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Inspection on 14/11/07 for St Phillip & St James Residential Home

Also see our care home review for St Phillip & St James Residential Home for more information

This inspection was carried out on 14th November 2007.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The manager and staff continue to provide a relaxed and homely environment for individuals who live at St.Phillip & St James with a real sense that the needs of individuals are met with commitment and professional approach. One individual commented "the staff are always kind and patient and treat us as individuals". A real strength of the home is the stability of staff this has helped in staff working well as a team and having strong relationships with residents. An important aspect of the home is that individuals are able to exercise real choice in their daily routines and a number have maintained their links with the local community. One individual told me that they felt "this is very much my home and what`s good is that I don`t feel restricted in any way".

What has improved since the last inspection?

The last inspection identified the need to improve practice in completing and reviewing moving and handling assessments. Looking at records on this visit it was noted that practice in this area has improved.

What the care home could do better:

This inspection identified the need for the home to improve its practice in relation to quality assurance in the seeking the views of individuals in the home, relatives and professionals about the quality of the service provided. It is recognised that individuals in the home are able to express their views by talking with staff and the manager. However it is also important that individuals have an opportunity to formally state their views about the service they receive through the use of questionaires which ask them directly about their thoughts on the service they receive. This is particularly crucial in that the frequency of CSCI inspection have changed and such information will provide evidence of the quality of service and highlight any concerns about the service which may prompt an inspection.

CARE HOMES FOR OLDER PEOPLE St Phillips & St James Residential Home 9-10 Priory Road Keynsham Bath & N E Somerset BS31 2BX Lead Inspector Jon Clarke Unannounced Inspection 14th November 2007 09:30 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 Phillips & St James Residential Home DS0000008161.V352083.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 Phillips & St James Residential Home DS0000008161.V352083.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Phillips & St James Residential Home Address 9-10 Priory Road Keynsham Bath & N E Somerset BS31 2BX 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) 0117 9863505 NONE Mrs Patricia Elizabeth Clarke Mrs Patricia Elizabeth Clarke Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places St Phillips & St James Residential Home DS0000008161.V352083.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 18 persons aged 65 years and over requiring personal care only. 8th June 2006 Date of last inspection Brief Description of the Service: St.Phillip & St.James provide accommodation for up to 18 older people in single rooms all with en-suite facilities. All of the rooms except two are over 10 square metres; all are fitted with a call bell system. The home is two houses, which have been converted to provide a pleasant and spacious environment with attractive and accessible rear gardens with decking and seating area. There is one communal lounges, a dining room and conservatory. The home is situated a short distance from the amenities of Keysham. The homes philosophy of care: To provide a warm and welcoming home environment for residents and their visitors. To allow residents the chance to express their individuality and respect privacy, residents are encouraged to bring personal possessions and rooms are fitted with a lockable door or lockable cupboard. To allow residents the chance to continue to live as a life as they wish within a support the supportive environment of the home. Care plans are agreed with each resident and regularly reviewed. To provide good quality food and well-balanced meals and allow for individual preferences. To encourage social participation and maintain skills and interests regular activities are provided. St Phillips & St James Residential Home DS0000008161.V352083.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit to the home as part of an inspection the manager was present for part of the visit. As part of this inspection a number of documents were looked at including care plans, medication records and storage arrangements, staff records and those relating to health and safety practice in the home. There was also an opportunity to talk with individuals who live and work in the home. A number of Have Your say questionnaires were sent to the home before this visit replied were received from 5 residents and 5 relatives. As part of this inspection the manager completed a Annual Quality Assurance Assessment (AQAA) which set out the areas of practice based around the National Minimum Standards summarising what the home does well, the evidence for this, what they could do better and how they have improved in the last 12 months. The information from the AQAA and questionnaires have been used to help make a judgement about the quality of care provided in the home. What the service does well: What has improved since the last inspection? The last inspection identified the need to improve practice in completing and reviewing moving and handling assessments. Looking at records on this visit it was noted that practice in this area has improved. St Phillips & St James Residential Home DS0000008161.V352083.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. St Phillips & St James Residential Home DS0000008161.V352083.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 Phillips & St James Residential Home DS0000008161.V352083.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s Statement of Purpose provides the required information about the home, the facilities, staffing arrangements, admission procedure and aims and objectives of the home so that individuals can make an informed choice about the suitability of the home. The home undertakes full and comprehensive assessment of prospective residents so that they are able to make an informed decision about the capacity of the home to meet health and social care needs. EVIDENCE: The homes Statement of Purpose needs to provide information about the facilities following the changes made namely the removal of one lounge area. A number of pre-admission assessments were looked at and showed information about the health and social care needs. St Phillips & St James Residential Home DS0000008161.V352083.R01.S.doc Version 5.2 Page 9 Where individuals are known to the local authority a copy of the social services assessment is obtained. St Phillips & St James Residential Home DS0000008161.V352083.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care Planning and arrangements for meeting health care are generally good providing staff with the necessary information so that the health and social care needs of residents are met. Arrangements for managing resident’s medication make sure that resident’s health needs are protected. The practice of staff and policies of the home help to make sure that residents are treated with respect and their dignity is upheld. EVIDENCE: A number of care plans were looked at and showed a good level of information about the individual’s social and health care needs including personal hygiene, general health and general medication. Reviews held on regular basis and moving and handling assessments completed. Risk assessments are completed where necessary and identified risks for that individual. St Phillips & St James Residential Home DS0000008161.V352083.R01.S.doc Version 5.2 Page 11 Individuals who live in the home have good access to community based services such as chiropody, dental and optician. This was evidenced by care records seen and speaking to individuals who spoke of receiving these services. One individual said they “can see a doctor whenever we want if we need to see a doctor they always come quickly”. One individual was seen regularly by the district nurse and another by the diabetic nurse and had attending clinic for review of her diabetes. The arrangements for storage, managing and administering of medication was looked at. There are good systems in place to manage stocks of medication and storage is satisfactory however there is no separate secure storage for controlled drugs. This is now necessary under Drug & Misuse Act. Where an individual is self-medicating a risk assessment had been completed. Administering records were looked at and were satisfactory however the home must ensure all paracetamol given to individuals is recorded on the appropriate MARS record. In talking with individuals they spoke of how staff were always “respectful” “treat me well” “have no complaints about staff”. Individuals said they always felt able to do as they wished “I choose what I do”. A relative commented, “the staff treat residents with respect and in a caring manner”. Staff were observed assisting and talking with residents and always did so in a caring and supportive manner. St Phillips & St James Residential Home DS0000008161.V352083.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements for meeting the social and recreational needs of residents are good and there are opportunities for residents to maintain links with family, friends and the local community. The home’s practice and routines are flexible and enable residents to exercise choice and have control over their lives. The home provides meals, which are balanced and meet the dietary needs of individuals in the home. EVIDENCE: Individuals spoke of a range of activities available in the home including poetry reading, music, quizzes and cinema. A number of individuals are able to use the local facilities and regularly walk to the local shops and attend local clubs or church. Individuals spoke of their visitors always being “welcomed” “staff all very friendly”. A comment received said “a very happy caring home, very welcoming to relatives”. St Phillips & St James Residential Home DS0000008161.V352083.R01.S.doc Version 5.2 Page 13 When asked about meals in the home individuals were very positive about the choice of meals “there’s always something else if we don’t like what’s on”. Respondents to the questionnaire said they always or usually liked the meals at the home. Menus showed a good variety of meals available with emphasis on home cooked food. On the day of my visit the meal was well presented and there was a relaxed and comfortable atmosphere in the dining room with staff available to give assistance if required. A relative commented, “diet is very good all home cooked meals are nutritious and look appetising”. St Phillips & St James Residential Home DS0000008161.V352083.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has clear procedures in place and this enables individuals to make a complaint and voice their views about the service they receive and to know that they will be listened to and actions taken where necessary. The home makes sure that as far as possible residents are protected from harm by having policy and procedure about the Protection of Vulnerable Adults and providing training to all staff in this area. EVIDENCE: All respondents to the questionnaire said they knew how to make a complaint. I discussed this with a number of individuals asking what they would do if unhappy about anything all spoke of “always tell one of the staff” “talk to the manager” “always able to discuss anything with the manager”. Importantly there was a sense that something would be done and this was confirmed by people I spoke with “they always listen to what we have to say” “they would do something about it”. There have been no complaints made to the home since the last inspection. Staff have undertaken Adult protection training and the home has procedures in place if an individual were to make an allegation of abuse. St Phillips & St James Residential Home DS0000008161.V352083.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a safe and hygienic environment for the residents and staff. People who live and work in the home benefit from a warm, welcoming and well-maintained environment. EVIDENCE: There have been changes to the environment of the home since the last inspection in that an additional bedroom has been made of what was a communal lounge. One individual commented about this in that it reduced the space available. I discussed this with the manager who told me that the room had been left for some time as a lounge and was rarely if ever used by residents. The dining room is now a bigger space, armchairs have been placed in this area, in that the kitchen has been moved to what was previously a bedroom. St Phillips & St James Residential Home DS0000008161.V352083.R01.S.doc Version 5.2 Page 16 This has certainly improved the dining room space however it was noted that this is a rather cold area of the home due to the amount of glass and I raised this with the manager again an individual had spoken to me about the heating in this area of the home. In looking around the home there was good standard of decoration and the home was clean and free from offensive odours. Individuals spoke of the home “always clean and tidy” and all respondents to the questionnaire said the home was always fresh and clean. A relative commented that her relative’s “room and rest of home always kept extremely clean”. St Phillips & St James Residential Home DS0000008161.V352083.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): 27,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing arrangements in the home are generally satisfactory so that the needs of residents can be met in an efficient way with care being provided by skilled and competent staff. The recruitment and selection of staff is undertaken to make sure that as far as possible the health and welfare of resident is protected. EVIDENCE: Staffing rotas were looked at for a period of four weeks. They showed that there is a good level of staffing with 3 am, pm 3/2 with waking night. Individuals spoke of staff being “there if we want them” “I always get the help I need”. A real strength of the home is the retaining of staff and this was commented on by a relative: “keep staff and therefore staff know residents well” a staff member also said how staff changes were rare “so continuity flows”. A number of staff records were looked at and showed that they had received the required training: fire safety, moving and handling. A staff member commented in their returned questionnaire “I feel that I am offered a varied choice of training courses and regularly use the opportunity to further my professional knowledge”. St Phillips & St James Residential Home DS0000008161.V352083.R01.S.doc Version 5.2 Page 18 On the day of the visit the manager had attended a training session on palliative care and it is planned for other staff to attend this training. Application forms had been completed other then in one instance (this was discussed with the manager) Criminal Record Bureau checks had been obtained on all individuals and two references taken up. St Phillips & St James Residential Home DS0000008161.V352083.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): 33,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are limited opportunities for individuals who live in the home and others to formally express their views about the service they receive. The practices of the home help to make sure that the health, safety and welfare of residents and staff is protected. EVIDENCE: Individuals I spoke with confirmed that resident’s meeting are held in the home and one individual said, “they are useful we can raise any suggestions we may have”. Minutes of meetings were not available. The manager advised that no questionnaires had been issued to residents or others to get their views about the quality of the service provided in the home. Since the visit the home has advised that quality assurance questionaires will be issued every 6 months. St Phillips & St James Residential Home DS0000008161.V352083.R01.S.doc Version 5.2 Page 20 Following the visit the home provided evidence of fire safety training being carried out in August 07 and all staff have completed fire drills. A Fire Safety Risk assessment was carried out in September 07. St Phillips & St James Residential Home DS0000008161.V352083.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 3 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 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 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X X X X 3 St Phillips & St James Residential Home DS0000008161.V352083.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. 1 Standard OP33 Regulation 24 Requirement The manager to undertake quality review of the service provided and provide to the CSCI a report in respect of the review. (This refers to questionnaires being issued to residents and others about the quality of the service provided in the home and the report to outline the results, conclusions and any actions taken) Timescale for action 01/03/08 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 Phillips & St James Residential Home DS0000008161.V352083.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection South West Regional Office 4th Floor, Colston 33 33 Colston Avenue Bristol BS1 4UA 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. Extracts may not be used or reproduced without the express permission of CSCI St Phillips & St James Residential Home DS0000008161.V352083.R01.S.doc Version 5.2 Page 24 - 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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