This inspection was carried out on 20th July 2005.
CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.
The inspector made no statutory requirements on the home as a result of this inspection
and there were no outstanding actions from the previous inspection report.
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 20 July 2005 09:30
th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. St Phillips & St James Residential Home D56_D05_S8161_stphillips&stjames_V235145_010705_Stage2.doc Version 1.30 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 0117 9863505 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Patricia Elizabeth Clarke Mrs Patricia Elizabeth Clarke PC Care home 18 Category(ies) of OP Old age (18) registration, with number of places St Phillips & St James Residential Home D56_D05_S8161_stphillips&stjames_V235145_010705_Stage2.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: May accommodate up to 18 persons aged 65 years and over requiring personal care only. Date of last inspection 21-Feb-2005 Brief Description of the Service: St.Phillip & St.James provide accomodation for up to 18 older people in single rooms some 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 newly installed decking and seating area. There are two communal lounges, a dining room and conservatory. The home is situated a short distance from the amenties 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 regualar activities are provided.
St Phillips & St James Residential Home Version 1.30 Page 5 D56_D05_S8161_stphillips&stjames_V235145_010705_Stage2.doc SUMMARY
This is an overview of what the inspector found during the inspection. Thus unannounced inspection took place over one day during which the manager and deputy manager were present. Documents including care plans, assessments and medication records were seen. A number of residents were also ‘ interviewed’ to get their views of the quality of life at the home. What the service does well: What has improved since the last inspection? What they could do better:
A significant failure is in the recording of prescribed medication given to residents. In looking at the administering records they showed there were a
St Phillips & St James Residential Home D56_D05_S8161_stphillips&stjames_V235145_010705_Stage2.doc Version 1.30 Page 6 large number of gaps. The home is failing to make sure that the administering of prescribed medication is recorded on every occasion and this represents a risk to residents because there is no evidence that their health needs are being fully met with regard to prescribed medication. Care plans need a more consistent approach because there were some areas which had not been completed ie Moving & Handling assessments. 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 Phillips & St James Residential Home D56_D05_S8161_stphillips&stjames_V235145_010705_Stage2.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection St Phillips & St James Residential Home D56_D05_S8161_stphillips&stjames_V235145_010705_Stage2.doc Version 1.30 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 Assessments are obtained on individuals admitted to the home this gives them information about their care needs so that they can provide the necessary care and make a judgement about whether they can meet the identified care needs. EVIDENCE: Assessments are provided by the local authority about the health and social care needs of perspective residents. This includes information about the wishes of the individual or their carer. Where there are mental health needs the views of the mental health team are included in the assessment. St Phillips & St James Residential Home D56_D05_S8161_stphillips&stjames_V235145_010705_Stage2.doc Version 1.30 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,9 Care Plans fail to provide the necessary information about the individual’s care needs and potentially place the resident at risk because staff may not have all the information they need to provide safe care. The administering of medication is not always recorded to the standard required potentially placing residents at risk. EVIDENCE: Care plans did not always have moving and handling assessments. Risk assessments are undertaken particularly where individuals are looking after their own medication. Reviews are held. Included are daily routines and personal history as well as details about ability and assistance needed by the individual. Medication administering records were not fully completed. Storage of medication was satisfactory. Individuals where able can manage and be responsible for their own medication. St Phillips & St James Residential Home D56_D05_S8161_stphillips&stjames_V235145_010705_Stage2.doc Version 1.30 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13 The home provides opportunities for the social, recreational and religious needs of residents to be met. Residents are able to exercise choice and control over their daily lives. Links with the community are good and resident’s social needs are met. EVIDENCE: Where able residents attend a local church and a multi-faith service is held monthly in the home. On the day of this inspection a number of residents were taken out by a member of staff these trips take place on a regular basis. A member of staff undertakes activities with residents including exercise, crafts. When asked about activities in the home residents stated there was enough going on in the home. Residents spoke of the flexibility of the home and that they didn’t feel there were any fixed “routines” other then mealtimes. They were able to chose how they spent their day “I am able to do what I like don’t feel I have to do anything”. When asked about getting up and going to bed a resident said “its up to me”. The home recognises the importance of residents maintaining contact with family and friends. A relative said they were always made to “feel welcome”. Residents are actively encouraged to keep their links with the community. St Phillips & St James Residential Home D56_D05_S8161_stphillips&stjames_V235145_010705_Stage2.doc Version 1.30 Page 11 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 The home has a satisfactory complaints procedure and residents feel they are able to make a ‘ complaint ‘ be listened to and something will be done in response to any dissatisfaction or complaint. EVIDENCE: The homes complaint procedure sets out in a clear way how complaints will be dealt with and the timescales. It also advises how individuals may register their complaint with the CSCI if they wish. Residents confirmed that they felt able to say if they were unhappy about anything “ would tell Pat” (manager) “ sure they would listen” “would definitely say something”. Residents were very positive about the home in that they all felt that the staff and manager were approachable and none felt unable to express how they felt. St Phillips & St James Residential Home D56_D05_S8161_stphillips&stjames_V235145_010705_Stage2.doc Version 1.30 Page 12 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 The standard of the décor and general environment is good providing residents with a homely and comfortable place to live. EVIDENCE: In looking around the home it was evident that the standard of maintenance is good. The installation of decking has improved access to the rear garden and provided a pleasant and attractive seating area. The home provides a pleasant and “homely” & “very peaceful” environment for residents with a relaxed atmosphere. The home was clean and free from offensive odours. St Phillips & St James Residential Home D56_D05_S8161_stphillips&stjames_V235145_010705_Stage2.doc Version 1.30 Page 13 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 There is adequate staffing who are committed to working with residents to maintain and improve their quality of life. EVIDENCE: Staffing rotas showed that the necessary staff are on duty at all times to meet the needs of residents. Staff have the required mandatory training such as moving and handling, fire health & safety. Residents said they felt “safe” and commented on the “friendliness” and “always helpful” staff. St Phillips & St James Residential Home D56_D05_S8161_stphillips&stjames_V235145_010705_Stage2.doc Version 1.30 Page 14 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These key standards will be looked at the next inspection. EVIDENCE: St Phillips & St James Residential Home D56_D05_S8161_stphillips&stjames_V235145_010705_Stage2.doc Version 1.30 Page 15 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x
COMPLAINTS AND PROTECTION 3 x x x x x x x STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x x x x x St Phillips & St James Residential Home D56_D05_S8161_stphillips&stjames_V235145_010705_Stage2.doc Version 1.30 Page 16 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 7 Regulation 15 (2) Requirement Timescale for action From 20/07/05 2. 9 13 (2), 4(c), 12 (1a,b,) Ensure all elements of individuals care plan is completed specifically Moving & Handling assessments and where necessary risk assessments. Ensure medication administering From records are fully completed. 20/07/05 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. Refer to Standard Good Practice Recommendations St Phillips & St James Residential Home D56_D05_S8161_stphillips&stjames_V235145_010705_Stage2.doc Version 1.30 Page 17 Commission for Social Care Inspection 300 Aztec West Almondsbury South Glos BS32 4RG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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