Inspection on 04/07/06 for St Peters Home

This inspection was carried out on 4th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

St Peters Home 19/06/07

St Peters Home 13/02/07

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 Peter`s Home Limited St Peter`s Home 26 St Peter`s Road Margate Kent CT9 1TH Lead Inspector Sandra Crosby & Christine Grafton Key Unannounced Inspection 4th July 2006 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 Peter`s Home Limited DS0000023548.V299498.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 Peter`s Home Limited DS0000023548.V299498.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Peter`s Home Limited Address St Peter`s Home 26 St Peter`s Road Margate Kent CT9 1TH 01843 291363 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 Peter`s Home Limited DS0000023548.V299498.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd February 2006 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 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 July 2006 states that the fees range from £367.00 to £444.00 per week. St Peter`s Home Limited DS0000023548.V299498.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key inspection visit was unannounced and carried out by two Inspectors on Tuesday 04 July 2006 between 10.00 and 2.15, and on Wednesday 05 July 2006 between 9.30 and 1.30. During the inspection the Inspectors spoke with Service Users, observed practice over one dinner time period, and spoke with the Registered Person, the Deputy Manager and staff. Records were seen and an accompanied tour of some areas of the premises was made. The focus of the inspection was to inspect the home in relation to the Key Standards and check on compliance with the requirements and recommendations made at the unannounced inspection visit dated 02 February 2006. Discussion took place at the end of the second day of the inspection visit with the Registered Person and the Deputy Manager and feedback summary sheets were completed and left with the Registered Person. The Inspectors appreciated the helpful attitude and approach to the inspection adopted by the Deputy Manager in the absence of the Manager. One Care Managers comment card was received confirming that they were satisfied with the care provided at the home. Eight Relatives/Visitors comment cards were received and these on the whole commented positively on the services and care provided at the home, although comments such as ‘they do not feel that the Service Users received enough stimulation and that they were never taken out’, ‘often has food on his clothes and has not been shaved’ and several commented that they had not seen an inspection report. Others said ‘very satisfied with the care’ ‘receives contact with staff when necessary’. The Inspectors spoke with one relative who confirmed that they were on the whole happy with the care and support provided by the staff of the home. The Pre-inspection Questionnaire completed by the home and provided on the second day of the inspection visit, together with observational information and discussion with the Registered Person, Deputy Manager, Service Users and staff at the time of the inspection, has been used when compiling this report. It was evidenced that the Registered Person is working very hard to comply with the large number of requirements made following the last inspection visit. However, many requirements remain partially or wholly outstanding. The Registered Person has confirmed his commitment to endeavouring to meet the required standards. St Peter`s Home Limited DS0000023548.V299498.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Small additions and amendments to be made to the Statement of Purpose and Service User Guide to clearly show that for example the home has shower facilities only and no baths, no ironing is carried out as part of the laundry service provided. This requirement has been made on a number of occasions. Although Service User Plans were seen to be comprehensive improvement needs to be made in relation to cross-referencing, together with ensuring that all appropriate entries are made. Medication administration practices were seen to be poor and improvement is required to maintain the health and safety of Service Users. Staff practices to be improved when assisting Service Users at mealtimes ensuring the promotion of Service Users dignity. Moving and Handling practices to be improved thereby promoting health and safety of Service Users and staff. The use of the wooden dining table to be reviewed as the surface it was found may not be appropriate or suitable for the Service User group. St Peter`s Home Limited DS0000023548.V299498.R01.S.doc Version 5.2 Page 7 The ongoing issue of the conservatory area of the home being to hot on some days and to cold in the winter has not been adequately resolved. Blinds have been fitted and roof covering and a fan are suggestions of further improvements that should be made. This area could not be used for the midday meal at the time of the inspection visit, as it was too hot. Maintain control of strong odours noticed in some areas of the home at the time of the inspection visit. The kitchen is in need of an urgent upgrade as currently although the main meals are provided by external contractors, the home only has one domestic cooker, and still does not have a dishwasher. This has been discussed on a number of occasions. It has also been recommended that the laundry area is upgraded. Foot operated pedal bins need to be provided as appropriate. The staffing levels at the home to be reviewed, as currently care staff undertake some laundry duties, washing up duties, and recreational activities. Further training needs to be undertaken by staff to understanding of working with Service Users with Dementia. broaden their Training is needed in relation Health and Safety, COSHH, Infection Control, Continence Care, Food Hygiene, Adult Protection and First Aid. Recruitment procedures need to be improved in order to comply with regulation. Management practices, together with working with and supporting the staff team require improvement. All of the above issues were discussed with the Management of the home. 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 Peter`s Home Limited DS0000023548.V299498.R01.S.doc Version 5.2 Page 8 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 Peter`s Home Limited DS0000023548.V299498.R01.S.doc Version 5.2 Page 9 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): 1,3,6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The homes Statement of Purpose and Service User Guide were seen and still require further amendments to be made in order to provide Service Users and prospective Service Users with the information they need to make a decision about moving into the home. Service Users move into the home knowing that their needs have been assessed, and the home endeavours to meet their needs. Standard 6 was judged as not application at this inspection visit. St Peter`s Home Limited DS0000023548.V299498.R01.S.doc Version 5.2 Page 10 EVIDENCE: The Statement of Purpose and Service User Guide were seen and it was again requested that the documents be reviewed to ensure accuracy and add any information as appropriate in relation to the practices undertaken at the home, for example the home provides shower facilities only and no baths, the laundry service provided does not include the ironing of clothes, the home uses outside caterers for the main meal of the day. Some of these examples and other small amendments needed to these two documents have been discussed at previous inspections. At the visit on the 09 February 2006 the Manager said that she had made the changes discussed to the two documents. At a previous announced inspection visit it was seen that Care Management provide completed assessment paperwork for Social Services Service Users, and the home would carry out a pre-admission assessment for any privately funded Service Users prior to admission to the home. St Peter`s Home Limited DS0000023548.V299498.R01.S.doc Version 5.2 Page 11 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 poor. This judgement has been made using available evidence including a visit to this service. The care planning system meets the requirements of the national minimum standards and regulations, however it was found that not all information recorded was then followed up, and that some information was not recorded and this could be detrimental to the well being of Service Users. The medication systems in place, should if followed properly by staff protect residents, however practices seen in relation to the administration of medications were poor at this visit. Staff endeavour to treat Service Users with respect, and aim to promote privacy and dignity, although practices witnessed at a mealtime would question this. St Peter`s Home Limited DS0000023548.V299498.R01.S.doc Version 5.2 Page 12 EVIDENCE: A selection of Service User Plans were examined, and showed that all the components as required by the Standards and Regulation were in place, and efforts to improve the documentation has been ongoing. It was however seen that in relation to health care matters that information that should have been recorded had not been recorded, together with there being insufficient information recorded in relation to the follow up action to be taken. It was also seen that although there is a formatted form for monthly reviews, these were not necessarily being completed appropriately and it was seen that members of staff had put a date and wrote the word review with no further information for three months in succession. The weight records were seen now to be part of the Service User Plan, but for one Service User although a substantial weight loss had been recorded, there was insufficient supporting evidence to show what actions the home was taking and how they were monitoring this situation. This reflects on the homes ability to promote and make proper provision for the health and safety of Service Users. The medication records were examined and overall indicated that they were appropriately recorded and up to date, however it was seen that on a day at the beginning of the month, the breakfast and teatime medications for all Service Users had not been signed for although when checked it was indicated that they had been administered. It was also found that a controlled drugs book record showed on one page that although the Service User was prescribed to take two tablets twice a day, the records indicated that on six occasions only one tablet was given. The Mars Sheet and the Controlled Drugs Book entries differ on one day of the month, and there was a period shown of over forty-eight hours before the new pain relief medications were commenced. The home was unable to provide supporting evidence in relation to this issue. The medication storage was seen, and the Deputy Manager was asked to separate the internal and external medications. It was also found that the medication fridge was not locked. A prescribed medication in the form of a cream was seen in one of the Service Users bedrooms. It was questioned that as this had been dispensed in March 06 and stated to be ‘applied to affected areas two or three times a day’, why had only the smallest amount of the cream been used, staff were unable to provide any supporting evidence to resolve this issue. St Peter`s Home Limited DS0000023548.V299498.R01.S.doc Version 5.2 Page 13 Staff at the home have undertaken medication administration training. However, the deputy manager had identified that staff were not putting this training into practice, when she became aware of some serious medication errors. From discussion it was indicated that appropriate action had been taken and extra supervision had been provided for a period of several weeks to make sure that the staff had re-learnt correct procedures. There were some good practices seen by a couple of members of staff over the mealtime period, for example sitting with a Service User assisting them to eat their meal. However other issues seen and raised with Management included at one time there being one member of staff in the large lounge/dining room to ‘oversee’ sixteen Service Users, staff members terms of address for Service Users, staff assisting with feeding being stood over the Service Users and little communication between staff and Service Users, for example not being asked about choices of drink. None of the Service Users observed were provided with protective clothing such as tabard or apron at this mealtime. St Peter`s Home Limited DS0000023548.V299498.R01.S.doc Version 5.2 Page 14 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 adequate. This judgement has been made using available evidence including a visit to this service. As the home is registered for Dementia Category, it is difficult to judge if the lifestyle the Service Users experience in the home matches their expectations and preferences. The home endeavours to provide suitable services to meet Service Users needs. Service Users are able to maintain contact with family and friends. Service Users do not usually go outside of the home and grounds unless taken out by family. Service Users due to their mental state of health are unable to exercise many choices and little control over their lives, and staff practices need to promote and encourage choices wherever possible. Conversation and interaction, particularly during mealtimes, was minimal in the home. If more verbal contact was generally undertaken, this would encourage and promote choices even if this is achieved through observation. External Contractors now provide the main meal of the day to the home and these meals provide a balanced diet with alternatives available. St Peter`s Home Limited DS0000023548.V299498.R01.S.doc Version 5.2 Page 15 EVIDENCE: The routines for daily living at the home are such that it has previously been seen that all Service Users are up and dressed before breakfast, and Management have previously stated that this is due to the Service User category and that Service Users may be in bed by 6.00pm. Once Service Users are up and dressed before breakfast, it was observed that the majority of Service Users spend their day in the main Lounge/dining area of the home. Management said that efforts are being made to encourage Service Users to use the other communal areas of the home. It was seen that a number of more suitable dining room chairs had been purchased, and that Service Users were now able to enjoy their meal seated around tables in areas of the home other than the main lounge. Unfortunately on the days of the inspection the weather was very hot, and due to this the Conservatory area could not be used, however the Inspectors were told that this area is now usually used at mealtimes. A member of the family as an external contractor is providing the main meal of the day. The meal observed on the first day of the inspection visit was salmon with a sauce, mash potato and vegetables, with some Services Users having finger food. The food looked appetising and was well presented. The menus seen indicated that a varied diet was catered for with alternative choices provided. The food records seen were discussed with the Deputy Manager, and she agreed for a more comprehensive record to be maintained. The situation in relation to the recreational activities provided at the home remains the same in that care staff on duty, provide any activities undertaken. A record of activities was seen from one member of care staff these included manicures, games, music and movement and activities in relation to the football world cup. The situation in relation to the provision of sufficient meaningful activities being provided suitable for Service Users with Dementia has been discussed at a number of inspections and as the registered number of Service Users has increased immediate action needs to be taken to address this issue. In relation to the use of Multi Purpose cloths used for personal care as seen in use at previous inspection visits the Senior Carer said that not as many are now used as Service Users now have flannels. St Peter`s Home Limited DS0000023548.V299498.R01.S.doc Version 5.2 Page 16 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 poor. This judgement has been made using available evidence including a visit to this service. The complaints record was seen and indicated that complaints are recorded together with the action taken and outcome, although information was not always shared with other appropriate professionals. The Services Users may not have always been protected from abuse, and required notification under Regulation 37 has not been consistently followed through. A few members of staff only have completed Adult Protection training. EVIDENCE: The complaints book was seen, and in discussion with issues raised and the outcomes recorded it was indicated that information was not always shared with other appropriate professionals. Issues that had taken place at the home and had been investigated had not been notified under Regulation 37 to the Commission, or to other professional bodies as appropriate for example drug errors. In relation to the staff training matrix provided at the time of the inspection visit five staff only have undertaken training in Adult Protection. St Peter`s Home Limited DS0000023548.V299498.R01.S.doc Version 5.2 Page 17 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): 19,20,21,22,23,24,25,26 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The standard of the environment of some areas of the home is good providing Service Users with on the whole an attractive and homely place to live. The garden area is well maintained. However refurbishment is required in some areas. The home was mainly clean and pleasant at the time of the inspection visit, although odours were noticed in some areas. EVIDENCE: It was seen at the announced inspection visit that Service Users remain mainly in the large Lounge/dining area during the day. Efforts have been made to encourage the use of the Conservatory area, although again at this inspection visit the room was to hot for the Service Users to have their main meal of the day in. Blinds have been purchased however further consideration needs to be given to ways in which the temperature in this area can be adequately St Peter`s Home Limited DS0000023548.V299498.R01.S.doc Version 5.2 Page 18 controlled to provide an ambient temperature in order for the room to be in use at all times as this area is registered as part of the communal space of the home. The new lounge area is also now being used at mealtimes, and it was seen that a large wooden table have been placed in this room. It was discussed that a wooden table may not be an ideal surface to be used for a dining room table in the home as it was found on both days of the visit that the surface was sticky and residue of food was on the surface. It was also observed that as the conservatory was unable to be used more Service Users were seated around the table at the mealtime and this made it difficult for the carer to assist the Service Users and she remained standing to undertake this role. An issue that arose in relation to the position of a Service User seen sitting in one of the lounge chairs was discussed with a relative and with management. It is considered that there are many adaptations available that would provide this Service User with a more comfortable seating arrangement. The Deputy Manager agreed to address this issue. As previously stated since the last inspection visit, external contractors now provide the main meal at the home. As there have been some difficulties in relation to the new cooker not being able to be installed, and the home currently only having a normal domestic cooker in place, a further recommendation is made that the kitchen be refurbished as soon as possible, including the provision of a commercial dishwasher. Additional consideration needs to be given to the provision of more suitable laundry facilities in relation to the registered number of the home. This area again was extremely hot. It was also seen that there were not always appropriate waste pedal bins in place. The bedrooms do not have a bedside light, as this has been risk assessed as a hazard for the whole of the Service User group. Although atomising sprays are used, it was noticeable that some areas in the home were odorous. The external grounds are well maintained and provide sheltered areas where Service Users may be encouraged to utilise, dependent upon the availability of staff to supervise. St Peter`s Home Limited DS0000023548.V299498.R01.S.doc Version 5.2 Page 19 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 poor. This judgement has been made using available evidence including a visit to this service. It is judged that consideration needs to again be given to staffing levels especially during the meal time periods in relation to the number of Service Users who require assistance with eating their meals. Action is also to be taken in light of current changes at the home, and this standard will be further assessed at future inspections to ensure that the homes staffing levels meet the needs of the Service Users. The homes good recruitment procedures have not been maintained since the last inspection visit, thereby not always ensuring that Service Users are supported and protected. Care needs to be taken to ensure that all documentation is completed. Staff training is ongoing at the home. EVIDENCE: As the registered number at the home has increased, there has for sometime been ongoing discussion in relation to the staffing levels at the home. The Deputy Manager has confirmed that currently the home is working towards one senior carer and four carers on shift during the daytime hours. Evidence was seen from a recent incident, and it is considered that staffing levels at that time were insufficient to meet the needs of the current group of Service Users. St Peter`s Home Limited DS0000023548.V299498.R01.S.doc Version 5.2 Page 20 It remains a concern that care staff undertake laundry duties, washing up duties and any activities provided, and this makes it debatable as to whether the staffing levels at the home meet the required minimum standards, although Management confirms that the Residential Staffing Forum hours are met. When considering the assistance that is required during the day, the support needed to provide a good quality of life and the stimulation that service users obviously need to develop or maintain skills, it is questionable that staffing levels are always adequate. It is therefore suggested that Management again review the staffing levels at the home. Staff files were viewed at the second inspection visit and showed that not all necessary documentation was in place; therefore indicating that a thorough recruitment process was not now being carried out. The Deputy Manager agreed, and said that action would be taken to address this issue. The Inspectors were told at the second inspection visit that staff have attained NVQ Level 2 training or the equivalent in order to meet the required standard, and that further staff members are undertaking NVQ Level 2. The attitude of some staff, and observations made in relation to staff practices does not support their NVQ training and issues need to be addressed by management. At the time of the inspection visit the Deputy Manager confirmed that a number of training courses had been undertaken, and indeed on the second day of the inspection visit Fire Training was taking place in the afternoon. The Inspectors advised at the previous inspection visit that the full date of training be entered and not just the year. A further updated staff training matrix as requested was received at the Commission Office on the 12 July 2006, and shows that training has been undertaken during 2005 and 2006, shows that training in relation to Health and Safety, COSSHH, Infection Control, Continence Care, Food Hygiene, First Aid and Adult Protection is still required for varying numbers of staff. St Peter`s Home Limited DS0000023548.V299498.R01.S.doc Version 5.2 Page 21 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): 31,32,33,35,36,37,38 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. It is indicated that the home is not being managed with sufficient care, competence and skill. No judgement was made in relation to Standard 35 at this inspection visit as Management confirmed at the announced inspection visit that currently they do not handle personal allowance monies for any of the current Service Users. Some practices seen at the home do not promote and safeguard the health, safety and welfare of the people using the service. The Deputy Manager confirmed that regular supervision of staff took place Systems are in place in relation to the safe storage of records. St Peter`s Home Limited DS0000023548.V299498.R01.S.doc Version 5.2 Page 22 EVIDENCE: Evidence obtained, and observations made indicate that management practices, together with working with and supporting the staff team require improvement. An in depth reply by a relative of a Service User in response to the homes quality assurance monitoring system highlights a number of issues for which requirements have been made in previous inspection reports on a number of occasions. Action needs to be taken by the management of the home to address the issues discussed, and management should pro-actively make changes and work towards raising the standard of care provided. The Deputy Manager confirmed that the home does not hold any personal allowance monies for the current group of Service Users. The pre-inspection questionnaire information states that a monthly sum of £7.50 is charged to cover toiletries for those Service Users whose relatives do not provide these items. The Deputy Manager confirmed that regular supervision for staff is undertaken with written records kept. The Fire Log Book was seen and indicates that in the main regular checks are undertaken. There was insufficient fire drills recorded, however Fire Training was booked for the afternoon of the second day of the inspection visit. The home needs to ensure that the records show that all staff have undertaken the required fire practices. Further training is required in relation to Health and Safety, COSSHH, Infection Control, Continence Care, Food Hygiene, First Aid and Adult Protection. St Peter`s Home Limited DS0000023548.V299498.R01.S.doc Version 5.2 Page 23 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 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 1 9 1 10 1 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 1 2 2 2 1 2 2 1 1 STAFFING Standard No Score 27 1 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 1 1 X N/A 3 2 1 St Peter`s Home Limited DS0000023548.V299498.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? YES 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 OP1 Regulation 4&5 Timescale for action The Statement of Purpose and 05/07/06 Service User Guide to be reviewed and additions and amendments to be made – Provide amended copies of both documents to the Commission Office when completed Previous timescales 31/03/06 31/12/05 30/01/04 31/10/04 Comprehensive Service User 05/07/06 Plans to contain all appropriate information - Cross-referencing within the Service User plan to be improved Previous timescales 02/02/06 11/08/05 03/07/05 30/01/05 21/07/04 To promote and make proper 05/07/06 provision for the health and welfare of Service Users Previous timescales 02/02/06 11/08/05 The registered person ensures 05/07/06 that there is a policy and staff adhere to the procedures for the receipt, recording, storage, DS0000023548.V299498.R01.S.doc Version 5.2 Page 25 Requirement 2. OP7 15 3. OP8 12(1)(a) 4. OP9 13 St Peter`s Home Limited handling administration disposal of medicines 5. OP10 12(4)(a) and Previous timescale 02/02/06 The Registered Person shall 05/07/06 make suitable arrangements to ensure that the care home is conducted in a manner which respects the privacy and dignity of service users Previous timescale 02/02/06 Sufficient meaningful activities to be provided suitable for Service Users with dementia Provide and maintain comprehensive records of food provided at the home The Registered Person shall give notice to the Commission - any event in the care home which adversely affects the well-being or safety of any service user Provide suitable adaptations/ equipment as appropriate to meet Service Users needs The heating, lighting, water supply and ventilation of service users’ accommodation meet the relevant environmental health and safety requirements and the needs of individual service users 05/07/06 05/07/06 05/07/06 6. 7. 8. OP12 OP15 OP18 16(1)(n) 17(2) Sch 4 - 13 37 9. 10. OP22 OP25 12(1) 16(2) 23(2)(p) 05/07/06 05/07/06 11. OP26 16(2)(k) Previous timescale 02/02/06 The premises are kept clean, 05/07/06 hygienic and free from offensive odours throughout and systems are in place to control the spread of infection, in accordance with relevant legislation and published professional guidance Provide appropriate operated pedal bins Previous timescale 02/02/06 foot 12. OP27 18(1) Staffing numbers and skill mix of 05/07/06 DS0000023548.V299498.R01.S.doc Version 5.2 Page 26 St Peter`s Home Limited qualified/unqualified staff are appropriate to the assessed need of the service users 13. OP29 7,9,19, Sch2 Previous timescale 02/02/06 Ensure recruitment procedures 05/07/06 comply with the requirements of regulation – e.g. two references, letter confirming appointment, contract of employment, interview notes The registered provider and the 05/07/06 registered manager shall, having regard to the size of the care home, the statement of purpose, and the number and needs of service users, carry on or manage the care home (as the case may be) with sufficient care, competence and skill Staff to update First Aid Training 05/07/06 Previous timescales 11/08/05, 31/03/06 Training needs to be undertaken in Health and Safety, COSSH, Infection Control, Continence Care and Food Hygiene and Adult Protection The registered manager ensures 05/07/06 so far as is reasonably practicable the health, safety and welfare of service users and staff - Maintain Fire Records and undertake regular Fire Practice Drills Previous timescale 02/02/06 14. OP31 10 15. OP38 18(1) 16. OP38 17(2) Schedule 4-14 St Peter`s Home Limited DS0000023548.V299498.R01.S.doc Version 5.2 Page 27 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. Refer to Standard OP9 OP19 Good Practice Recommendations The home to purchase a suitable ‘controlled drugs’ book To consider further means to reduce the temperature in the conservatory area in summertime, and to increase the temperature in this area in the wintertime to enable full utilisation of communal space Upgrade the kitchen facilities at the home – provision of a dishwasher Upgrade the laundry facilities at the home 3. 4.. OP19 OP26 St Peter`s Home Limited DS0000023548.V299498.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 Peter`s Home Limited DS0000023548.V299498.R01.S.doc Version 5.2 Page 29 - 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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