Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 04/06/08 for St Quentin Nursing Home

Also see our care home review for St Quentin Nursing Home for more information

This inspection was carried out on 4th June 2008.

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.

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

People told us that they were happy living at the home. They said "quite happy here" and "am safe and secure". People receive good standards of care and support meeting their individual needs and choices. Healthcare needs are met by the home. Peoples` needs are assessed before they come to live at the home. Assessment of peoples` needs, gives confidence that staff are aware of their needs are andwill be able to meet them. People are encouraged to visit the home prior to them deciding to come and live there. Food is described as "excellent" and there is always a choice available. It is good that people have a choice of hot meal at each mealtime. The Home has an experienced Manager who provides appropriate and effective leadership. There is safe and thorough recruitment processes for staff, which safeguard people who live at the home. Knowledgeable and friendly staff provide care at the home.

What has improved since the last inspection?

We made a requirement at the previous inspection that care plans should provide staff with the information on how to respond to incidents of challenging behaviour. We found this requirement was met with good instructions available for staff on how to manage peoples` behaviour which may sometimes be `challenging`. Records for the receipt, administration and disposal of medicines had improved and demonstrated that medication is administered as prescribed by peoples` doctors. There has been a review of activities to ensure that they are suitable to meet the needs of people living at the home. A previous requirement made for wheelchairs to be appropriately maintained and for footplates to be used to prevent accidents or injury has been addressed. Improvement to the environment of the home is ongoing. At the time of our inspection windows were being painted and some were being replaced. Several bedrooms and corridors have been redecorated these are light and attractive. There is also a new floor in the main downstairs corridor. An assisted bath was being replaced in the downstairs bathroom enabling people who are more dependent to use it. We were also told that cleaners are provided seven days a week to maintain the high standard of cleanliness of the home. The home now has a fire evacuation plan that takes account of the individual needs of the people that live there to make sure that all staff know the type of support each person would require in such circumstances. We saw additional special door wedges that release when the fire alarm is activated, thus protecting people in the event of a fire.

What the care home could do better:

The registered person must ensure that hot water is available to all peoples` rooms at all times so that personal hygiene needs can be met and the risk of infection reduced. Staff are currently transporting hot water around the building which is a potential danger. The lack of hot water means that hand washing facilities are inadequate and do not protect from the risk of infection. Some hot water is too hot and puts people at risk from scalding. Peoples` choices must be explored and particularly their wishes in relation how frequently they wish to have a bath, so that their needs and choices can be met. All toilets and bathrooms should be identifiable and lockable to ensure that people`s independence, privacy and dignity can be met. There are also no locks on bedroom doors. When these are asked for they should be fitted.

CARE HOMES FOR OLDER PEOPLE St Quentin Nursing Home Sandy Lane Newcastle Staffordshire ST5 0LZ Lead Inspector Amanda Hennessy Unannounced Inspection 4th June 2008 11:00 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 Quentin Nursing Home DS0000026964.V365740.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 Quentin Nursing Home DS0000026964.V365740.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Quentin Nursing Home Address Sandy Lane Newcastle Staffordshire ST5 0LZ 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) 01782 662911 01782 620255 st.q@virgin.net St. Quentin Residential Homes Limited Angela Harrison Care Home 33 Category(ies) of Dementia (2), Old age, not falling within any registration, with number other category (33), Physical disability (4) of places St Quentin Nursing Home DS0000026964.V365740.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 2 DE(E) 33 PD over 60 years Date of last inspection 4th June 2007 Brief Description of the Service: St Quentin Nursing Home is registered for 33 people who require 24 hour nursing care. The home is a large detached property that has been extended to provide comfortable accommodation on two floors. A passenger lift provides access between the floors. There are two lounges and a dining room situated on the ground floor. The aim of St Quentin Nursing Home is to provide a high standard of nursing care provided by an experienced and competent team of staff. The home is set in approximately one acre of very pleasant gardens, a mile or so from the wide range of community facilities provided in the town of Newcastle-under-Lyme. There are adequate parking facilities. We did not see any information about fees charged in the service user guide seen during the inspection. A copy of the service user guide is available on the homes web site although the website information about fees refers to 2006-7. Readers of this report are asked to contact the service directly for information on fees charged. St Quentin Nursing Home DS0000026964.V365740.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. The means the people who use this service experience adequate quality outcomes. This unannounced inspection was carried out on one day by two Inspectors and an ‘Expert by Experience’. An ‘expert by experience’ is a person who, because of their shared experience of using services, and or ways of communicating, visits a service with us to help us get a picture of what it is like to live in or use the service. Our inspection commenced at 11:00 am. As it was unannounced neither the home nor the provider knew we were going. The manager was present throughout the inspection. Information for the report was gathered from a number of sources: We carried out a tour of the building and looked at records and documents. We had discussions with the manager and care staff plus visitors and people who live at the home to gain their views on what it is like to live in and receive care from this service. Some people were unable to communicate their views verbally to us so we used direct and indirect observation to inform the inspection process. Three people who live in the home were ‘case tracked’ this process involves establishing people’s experiences of living in the care home by meeting or observing them, discussing their care with staff, looking at care files, and focusing on outcomes of the care that they receive. Tracking peoples’ care helps us understand the experience of people who use the service The Proprietor was sent an “Urgent Action” letter due to concerns relating to the insufficiency of hot water at the home. Six good practice recommendations were made as a result of this inspection. What the service does well: People told us that they were happy living at the home. They said “quite happy here” and “am safe and secure”. People receive good standards of care and support meeting their individual needs and choices. Healthcare needs are met by the home. Peoples’ needs are assessed before they come to live at the home. Assessment of peoples’ needs, gives confidence that staff are aware of their needs are and St Quentin Nursing Home DS0000026964.V365740.R01.S.doc Version 5.2 Page 6 will be able to meet them. People are encouraged to visit the home prior to them deciding to come and live there. Food is described as “excellent” and there is always a choice available. It is good that people have a choice of hot meal at each mealtime. The Home has an experienced Manager who provides appropriate and effective leadership. There is safe and thorough recruitment processes for staff, which safeguard people who live at the home. Knowledgeable and friendly staff provide care at the home. What has improved since the last inspection? We made a requirement at the previous inspection that care plans should provide staff with the information on how to respond to incidents of challenging behaviour. We found this requirement was met with good instructions available for staff on how to manage peoples’ behaviour which may sometimes be ‘challenging’. Records for the receipt, administration and disposal of medicines had improved and demonstrated that medication is administered as prescribed by peoples’ doctors. There has been a review of activities to ensure that they are suitable to meet the needs of people living at the home. A previous requirement made for wheelchairs to be appropriately maintained and for footplates to be used to prevent accidents or injury has been addressed. Improvement to the environment of the home is ongoing. At the time of our inspection windows were being painted and some were being replaced. Several bedrooms and corridors have been redecorated these are light and attractive. There is also a new floor in the main downstairs corridor. An assisted bath was being replaced in the downstairs bathroom enabling people who are more dependent to use it. We were also told that cleaners are provided seven days a week to maintain the high standard of cleanliness of the home. The home now has a fire evacuation plan that takes account of the individual needs of the people that live there to make sure that all staff know the type of support each person would require in such circumstances. We saw additional special door wedges that release when the fire alarm is activated, thus protecting people in the event of a fire. St Quentin Nursing Home DS0000026964.V365740.R01.S.doc Version 5.2 Page 7 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 Quentin Nursing Home DS0000026964.V365740.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 Quentin Nursing Home DS0000026964.V365740.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 5 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can feel confident that their needs will be assessed in full prior to admission and that once they move into the home their needs will be met. Information about the home needs to be updated so that all required information is available to inform people when making their decision to live there. EVIDENCE: The home provides information to people about the services they offer. The service user guide is on display in the reception area, the Statement of Purpose is included within it. Both documents give an accurate picture of what people can expect from the service should they choose to live here. The service user guide on display did not include information about fees charged. The homes owner has told us since the inspection that it is usual practice to St Quentin Nursing Home DS0000026964.V365740.R01.S.doc Version 5.2 Page 10 include fees that they charge. There is a need to ensure that people living at the home or their representatives are aware of the most recent inspection report and the correct address of the Commission for Social Care Inspection should they need to contact us. People have an assessment of their needs undertaken by the manager before they come to live at the home. We looked at these assessments and found them to be comprehensively completed. The assessment of needs then forms the basis of the person’s plan of care, giving staff information about their care needs. Introductory visits and trial stays are encouraged by the home, ensuring that people have time to make decisions. People told us that they had visited the home before they had come to stay permanently, other people told us that their family had visited the home on their behalf. The home does not have people requiring intermediate care. St Quentin Nursing Home DS0000026964.V365740.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. 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. People can feel confident their healthcare needs will be met. The development of care planning to more fully include peoples needs, choices and capabilities will give additional confidence that their care will continue to be met. Medication practices within this home are generally satisfactory and promote the well-being of the people who live there. EVIDENCE: We found that people have a plan of care that gives staff information on how people’s needs should be met. We did discuss a need to further develop plans to more fully highlight people’s individual needs and choices. One example of this was that all care plans seen identified “ weekly bath.” When we spoke to staff and questioned them about the sufficiency of a weekly bath and ensuring St Quentin Nursing Home DS0000026964.V365740.R01.S.doc Version 5.2 Page 12 that peoples’ wishes are taken into account they stated: “We do try and accommodate another bath if we have the time”. The need for people to have to ask for an additional bath is not good practice. We have since been informed by the home’ s proprietor that a weekly bath is the minimum rather than the maximum. There is a need for care plans to demonstrate that people living in the home have been involved in agreeing the content of their plan of care and preferences about their care. We found that people living at the home are well dressed and there was no evidence of food staining showing that staff are alert to personal care and dignity needs. People have access to a wide variety of healthcare professionals as their needs dictate. Doctors regularly visit the home, people who use the service confirmed this they told us “whenever I am ill they call the Doctor for me” Relatives told us “ we are always kept informed of how they are”. Medication practices throughout the home are safe and protect the people living there. The home orders medication on a weekly basis and ensures that repeat prescriptions are ordered before medicines run out. Weekly ordering rather than monthly ordering is more time consuming and can be problematic, but we found that staff ensure there are no problems with medicine supply using this weekly medication ordering system. Staff do not check the accuracy and content of prescriptions before they are sent from the Doctor to the Pharmacist. This is contrary to advice of the Royal Pharmaceutical Association to ensure that appropriate safeguards are in place and the home fulfils its responsibility to undertake this task. It was positive to see that staff appropriately sign to confirm that medicines have been given and that they record all medicines received into the home and disposed of. The Manager checks the amounts of medicines regularly, increasing confidence that systems are in place to ensure that people have had their medicines as they have been prescribed. Staff carry out regular checks on the temperature of the medicines fridge to make sure that medicines are stored within required temperatures for their safety. We highlighted the need to check the room temperature where medication is stored to make sure that the recommended storage temperature is not exceeded. We saw that people were treated respectfully and spoken to politely throughout the inspection. Staff were courteous and knocked on doors before they entered taking care to maintain peoples’ dignity. A good practice recommendation made at our previous inspection for locks to be available on all toilet doors has not been addressed. We discussed this with the Manager and suggested that a sign with “vacant” on one side and “engaged “ on the other would enable staff to come and go when needed, but would reduce the risk of other people entering the toilet when it was in use. St Quentin Nursing Home DS0000026964.V365740.R01.S.doc Version 5.2 Page 13 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 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live at the home have the opportunity to take part in a range of activities, maintain relationships with friends and relatives and are provided with a choice of tasty and generously portioned meals. EVIDENCE: The home has a member of staff who organises activities and has an activity plan. Activities are arranged for both individuals and small groups. The home has a library available the Activity Organiser told us : “it is difficult to get the residents to read for any length of time as their attention soon fades” and although there are some “talking” books they are not popular. St Quentin Nursing Home DS0000026964.V365740.R01.S.doc Version 5.2 Page 14 We were told about activities available, painting was proving to be the most popular. Other activities include: board games such as dominoes, draughts and frustration, magnetic darts and bingo. Trips out are organised and include visits to the Brampton (a local park) and visits to town. In August a trip to a wild life project near Leek has been arranged. People also have a slide show four times a year showing slides of local parks, which is enjoyed and stimulates memories. The local evening paper (The “Sentinel”) is delivered and staff discuss the newspaper with people. People can also have their own newspaper delivered at additional cost. We were told that the home is able to meet the spiritual needs of the main Christian denominations. A Church of England service is held monthly. People are able to choose where or how they spend their day. People told us that they spend their time either in one of the three lounges or their bedroom. People can choose whether to join in with activities or not. Discussions with people that live within the home showed that they could choose when to go to bed and that staff always ask them when they wanted to get up. We did however find that people might not always have a bath when they would like one. We were told that visitors are welcome at anytime. One relative we spoke to confirmed that she visited everyday. The home has a menu offering a hot option at breakfast dinner and tea. We were invited to have lunch with people living at the home. About half of the people came into the lounge for their lunch, whilst others stayed in the lounge in their armchairs and were fed by staff there. Tables in the dining room were attractively presented with tablecloths, cruets and cutlery. Lunch was unhurried. We saw staff supporting people to have their meal and this was done in a relaxed and sensitive manner. Hot drinks are provided several times throughout the day and evening. We were told that a hot drink and a biscuits were available about 7pm but this was the last drink/ snack of the day. People do not have anything else until 8 am the following day. This needs to be addressed, as it is not acceptable for people to have a gap of more than twelve hours from the last meal of the day and breakfast the following day. St Quentin Nursing Home DS0000026964.V365740.R01.S.doc Version 5.2 Page 15 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 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service can feel confident the home will listen to their concerns and act upon them. They can also feel assured the home will act in their best interests and protect them from abuse. EVIDENCE: The home has a complaints policy and procedure. People can find the complaint procedure in the Service User Guide and also displayed in the home. The home has received one complaint since our previous inspection. There was a record of the complaint and a record of ongoing discussions with the family concerned and agreed actions that the home would take. People that we spoke to said they would discuss any concerns that they had: “with the Matron”. Staff we spoke to said that they would highlight any concerns that they had to the Matron or the Nurse. It was also positive that all staff have recently had a St Quentin Nursing Home DS0000026964.V365740.R01.S.doc Version 5.2 Page 16 training session in “Safeguarding” to protect people living at the home. The home has both its own “safeguarding” policy and also a copy of the Local Authority guidance. There have been two incidents when the home has raised concerns with the local Adult Protection team. These incidents were not upheld but show that the home acts proactively to respond to any concerns and protects people living within it. We found people who required bed rails have their needs assessed and this assessment is recorded and regularly reviewed. Good and appropriate risk assessments give greater confidence that risk is minimised and that people are protected from accident. St Quentin Nursing Home DS0000026964.V365740.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 25 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People live in a pleasant, clean and comfortable home but insufficient hot water and hot water that is too hot compromises peoples’ safety and comfort. EVIDENCE: The home is a large, extended, detached property that is clean and homely. It is set in large and pleasant grounds, which have both grassed and paved areas with garden furniture where people can sit if they wish to. There are steep steps to the front entrance, although the Manager did tell us that there is level access at the back of the home. We recommended that access for people with mobility difficulties is signposted, particularly as not all people are familiar with the home. St Quentin Nursing Home DS0000026964.V365740.R01.S.doc Version 5.2 Page 18 The home is generally well maintained and there is an ongoing refurbishment plan. We found that there was a considerable amount of work being undertaken at the time of our inspection. This included the replacement of some windows and improved facilities for more dependent people in one bathroom. The hallway has recently been decorated and had a new floor. There are two large lounges and a separate dining room, which are suitably furnished and decorated. Bedrooms are on the both the ground and first floor, with two passenger lifts to access the first floor. There are now only two double rooms. Other double rooms are used for single occupancy. The double bedrooms have a privacy screen provided. One bedroom has en-suite facilities. Bedrooms have been personalised with ornaments, small items of furniture and family photographs. Bedroom doors are not lockable although the home owner did tell us that people can have a door lock fitted if they ask for one. There are bathing and toilet facilities suitable for dependent people throughout the home. Our previous inspection highlighted that some of the toilets downstairs do not have a lock so people cannot lock the door when they use the toilet. It was also highlighted that toilets are not clearly marked. We found that neither the door locks nor the signage for the toilets have been addressed. The home provides people with a range of equipment to support them to be as independent as possible. The baths are fitted with hoists and there is a range of grab and hand rails around the building. Hoists are available for moving people safely. Concerns made at the previous inspection about the poor condition of some wheelchairs and the lack of wheelchair footplates have been addressed. A staff call system is available throughout the home. There has been an ongoing problem with the hot water at the home. We were told and records that we saw identified that some rooms do not always have hot water whilst the water in others is too hot. This has been the situation at our previous two visits. The owners have previously written to us and told us the difficulties that they have found with the hot water since they have owned the home and that required work will be a major upheaval to people living at the home. We sent the home’s proprietor a urgent action letter asking them for independent professional assurance that people are protected from the risk of scalding and have hot water to wash and bathe when they need it, they have sent us this confirmation. We feel that the home needs to seek a long term solution to the hot water problem in the home and a recommendation has been given to the home highlighting this. We were told that when hot water is not available that staff take bowls of hot water to people’s room in order for them to have a wash. The home is clean throughout. The service has increased its domestic staff so that staff are provided everyday. The home has good arrangements for the St Quentin Nursing Home DS0000026964.V365740.R01.S.doc Version 5.2 Page 19 laundering of people’s clothing and linen. Sluice cycles on washing machines ensure that linen is washing a disinfection temperatures further protecting people from the risk of infection. We were told that the laundry was due to be painted which will mean that the walls can be more easily cleanable. Staff were observed to use gloves and aprons to complete personal care tasks. The lack of hot water throughout the home means that staff may not always be able to effectively wash their hands to minimise the risk of cross infection. St Quentin Nursing Home DS0000026964.V365740.R01.S.doc Version 5.2 Page 20 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 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Sufficient, knowledgeable and well-trained staff are provided to meet peoples’ needs. Recruitment practices can be further improved to protect people from unsuitable people working at the home. EVIDENCE: The home is staffed with appropriate numbers and skill mix to meet people’s needs. Staff we met spoke positively about support and training they receive and were knowledgeable about peoples’ needs. We also observed good interaction between staff and people living at the home. People were very complementary about the staff and told us: “They are very good”. The Manager told us that staff are supported to undertake a care qualification (minimum of National Vocational Qualification level 2) with 75 of care staff having a care qualification. This gives confidence that staff are knowledgeable and understand peoples’ care needs. St Quentin Nursing Home DS0000026964.V365740.R01.S.doc Version 5.2 Page 21 Staff recruitment and selection is generally completed to the required standard. Some staff are employed following a protection of vulnerable adults check before their criminal records check is received. It is recommended that a risk assessment be undertaken to give assurance that the risk of unsuitable people working at the home is minimised as this is not currently undertaken. We were told that new staff have, induction training with an external training provider that meets the “Skills for Care” standards. No records of the completion of staff induction were available in any files seen. We advised the manager that she needed to do this. St Quentin Nursing Home DS0000026964.V365740.R01.S.doc Version 5.2 Page 22 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, 36 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has good management systems in place although the longstanding insufficiency of hot water compromises people living there. EVIDENCE: The manager has worked at the home for fifteen years, five of which in her role as manager. The manager is a qualified nurse and has undertaken training to ensure her nursing knowledge and skills are kept up to date. She was fully aware of the needs of the people that lived there and provides good support to St Quentin Nursing Home DS0000026964.V365740.R01.S.doc Version 5.2 Page 23 the staff. She does not currently have a management qualification. People told us that they found the Manager approachable: “we can talk to Angela about anything”. There are good systems in place to support the staff. Regular staff meetings take place and staff supervision is also undertaken regularly. We looked at the system the home has to monitor quality and improve the service provided to the people that live there. We were told that surveys are sent to people living at the home and their relatives every six months to seek their views on what it is like to receive the service. We were told that people are sent different surveys at different times, dependent on how long they had been living there. For example; new people were sent a questionnaire asking about them about coming to live at the home. We discussed the surveys that we were shown with the Manager. It was evident from discussion with her that she had looked at all comments and clarified any information as and when required. No report is undertaken of her findings that can be shared, identifying good practice issues at the home. We gave a recommendation that the views of significant others such as health and social care professionals should be sought a part of the homes Quality Assurance system. This has not been addressed. Staff do not manage any person’s personal allowance but look after small amounts of money on their behalf. Sampling showed that suitable records were being kept with receipts supporting expenditure. We did advise however that there was a need for two signatures to confirm the transaction, one of whom, whenever possible, should be the person whose money it is. Balances we checked were all found to be correct. We looked at staff training in health and safety and other required areas. The home ensures that all staff receive training as and when they need it. All maintenance contracts seen were up to date. We saw records of the home’s hot water temperatures and, as already highlighted within the environment section of this report, we identified concerns about the lack of hot water available. The homes’ records highlighted deficiencies in hot water: they stated that eight bedrooms had “no hot water”. There were eleven bedrooms where the hot water temperature was lower than the required guidelines. Two baths had hot water temperatures of 35oC, which is lower than guideline temperatures. Two bedrooms (rooms 4 and 28) had hot water at 48oC, which is too hot and puts people at risk of scalding. There has been a longstanding requirement since 4/2/07. We randomly checked fire system, fire drill and training records and were satisfied these are being maintained to protect the people living at the home. St Quentin Nursing Home DS0000026964.V365740.R01.S.doc Version 5.2 Page 24 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 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x 2 2 STAFFING Standard No Score 27 3 28 4 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 2 3 x 2 St Quentin Nursing Home DS0000026964.V365740.R01.S.doc Version 5.2 Page 25 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. 1. 2. 3. Refer to Standard OP7 OP9 OP10 Good Practice Recommendations Care plans should be developed to more fully identify the person’s individual needs, choices and capabilities. Prescriptions from peoples’ doctors should be returned to the home to check their accuracy before being sent to chemist for dispensing. All toilets and bathrooms should be identifiable and be lockable to aid people’s independence and to improve the level of privacy available. The service should provide bedrooms that are lockable to increase people’s choices and to improve their privacy There should be a long- term solution to the hot water problem at the home. Staff employed on a Protection Of Vulnerable Adults (POVA) first list check should have a risk assessment to give assurance that the risk from the employment of DS0000026964.V365740.R01.S.doc Version 5.2 Page 26 4. 5 6. OP24 OP25 OP29 St Quentin Nursing Home unsuitable people is minimised. St Quentin Nursing Home DS0000026964.V365740.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 Quentin Nursing Home DS0000026964.V365740.R01.S.doc Version 5.2 Page 28 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!