Inspection on 11/07/06 for St Vincent House

This inspection was carried out on 11th July 2006.

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.

Other inspections for this house

St Vincent House 28/05/08

St Vincent House 13/02/06

St Vincent House 21/07/05

St Vincent House 25/01/05

St Vincent House 07/07/04

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

CARE HOMES FOR OLDER PEOPLE St Vincent House Forton Road Gosport Hampshire PO12 4TH Lead Inspector Michael Gough Unannounced Inspection 11th 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 Vincent House DS0000011868.V300437.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 Vincent House DS0000011868.V300437.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Vincent House Address Forton Road Gosport Hampshire PO12 4TH 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) 023 9235 1668 St Vincent Care Homes Limited Mrs L Lawrence Care Home 34 Category(ies) of Dementia (13), Dementia - over 65 years of age registration, with number (26), Old age, not falling within any other of places category (34), Physical disability (16), Physical disability over 65 years of age (16) St Vincent House DS0000011868.V300437.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users in the categories DE and PD must be at least 55 years of age 13th February 2006 Date of last inspection Brief Description of the Service: St Vincent’s House is a large well maintained detached house set in its own grounds; the house is a grade II listed building and has a large enclosed rear garden. There is parking at the front of the building. The home is registered with the Commission for Social Care Inspection (CSCI) to provide residential care for up to 34 older people 26 of which may be suffering from age related mental health problems. There are 22 single rooms and 6 double rooms and the house is situated on the main road into the town centre of Gosport and is close to local amenities. Fees at the home range from £386 to £465 per week and on the day of the inspection there were 33 service users living at the home. St Vincent House DS0000011868.V300437.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 5.5 hours and was unannounced. The inspector was assisted by the homes deputy manager and also the registered manager throughout the inspection. Evidence for this report was obtained by speaking with 12 service users, 6 members of staff and from 3 visitors to the home. Further information was gathered from reading and inspecting records, touring the home and from observing the interaction between staff and service users. What the service does well: What has improved since the last inspection? What they could do better: The homes medication policy needs to be updated to accurately reflect the procedures carried out at the home and this will benefit service users. An area outside the home which leads to the garden has been placed out of bounds due to some corrosion of metal grills which cover drops to the basement level, these have been sectioned off with red and white coloured tape, but this is insufficient to prevent service users gaining access to this area and more secure and robust barriers need to be put in place to fully protect service users, a clear risk assessment needs to be put in place and the grills need to be inspected and repaired. There was an issue with the hot water supply to some areas of the home, however, the proprietors were having this investigated by an engineer and St Vincent House DS0000011868.V300437.R01.S.doc Version 5.2 Page 6 remedial work is due to commence shortly and this issue will be followed up at the next inspection of the home. The home needs to develop further its supervision procedures for all staff at the home to allow management to brief staff and for staff to give direct feedback, this will provide good communication which will benefit service users, staff and managers and help in the smooth running of the home. Health and safety issues were discussed and the home needs to obtain an in date certificate for the homes gas appliances. 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 Vincent House DS0000011868.V300437.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 Vincent House DS0000011868.V300437.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area is “good”. This judgement has been made using available evidence including a visit to the service. New service users have a needs assessment undertaken prior to moving into the home this allows both the home and the service users to see if the home can meet the service users needs. The home does not provide intermediate care. EVIDENCE: The manager or her deputy carries out an individual needs assessment prior to service users moving into the home, the home use an assessment form to obtain relevant information about any potential new service user. Social services also carry out assessments for any service user who is funded by the local authority. Assessments were on file at the home. Intermediate care is not provided by the home. St Vincent House DS0000011868.V300437.R01.S.doc Version 5.2 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 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 the service. The health, personal and social care needs of service users are set out in an individual plan of care, which give details of the care to be provided and also gives details on how this care should be given, however risk assessments in care plans would benefit from further information on how to minimise any identified risks. Service users are registered with a number of GP’s and are able to keep their own GP if possible and this benefits service users. The home ensures that all service users have access to all relevant health care professionals and the health care needs of service users are met. Service users are generally protected by the home policies and procedures for dealing with medicines, however the homes “in house” medication policy does not give clear information to staff on the procedure to be followed with regard to controlled drugs and this could be detrimental to service users. Service users at the home are treated with dignity and respect and their right to privacy is upheld. St Vincent House DS0000011868.V300437.R01.S.doc Version 5.2 Page 10 EVIDENCE: Care plans were seen for 3 service users and these were clear and easy to follow and contained relevant information and informed staff of individual needs and how these should be met. Care plans contained risk assessments and identified risks as “high, medium or low” however these risk assessments would benefit from further information on how to minimise any identified risks. Service users at the home are registered with a number of different GP’s and they may keep their own GP if they wish. Dental checks are arranged through a local health centre, although some service users have their own dentist in the local area. Gosport War Memorial Hospital is able to provide hearing tests and foot care with GP referral if treatment is required. 2 service users who are diabetic are aware they can receive free podiatry treatment through the NHS but choose to use the visiting chiropodist. A visiting optician service provides eye care and the home has a visiting chiropodist who calls once per month. The home has a policy for the receipt, storage, return and administration of medication and medication records inspected were clear and up to date. The home has controlled drugs (CD) (tempazepam) for 2 service users and these were kept in a locked cabinet inside a locked room and security appeared adequate. All medication including CD’s were provided to the home through the local pharmacist and these are contained within blister packs. The home also has a controlled drug book where a clear record of CD medication is recorded. 2 signatures are obtained for CD’s. However the home’s medication policy must be amended to ensure that the policy reflects the actual practice carried out within the home. Any medication for disposal is placed in a container and this is recorded. Medication is returned to the pharmacist and signatures are obtained. Service users spoken to were happy with the care they receive at the home and those spoken to said that staff were very helpful and friendly they stated that they were always treated with dignity and respect. It was clear through observations made by the inspector that service users and staff get on well together and staff were observed interacting with service users and were seen to treat service users with dignity and respect. Staff were seen to use service users preferred form of address when talking to service users. St Vincent House DS0000011868.V300437.R01.S.doc Version 5.2 Page 11 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 “good”. This judgement has been made using available evidence including a visit to the service. The home provides a range of activities for service users, which meets their expectations and the religious and recreational interests of service users at the home are provided for. Service users are able to maintain contact with family and friends and visitors are welcome at any time. Service users are supported to exercise choice and control over their lives and are provided with a wholesome and balanced diet in pleasant surroundings at a time convenient to them. EVIDENCE: Care plans for service users contained daily living routines and service users likes and dislikes. On the day of the inspection there was an arts and crafts session taking place and the lady who arranges this calls 3 times per week. The inspector had the opportunity to speak with a group of 6 service users who were taking part and they all stated that they were happy with the activities provided by the home. The home has an activities co-ordinator and activities provided include musical movement, games, scrabble, trips out (there is a trip on booked for Thursday 13 July) and visiting entertainers. The local library provides a visiting service to the home. Some service users like to spend time on their own while others like to watch TV. The home has an activities file, St Vincent House DS0000011868.V300437.R01.S.doc Version 5.2 Page 12 which gives details of what activities have been provided and who took part. Other service users spoken to were happy with the activities provided. The home has a visiting policy and there are no restrictions on visitors. They are encouraged to stay and have a meal with relatives and are invited to social gatherings held in the home. The inspector had the opportunity to speak with 3 visitors to the home and they all stated that they were always made very welcome and were happy with the home. Service users spoken to were able to confirm that they are able to make informed choices and were able to control their own lives as much as possible. The manager stated that a local vicar visits the home on a regular basis and service users can choose to attend if they wish. The inspector observed staff and service users interacting and service users were consulted regularly and the staff at the home respected their views. Staff were observed knocking on service users doors before entering and a number of service users had bought some of their own possessions into the home and rooms had been personalised. The home operates a four-week rolling menu and service users are offered a choice at meal times and are able to eat their meals in the dining room or elsewhere if they prefer. Staff was observed consulting residents about the choices available and all service users spoken to stated that the food was good and that portions were ample. Staff were observed supporting service users at meal times and service users spoken to stated that there were sufficient staff around to help if needed. The environmental health officer last visited on 13 May 2005 and the home obtained a Silver award. St Vincent House DS0000011868.V300437.R01.S.doc Version 5.2 Page 13 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 “good”. This judgement has been made using available evidence including a visit to the service. There is a simple, clear and accessible complaints procedure, which includes timescales for the process and any complaints are logged and responded to appropriately and the home is committed to the protection of its service users. EVIDENCE: The inspector has visited the home on 3 separate occasions and has always found the homes policies and procedures with regard to complaints and adult protection to be in order. There have been no complaints made and no adult protection issues brought to the attention of the Commission for Social Care Inspection; therefore there is no evidence to suggest that there are any concerns in these areas. Service users spoken to during the inspection had no concerns and knew how to make a complaint. St Vincent House DS0000011868.V300437.R01.S.doc Version 5.2 Page 14 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, 21 & 26 Quality in this outcome area is “Adequate”. This judgement has been made using available evidence including a visit to the service. Service users generally live in a safe and well-maintained environment and have access to comfortable indoor and outdoor facilities, however more robust barriers are required to prevent service users walking on grills, which cover drops to the basement and that have been tapped off, as this could be a potential hazard for service users and a clear risk assessment is also required. Service users at the home have sufficient and suitable lavatories and washing facilities, however the hot water supply to some areas of the home needs to be improved as this is detrimental to service users and staff. The home was clean, pleasant and hygienic and free from offensive odours. EVIDENCE: A tour of the building was undertaken and the home was clean throughout with no unpleasant odours. Furniture in the home was in a satisfactory state of repair, communal areas were well lit and service users spoken to were happy St Vincent House DS0000011868.V300437.R01.S.doc Version 5.2 Page 15 with the facilities available. Service users have access to comfortable indoor and outdoor communal facilities and service users were seen to be using both the communal lounge and the conservatory in the home and these were bright and airy. There is an area outside the home which leads to the garden that has been placed out of bounds due to some corrosion of metal grills which cover drops to the basement level, these have been sectioned off with red and white coloured tape, but this is insufficient to prevent service users gaining access to this area and it is a requirement that more secure and robust barriers are put in place to fully protect service users, a clear risk assessment is required and the gills need to be inspected and repaired. A maintenance man carries out routine maintenance and the home is decorated on a needs led basis. There were some areas of the home where at times there is no hot water supply, the homes defect book showed that this has been recorded on 3 separate occasions, this has been an ongoing problem that the home has been trying to rectify and, the proprietors have had this investigated by an engineer and remedial work is due to commence shortly to sort out this problem and this issue will be followed up at the next inspection of the home. The laundry at the home is operated by dedicated laundry staff and has an industrial tumble drier and washing machine with sluice programmes. Any soiled laundry is brought down in yellow bags so that it is clearly identified. St Vincent House DS0000011868.V300437.R01.S.doc Version 5.2 Page 16 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 “good”. This judgement has been made using available evidence including a visit to the service. The home has mix of staff that has a range of skills and there were sufficient numbers of staff on duty to meet the needs of service users. Service users benefit from a staff team that has had sufficient training to meet the needs of service users and are competent and qualified. The homes recruitment policy and practice supports and protects service users. EVIDENCE: The homes staff rota was examined and this showed that the home provides 6 care staff on duty between 0800 – 1400, 5 care staff on duty between 1400 – 2000 and 3 care staff on duty between 2000 – 0800, staffing numbers vary at different times of the day to meet service users needs. The home also employs 2 x cooks and dedicated domestic staff. In addition there is the homes manager and her deputy. The home has 7 staff that has already obtained their NVQ qualification or equivalent, with 3 staff members currently undertaking this qualification. The home has policies and procedures in place with regard to recruitment and staff recruitment records were inspected for 3 staff members and these contained all the required information. Staff training records were not available as the person responsible for maintaining the records was unavailable and these will be inspected fully at the next inspection, however there have been no concerns regarding staff training in the past. There was information that training is provided for Health and St Vincent House DS0000011868.V300437.R01.S.doc Version 5.2 Page 17 Safety, fire, medication, moving and handling, first aid, adult protection, food hygiene, infection control, principles of care and communication. Staff spoken to confirmed that they had received training and they were confident that they could meet the needs of service users. The home has a new induction and foundation training booklet, which covers care practice and principles of care and is linked to NVQ. St Vincent House DS0000011868.V300437.R01.S.doc Version 5.2 Page 18 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, 33, 35, 36 & 38 Quality in this outcome area is “Good”. This judgement has been made using available evidence including a visit to the service. Overall the home is run in the best interests of service users and the homes manager is experienced, of good character and is able to effectively run the home. The home has a quality assurance monitoring system to obtain the view of service users at the home and this benefits both the home and its service users. The home accounting and financial procedures safeguard service users and service users financial interests are protected and they control their own money wherever possible. All staff at the home do not receive supervision on a formal basis and this could be detrimental to staff and service users. The health, safety and welfare of service users and staff are generally promoted and protected, however the home needs to obtain a safety certificate for gas appliances at the home. St Vincent House DS0000011868.V300437.R01.S.doc Version 5.2 Page 19 EVIDENCE: The manager is experienced and has been at the home for 10 years and she has completed NVQ4 and the registered managers award, she also has a deputy who has considerable experience and has a dedicated management role. The manager has introduced a new induction and foundation training booklet for new staff, which covers care practice and principles of care and care plans are good and have been developed to give the information required to meet the needs of individuals at the home. Relatives spoken to stated that they found the manager and her deputy very approachable and felt that they could raise any issues with them and get a clear explanation of what was going on in the home. Service users and staff spoken to stated that the manager and her deputy were always available for advice and felt they could speak with them at any time. The home has developed a questionnaire to give to service users and any visitors to the home and they also speak directly to relatives and service users to ascertain how the home is meeting its aims and objectives. The home also has a large number of cards and letters from satisfied relatives. Service are able to control their own finances as much as possible with the help of relatives and friends and the home does not keep money for service users, any items that are required are purchased by the home and then billed to service users or relatives. Appropriate records and receipts are kept. Not all staff at the home receives formal supervision, the manager stated that she is starting to carry out supervision but this is not in line with the national minimum standards and the manager herself does not receive formal supervision. It is a requirement that all staff at the home receive formal supervision at lease 6 times per year. Certificates were seen for annual tests of fire fighting equipment, fire alarms, and electrical equipment and for the lift and these were all in date, however the gas safety certificate at the home was out of date and it is a requirement that the home must obtain an in date safety certificate for the homes gas appliances. The fire log was inspected and all relevant training and testing is carried out within the specified timescales. St Vincent House DS0000011868.V300437.R01.S.doc Version 5.2 Page 20 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 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 2 X 2 X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 2 St Vincent House DS0000011868.V300437.R01.S.doc Version 5.2 Page 21 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 OP9 Regulation 13 (2) Requirement The home’s medication policy must be amended to ensure that the policy reflects the actual practice carried out within the home The home must ensure that secure barriers are put in place to prevent service users walking on grills, which cover drops to the basement and a clear risk assessment must be put in place. The home must make arrangements for the grills covering drops to the basement to be inspected and repaired. All staff at the home must receive formal supervision at lease 6 times per year. The home must obtain an in date safety certificate for the homes gas appliances. Timescale for action 30/08/06 2 OP19 13(4)(c) 30/08/06 3 OP19 13(4)(c) 30/11/06 4 5 OP36 OP38 18 (2) 13 (4) 30/08/06 30/08/06 St Vincent House DS0000011868.V300437.R01.S.doc Version 5.2 Page 22 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 Vincent House DS0000011868.V300437.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Vincent House DS0000011868.V300437.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. 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!