful”. St Paul`s Residential Home DS0000031351.V311899.R01.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users benefit from living in a home that is run and managed by a qualified and trained registered manager. More needs to be done to build on the work completed in gathering service users views to ensure that the home is run in their best interests. The home acts to safeguard service users financial interests. Safe working practices generally ensure service users safety. EVIDENCE: St Paul`s Residential Home DS0000031351.V311899.R01.S.doc Version 5.2 Page 19 The registered manager has achieved the registered managers award and is a qualified and practising pharmacist. She has had four years previous experience in owning and managing another care home. The registered manager has attended a care provider’s conference and has recently attended training in adult protection and dementia, following the principle that she attends the training that the care staff undertake. The views of service users in relation to how the service meets their needs and expectations has been gathered using questionnaires. However this needs to be presented in a report format demonstrating how this information will take up any issues identified to improve the service offered. Records of financial transactions now show where money has been deducted as a contribution towards care costs. The home does not hold any cash or valuables on behalf of service users however one service user has been supplied with a lockable box for cash and valuables and some service users wardrobes are lockable. Staff in the home have undertaken training in fire safety, infection control, moving and handling, first aid, health and safety and handling hazardous substances. The registered manager was in the process of arranging up dates in training for those that needed them. The home has had new boilers installed as part of the building work. Checks on electrical systems were awaiting completion of the building work. Safety checks on electrical appliances were last done in March 2005 and it is recommended that now this piece of work should be repeated. Work on reducing the any risk from Legionella in the home was last carried out in May 2005 and the annual check was awaiting the completion of the building work. Regular checks have been made and recorded on hot water outlets in the home to ensure that the temperatures are at a safe level for service users. Following a recent reported incident of theft at the home, a risk assessment must be completed regarding the security of the premises. The home has done good work in risk assessing each service user in relation to the rooms they occupy. St Paul`s Residential Home DS0000031351.V311899.R01.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 St Paul`s Residential Home DS0000031351.V311899.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No 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 OP33 Regulation 24 (1) (2) Requirement The registered person must complete the report on the quality assurance survey and forward a copy to the local CSCI office. The registered person must ensure that a risk assessment is completed regarding the security of the premises. Timescale for action 31/01/07 2. OP38 13 (4) (a) & (c) 30/11/06 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 OP9 OP9 OP38 Good Practice Recommendations All bottles of liquid and topical medication should be dated on opening. Medication storage temperatures should be monitored and recorded. Safety checks on portable electrical appliances should be repeated. St Paul`s Residential Home DS0000031351.V311899.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB 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 Paul`s Residential Home DS0000031351.V311899.R01.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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