Inspection on 19/06/07 for St Peters Home

This inspection was carried out on 19th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 Peters Home 13/02/07

St Peters Home 04/07/06

St Peters Home 02/02/06

St Peters Home 08/08/05

St Peters Home 30/01/05

St Peters Home 20/07/04

St Peters Home 16/02/04

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

CARE HOMES FOR OLDER PEOPLE St Peters Home Limited St Peters Home 26 St Peter`s Road Margate Kent CT9 1TH Lead Inspector Mrs Sue Gaskell Key Unannounced Inspection 19th June 2007 10:00 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 Peters Home Limited DS0000023548.V340307.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 Peters Home Limited DS0000023548.V340307.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Peters Home Limited Address St Peters Home 26 St Peter`s Road Margate Kent CT9 1TH 01843 291363 01843 299789 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) St Peters Care Home Limited Post Vacant Care Home 30 Category(ies) of Dementia - over 65 years of age (30) registration, with number of places St Peters Home Limited DS0000023548.V340307.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: St Peters Home occupies two semi-detached premises. There are 24 single bedrooms and 3 double bedrooms, of which 19 have en-suite facilities. Accommodation is available on three floors and there is a shaft lift. All rooms have call bells. The Home is close to local facilities and is located in a residential area close to Margate town centre with all its amenities. There is a large garden to the rear that is maintained for service users use. The home provides showers for Service Users use, but offers no baths. The aim of St Peters Home is to retain and promote independence for service users and there are specific objectives to underpin this aim. Information from the Registered Provider in June 2007 states that the fees range from £377.00 to £475.00 per week. St Peters Home Limited DS0000023548.V340307.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 19th June 2007 between 10.00 and 15.30. The home currently has no registered manager but the acting manager is applying for registration. There were 28 people living at the home and there are 2 vacancies. I spoke to three residents’ relatives and five members of staff. Some residents have limited communication and therefore I sat with residents for some time in order to see whether they appeared relaxed and comfortable. I toured the building and looked at bedrooms and all communal areas. The inspection process also consisted of information collected before and during the visit to the home, and feedback from a local Care Manager after the site visit finished. Other information seen included general assessments, risk assessments and care plans, medication records and the duty rota. The owner and acting manager are normally on the premises but, sadly, on this occasion were attending their father’s funeral. I provided them with a feedback shortly after the inspection. There were no outstanding requirements from the previous inspection and no requirements made following this inspection. What the service does well: What has improved since the last inspection? The statement of purpose, service user guides and contracts have been reviewed. Care Plans and risk assessments have been extended. Resident’s life histories, lifestyle information and activities are now recorded. St Peters Home Limited DS0000023548.V340307.R01.S.doc Version 5.2 Page 6 Staffing levels have increased and there has been further staff training in dementia awareness and adult protection. The home has been re-furbished and redecorated. There has been a change of manager and management style. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. St Peters Home Limited DS0000023548.V340307.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 Peters Home Limited DS0000023548.V340307.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 6 People who use the service experience excellent outcomes in this area. The statement of purpose and service user guide clearly says what service will be offered. Prospective residents can be confident that their needs can be met This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s Statement of Purpose and Service User Guide have been reviewed and amended since the last inspection and now provide residents, prospective residents and their relatives with all necessary information about the home. St Peters Home Limited DS0000023548.V340307.R01.S.doc Version 5.2 Page 9 Four care plan files were examined, including one referring to a resident who was admitted yesterday. That resident’s relative said that the manager had visited his relative at their home prior to admission. All files inspected include clear and comprehensive pre-admission assessments carried out by the home with supporting information from care managers. The acting manager writes to prospective residents to confirm that their needs can be met St Peters Home Limited DS0000023548.V340307.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 People who use the service experience excellent outcomes in this area. Residents’ care plans are reviewed and their health care needs are met. Residents are protected by the home’s policies and procedures for dealing with their medication. Residents are treated with respect. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All files inspected included reference to all various aspects of daily living including where appropriate, mobility, nutrition, behavioural, emotional and sexual needs. The care plans were seen to be reviewed recently and include risk assessments and guidelines on how best to assist residents, and details of their condition and any allergies. St Peters Home Limited DS0000023548.V340307.R01.S.doc Version 5.2 Page 11 The daily records are clear and contain enough detail to monitor residents’ health and well-being. There is further evidence in the care plan of monitoring residents’ health care needs and general well being, eg residents are weighed regularly and referred for specialist care when necessary. Residents have access to local health care services. The local District Nurses call regularly. Residents are able to choose their own GP and all have access to dentists, opticians and other community services. The home has a medication policy which is accessible to staff. Staff confirmed that staff do not administer medication unless they have received training, been judged as being competent, and feel confident. There are appropriate records for the receipt, administration and disposal of medication. Medication administration records were in order and important details and administration times are highlighted to make them clearer. Medication is safely and securely stored. The care plans contain written permission from the local GP for staff to administer medication in accordance with residents’ needs. Support with personal issues is provided in a sensitive manner that respects residents’ choice and dignity. All staff interviewed spoke of the need to treat residents with respect and to consider dignity when delivering personal care. There is specific information in the care plans to give staff guidance on specific personal care needs, eg catheter care. Three residents’ relatives said that the staff are very kind and helpful. One resident’s relatives said that their relative has lived in the home for a long time and that the care has improved over the years. Care Managers in the local care management team also said that the home has improved and that they are satisfied with the service. St Peters Home Limited DS0000023548.V340307.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, & 15 People who use the service experience good outcomes in this area. It is difficult in this instance to judge whether the residents’ lifestyle preferences and expectations are met. Residents have regular contact with their families and friends. Residents receive a nourishing and balanced diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Some of the residents are unable to make real choices, and have little control over their lives due to their condition. However, one resident’s relatives who were interviewed said that residents are often asked whether they need anything and that they are encouraged to make choices wherever possible. Staff keep a record of the activities offered, which include manicures, appropriate games and exercises. There is no evidence that residents have St Peters Home Limited DS0000023548.V340307.R01.S.doc Version 5.2 Page 13 been taken on outings for some time but there are occasional visits by various entertainers. Staff said that they try to identify residents’ life histories and particular interests either on admission or from relatives. They said that this helps them to provide appropriate activities, DVD’s etc. There are only showers, and no baths installed in the home, and therefore residents do not have a choice in this respect. One resident’s relatives said that they are always made welcome and offered refreshments. At the time of the inspection five residents were having visitors. Residents take their meals in one of three dining areas. The residents appeared to be seated comfortably and given appropriate cutlery. Some residents use knives and forks, others use spoons or have finger food, according to which method is most comfortable for them. The home still uses plastic plates, bowls and glasses but staff said that this is for reasons of safety. The menus records indicate that a varied diet is provided with alternative choices. A member of the family, as an external contractor, generally provides the main meal of the day. The meal served on the day of the inspection was a rare exception to this, but the food served looked appetising and was well presented. St Peters Home Limited DS0000023548.V340307.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use the service experience good outcomes in this area. Residents and/or their representatives can be confident complaints will be listened to and dealt with appropriately and that they will be protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service user guide includes the home’s complaints procedure. Although it was not possible to confirm this with residents, three residents’ relatives confirmed that they would feel comfortable in mentioning any complaints to the management or staff and confident that any concerns would be resolved. The staff interviewed all showed an awareness of the complaints procedure and adult protection issues. Staff said that there have recently been training sessions on “dementia awareness” which included training of the protection of vulnerable adults. Staff are provided with training on adult protection and are issued with a copy of the company’s “whistle blowing” procedures during their induction period. The home has a copy of the Kent and Medway Adult Protection procedures. St Peters Home Limited DS0000023548.V340307.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 People who use the service experience good outcomes in this area. Residents live in a comfortable, safe, clean environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The building is on two levels and there is a lift and an alarm call system. The home is suitable for people with impaired mobility. There is only currently one shared room but there is curtain style screening between the beds to give some privacy. All bedrooms and living areas are furnished and decorated to a reasonable standard, and contained the type of furniture and equipment necessary to provide a homely environment. Beds and bedding are of an acceptable St Peters Home Limited DS0000023548.V340307.R01.S.doc Version 5.2 Page 16 standard. New carpet and furnishings have been provided recently and there is an on-going programme for re-decoration and refurbishment, Some residents’ rooms are not provided with bedside lights but the owner said that this is because the issue has been risk assessed and would not be safe. Some bedroom doors have locks which are of a type which enable staff to gain access in the event of an emergency. The remainder of the bedroom doors do not have any locks. All windows have been fitted with restrictors or other means of reducing risk. There were some bedrooms with an odour at the time of the inspection but this was not excessive. However, all areas were seen to be clean and hygienic. One resident’s bedroom has a storage cupboard in the eves, which, although bolted should be risk assessed to establish whether it requires a more effective lock. At the time of the inspection there was a lack of ventilation in the main lounge which made it quite hot. There is a fan but this is quite noisy. There is a secure well-maintained garden and patio with garden furniture which is used by the residents. Staff said that residents do use the garden sometimes. Staff showed a good awareness of health and safety issues. There is separate laundry room with a commercial washer and a drier. There are disposable hand drying towels and pump soap dispensers in communal WC’s and shower rooms to reduce the risks of cross infection. Disposable wipes are used for personal care. There are appropriate foot operated bins for particular waste products and personal items are disposed of appropriately. St Peters Home Limited DS0000023548.V340307.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People who use the service experience good outcomes in this area. Staffing numbers are adequate to meet the daily needs of the residents. Residents are protected and supported by the home’s recruitment and induction training procedures. Residents benefit from an adequately trained and supported staff team. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staff rota showed that there are generally one senior and four care staff on duty, in addition to the owner and manager. There are adequate kitchen and domestic staff and a full time maintenance staff. One member of staff said that staffing levels have increased recently. Whilst staffing levels at the time of the inspection appeared generally adequate to meet residents’ needs in terms of their daily care, at lunchtime one staff was dividing her time between two residents and assisting them to feed, rather than giving them individual attention. The manager said that she is normally there to assist with helping residents at meal times. St Peters Home Limited DS0000023548.V340307.R01.S.doc Version 5.2 Page 18 One established member of staff said that she has received on-going training and that supervision and assistance with training have improved recently. Although it was not possible to access staff files at the time of the inspection, all three staff interviewed confirmed that they had to complete application forms, and that the home applied for their references, CRB checks and evidence of identity. The home is committed to providing NVQ training. Just over 50 of staff have completed NVQ2 training and three staff are working on their NVQ3. Refresher training has also been provided in areas such as food hygiene, COSHH, moving and handling, first aid, fire safety, adult protection and health and safety. There are several staff who first language is not English but the staff who were present on the day of the inspection were able to speak to the inspector and the residents and three residents’ relatives appeared to have no difficulty in communicating with them. These staff were employed through an agency and not interviewed personally by the owner or manager prior their employment. Staff said that they have recently had training or refresher training in dementia awareness. St Peters Home Limited DS0000023548.V340307.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 People who use the service experience good outcomes in this area. The current management arrangements ensure that the home is being run in a way which benefits residents and staff. The record keeping, and health and safety systems are sufficient to safeguard residents’ welfare, rights and best interests. This judgement has been made using available evidence including a visit to this service. St Peters Home Limited DS0000023548.V340307.R01.S.doc Version 5.2 Page 20 EVIDENCE: Although currently there is no registered manager in place, the acting manager is in the process of applying for registration. She holds a care management qualification and is currently undertaking NVQ4 training. Quality assurance is carried out through regularly reviewing policies and procedures, and through obtaining feedback from quality assurance surveys. Staff said that residents’ views and feelings are regularly questioned and monitored, either through talking to them, observing them to see whether or not they appear happy. Staff said that any feedback from residents and/or their families or advocates is acted upon. One Care Manager, who has recently reviewed clients in the home also confirmed this. The management of the home and completion of records are generally of a good standard. Staff said that morale in the home is good and that the owner and acting manager are supportive. There were no obvious safety hazards around the home and there was evidence to show that health and safety issues are taken seriously eg the home has reviewed infection control procedures, and fire safety procedures. Accident records are collected and risk assessments for residents and the environment have been carried out. The home has a maintenance man. He has responsibility for routine testing of equipment and ensures that regular weekly tests are carried out and recorded. Staff have had fire safety training and there are regular fire drills. There are current certificates to show that regular checks eg gas, electricity, are carried out. St Peters Home Limited DS0000023548.V340307.R01.S.doc Version 5.2 Page 21 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 4 X 4 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 4 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 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 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 3 St Peters Home Limited DS0000023548.V340307.R01.S.doc Version 5.2 Page 22 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations St Peters Home Limited DS0000023548.V340307.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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