Inspection on 20/06/05 for St Peter`s Nursing Home

This inspection was carried out on 20th June 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 Peter`s Nursing Home 19/11/07

St Peter`s Nursing Home 04/01/07

St Peter`s Nursing Home 05/01/06

St Peter`s Nursing Home 08/12/04

St Peter`s Nursing Home 21/06/04

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

CARE HOMES FOR OLDER PEOPLE Council Avenue Northfleet Gravesend Kent, DA11 9HN Lead Inspector Alison Spreadbridge Unannounced 20 June 2005 09:30 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. Council Avenue v228105 h56-h06 s26205 st peters v228105 200605 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service St Peters Nursing Home Address Council AvenueNorthfleetGravesendKentDA11 9HN 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) 01474 335241 01474 537242 Ranc Care Homes Limitd Mrs Carol Ann Merry Care Home 56 Category(ies) of Dementia (56) registration, with number of places Council Avenue v228105 h56-h06 s26205 st peters v228105 200605 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Patients detained under Sections of the Mental Health Act may not be admitted to the home. Date of last inspection 8th December 2005 Brief Description of the Service: St Peters Nursing home is a large detached listed building with a purpose built extension. The home provides care and accommodation for 56 Older people with dementia and nursing needs. The accommodation is in three units. Acorns provides accommodation for 8 service users in 2 single and 3 double rooms. Vines provides accommodation for 22 service users in 6 single rooms and 8 double rooms and Shamrock provides accommodation for 26 service users in 14 single rooms and 6 shared rooms, The home is situated about three miles from Gravesend and a main line station.. Council Avenue v228105 h56-h06 s26205 st peters v228105 200605 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspectors carried out an unannounced inspection to the home between 09.30am and 12.30pm on the 20 June and was continued for a second day ion the 24th August 2005 which took place between 2.25pm and 5.30pm During the inspections a tour of the home took place, some staff and service users were spoken with. The home is comfortable and well decorated. There is a pleasant and peaceful atmosphere. Good use has been made of a small area to the rear of the building where a sensory garden has been constructed. There is a pleasant patio and garden to the rear of the house. What the service does well: What has improved since the last inspection? What they could do better: Council Avenue v228105 h56-h06 s26205 st peters v228105 200605 stage 4.doc Version 1.40 Page 6 The home needs to ensure risk assessments are continually updated to meet the changing needs of service users 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. Council Avenue v228105 h56-h06 s26205 st peters v228105 200605 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 Council Avenue v228105 h56-h06 s26205 st peters v228105 200605 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) 1,3,4,5,6 The home provides sufficient information for service users and their families prior to making a decision about moving into the home EVIDENCE: Prospective service users and their representatives are able to visit the home prior to admission. They are provided with a statement of purpose that enables them to make an informed decision about moving into the house. All service users have an assessment prior to admission, this is usually carried out by the Matron or the deputy of the home with the assistance of members of the trained staff to ensure that the service user’s needs can be met. It was noted that some of the service users’ risk assessments are in need of updating as service users’ needs change. The home is able to offer care for people with dementia and they have the support of the local dementia liaison nurse. The home does not offer intermediate care Council Avenue v228105 h56-h06 s26205 st peters v228105 200605 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) 7,8,10, The care plans and risk assessment used in the home should be continually updated to ensure services users’ assessed needs are fully met EVIDENCE: The service users have individual care plans some of which are in need of updating as service users’ needs change. The care plans seen, contained assessments carried out by the homes trained staff. Area of care such as pressure areas and moving and handling were included. The care plans did not all contain risk assessments to ensure service users who like to wander can do so in safety Service users were treated with respect, however the practice of leaving doors propped open does not ensure service users’ privacy is maintained. If this is the Service users choice then it was not clearly recorded in the service users care plan. Shared rooms have curtains fitted that whilst offering privacy are not sited to ensure service users’ comfort and ease of use. In some shared rooms the curtains are very close to the side of the bed, making the use of bedside tables and chairs difficult when curtains are pulled around the bed. Council Avenue v228105 h56-h06 s26205 st peters v228105 200605 stage 4.doc Version 1.40 Page 10 The service users have access to specialist nurses such as the continence nurse, dementia liaison nurse and community nurses who will call to the home when requested. Council Avenue v228105 h56-h06 s26205 st peters v228105 200605 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) 12,13,14 Service users are encouraged to maintain contact with their families and friends. The home provides a range of activities and special areas where service users can relax. EVIDENCE: Service users friends and families are able to visit at any reasonable time. The question of service users dignity and privacy being compromised by the working practice of leaving bedroom doors open in the home was discussed and the need to ensure that choices made by the service users in this respect are recorded in their care plans. Some of the service users may wish to wander around the house, however there are currently issues around accessing day space on the first floor due to the siting of the stairs in relation to the day space. The needs of the service users are not being fully met due to the lack of ongoing risk assessments in the home, thereby compromising their ability to make choices for themselves. Service users have access to two activities co-ordinators who work in the home during the week offering a range of activities including flower arranging, tapes, cribbage, and dominoes. They also have access to a reminiscence room and a Council Avenue v228105 h56-h06 s26205 st peters v228105 200605 stage 4.doc Version 1.40 Page 12 quiet ‘snoozlen’ room where bubble tubes, aromatherapy, fibre optics and music provide a peaceful area for service users to relax and enjoy the peaceful setting Service users have access to a daily paper provided by the home. Council Avenue v228105 h56-h06 s26205 st peters v228105 200605 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) EVIDENCE: Council Avenue v228105 h56-h06 s26205 st peters v228105 200605 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) EVIDENCE: These standards were not assessed on this occasion. Council Avenue v228105 h56-h06 s26205 st peters v228105 200605 stage 4.doc Version 1.40 Page 15 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) 19,20,21,22,23,24,26 Service users live in a well decorated home with a very pleasant atmosphere EVIDENCE: The home is well decorated and homely. There are a number of areas where service users sit that would benefit from some small tables where drinks and personal items could be set down. Pictures and flowers are used throughout the home to make it as attractive as possible for service users. On entering the home there was a noticeable smell of urine. It is acknowledged that this may have been due to staff assisting service users to rise. The house was seen to be clean and tidy. The snack kitchen was spotlessly clean as was the microwave. The dining room on the first floor is a very pleasant and airy room, the possibility of it being used for other activities was discussed Some of the service users who share a room are unable to have the required furniture as per the national minimum standards due to the lack of space. When staff were changing beds it was noted that service users were unable to access their rooms as linen baskets had to be left in the door way. Council Avenue v228105 h56-h06 s26205 st peters v228105 200605 stage 4.doc Version 1.40 Page 16 On a window on the staircase used by service users two panes of glass were seen to be broken. The service users have only one hand-rail on the opposite wall. Service users might need to steady themselves by placing their hands on the window. This area should be risk assessed. There was also a cracked window in the dining room, these concerns were discussed with the deputy manager. On inspection a wheelchair was seen stored in one of the sluices preventing access to an already small area. The majority of the beds are not adjustable and therefore cannot ensure ease of use for service users and staff. It was noted that in some rooms that the curtains are so close to the bed it prevents the service user from sitting out in a chair in privacy. This affects both beds in the room. The issue was discussed with the deputy manager of the home. It was noted that the majority of the toilets are of normal height, service users and staff would benefit from having access to raised toilet when assisting service users with their personal care. The home would benefit from an Occupational Therapy assessment. A bath panel was broken and left off the side of the bath, the bathroom was still in use by service users. The carpet in the downstairs corridor felt quite ‘tacky’ when being walked upon. Council Avenue v228105 h56-h06 s26205 st peters v228105 200605 stage 4.doc Version 1.40 Page 17 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) Not inspected EVIDENCE: Council Avenue v228105 h56-h06 s26205 st peters v228105 200605 stage 4.doc Version 1.40 Page 18 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 3 3 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 x 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 x COMPLAINTS AND PROTECTION 2 2 2 3 x 2 x 3 STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x x x x x Council Avenue v228105 h56-h06 s26205 st peters v228105 200605 stage 4.doc Version 1.40 Page 19 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 8 Regulation 12 (1) (a) Requirement The registered person shall ensure that the home is conducted so as to promote and make proper provision for the health and welfare of service users. The registered person shall suitable arrangements to ensure service users dinity and privacy is maintained The registered person shall for the purposes of providing care to service users and making proper provision for the health and safety, so far as is possible ascertain and take into account their wishes and feelings The registered person shall having regard to the number and needs of service users ensure that the premises is kept in a good state of repair externally and internally The registered person shall having regard to the number and needs of service users ensure that the premises is kept in a good state of repair externally and internally The registered person shall having regard to the number and Timescale for action 31 August 2005 2. 10 12 (4) (a) 31 August 2005 31 August 2005 3. 14 12 (2) (3) 4. 19 23 (2) (b) 31 August 2005 5. 20 23 (2) (b) 31 August 2005 6. 21 23 (2) (b) 31 August 2005 Page 20 Council Avenue v228105 h56-h06 s26205 st peters v228105 200605 stage 4.doc Version 1.40 7. 8. 9. 10. 11. 12. 13. 14. 15. 24(3) 16 (2) needs of service users ensure that the premises is kept in a good state of repair externally and internally The registered person shall provide equipment suitable to the needs of service users 31 August 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. 4. 5. 6. 7. Refer to Standard 22 Good Practice Recommendations It is recommended that an Occupational Therapist makes an assessment of the home and the equipment currently in use by service users e.g. beds and toilets Council Avenue v228105 h56-h06 s26205 st peters v228105 200605 stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection The Oast Hermitage Court Hermitage Lane MaidstoneKent, ME16 9NT 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 Council Avenue v228105 h56-h06 s26205 st peters v228105 200605 stage 4.doc Version 1.40 Page 22 - 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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