Inspection on 07/09/05 for St Vincent`s

This inspection was carried out on 7th September 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.

Other inspections for this house

St Vincent`s 23/05/07

St Vincent`s 28/02/06

St Vincent`s 15/02/05

St Vincent`s 17/11/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE St Vincent`s 79 Fore Street Plympton St. Maurice Plymouth PL7 1NE Lead Inspector Fiona Cartlidge Unannounced 7 September 2005 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 Vincent`s D52-D04 S3609 St Vincents V235158 070905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service St Vincent`s Address 79 Fore Street, Plympton St. Maurice, Plymouth, Devon, PL7 1NE 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) 01752 336205 Convent of Sisters of Charity Mrs Vivienne Cheshire Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (3), Physical disability over 65 years of age (25) of places St Vincent`s D52-D04 S3609 St Vincents V235158 070905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named individual aged 32 years 2. Service Users aged 65 years and over 3. OP Maximum registered 3 service users (both) 4. PD(E) Maximum registered 25 service users (both). Date of last inspection 15/02/05 Brief Description of the Service: St Vincents’ is situated in a conservation area of Plympton St Maurice near the city of Plymouth in Devon. The building was originally a malt house, converted in the 1700’s into a private residence and opened as a nursing home in 1944 by the Anglican sisters of charity. The accommodation is provided on 2 floors – accessed via a passenger lift or stairs and comprises; 21 single rooms (11 with en suite) and 2 double rooms (1 with en suite) and 4 communal areas, the gardens are attractive, safe and accessible. The home is registered to provide nursing and/or personal care for a maximum of 25 people, over the age of 65 of either gender with physical disability, frailty and/or illness. The atmosphere within this home is quiet and peaceful. The home benefits from a stable staff team and achieved the investors in people award in 1998 which was renewed in 2002 and 2004 in recognition of their commitment to staff development and training. St Vincent`s D52-D04 S3609 St Vincents V235158 070905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 5 hours and was unannounced. A Colleague (Inspector Megan Walker) accompanied the inspector. A tour of the home took place and personal records of 3 residents and 5 members of staff were inspected. The inspectors spoke to 15 residents and 3 members of staff as well as the registered manager. What the service does well: What has improved since the last inspection? What they could do better: To ensure that all residents receive a consistent standard of care - all care plans should be regularly reviewed and where a change of need is identified a plan to meet this need must be documented. When a chronic health need is identified the staff in the home should refer this to an appropriate specialist to ensure the most up to date ‘best practise’ approach is taken to meet that need. St Vincent`s D52-D04 S3609 St Vincents V235158 070905 Stage 4.doc Version 1.40 Page 6 To promote the safety of residents all cleaning fluids should be stored securely and not left unattended at any times. All staff should follow safe moving and handling practise to prevent injury to residents and themselves. To ensure all staff will know what to do if an incidence or allegation of abuse or negligence is made a robust procedure which includes the names of external agencies that must be contacted needs to be put in place and be communicated to all staff and accessible at all times. 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`s D52-D04 S3609 St Vincents V235158 070905 Stage 4.doc Version 1.40 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 Vincent`s D52-D04 S3609 St Vincents V235158 070905 Stage 4.doc Version 1.40 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) 1,2,3 A proper assessment is performed on people before their admission to the home this allows the staff employed at the home to make an informed decision about if/how they will meet the individuals needs before a place is offered. An information pack provides ample information for prospective service users and/or their representatives to make a decision about what services and facilities will be available. EVIDENCE: St Vincent`s D52-D04 S3609 St Vincents V235158 070905 Stage 4.doc Version 1.40 Page 9 The inspector examined an information pack located in the entrance hall and found that the information about this home is written in plain English and large print. It includes a description of the accommodation and services provided; relevant qualifications and experience of the registered provider, manager and staff including photographs; the number of places provided and any special needs or interests catered for; the complaints procedure and how to view the homes latest inspection report. A copy of the contract/terms and conditions of residency is also included in this pack - a contract is provided to all residents/representatives at the time of admission. The personal records of 3 residents were seen. These provided evidence that prior to the individuals admission the registered person obtains a summary of the care management assessment and care plan for service users admitted through care management arrangements; in addition nursing information is received in transfer letters where service users are admitted direct from hospital. Registered nurses employed within the home perform needs assessments on service users whom are self funding. Each resident had a plan of care for daily living based on the care management assessment and homes own needs assessment. St Vincent`s D52-D04 S3609 St Vincents V235158 070905 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,10 The health care needs of residents are assessed, there was some inconsistency in the review process; this shortfall has a potential to place residents at risk. EVIDENCE: A number of care plans were examined, each trained nurse in the home is allocated as the lead nurse for a number of residents, the consistency of review depended on which nurse the resident had as their reviewer. Some plans had been reviewed on an at least monthly basis but in the case of 2 residents where their weights had steadily dropped over a period of months the plans to monitor or take actions to prevent further loss were not documented. Records of visits from General Practitioners’ s and other health professionals showed that residents see them on a needs led basis, a resident confirmed that they could see their doctor if they asked. A regular visit is made by a chiropodist those receiving treatment are charged for this service. Residents and information provided during the handover of shifts showed that residents have access to hospital and community health care specialists. Residents told the inspectors that their privacy and dignity is respected – doors to rooms where personal care is being given were closed and staff were seen St Vincent`s D52-D04 S3609 St Vincents V235158 070905 Stage 4.doc Version 1.40 Page 11 to knock on doors to personal accommodation before entering. One member of staff was overheard talking to residents in a chastising manner this less than satisfactory matter was discussed with the matron and registered manager during the inspection. All of the residents spoken to said that they feel well cared for. St Vincent`s D52-D04 S3609 St Vincents V235158 070905 Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15 Social activities are organised. Meals are nutritious and balanced and offer a healthy and varied diet for residents. EVIDENCE: St Vincent`s D52-D04 S3609 St Vincents V235158 070905 Stage 4.doc Version 1.40 Page 13 On the day of inspection a number of residents were enjoying a sing-a-long provided by 2 ladies visiting the home singing and playing an electric organ. Others were seen relaxing in their own rooms, reading or watching television one resident who is blind told the inspectors how much they enjoy listening to taped books and how this is facilitated within the home. One resident told the inspectors that the religious ethos of the home was important to them, there is a chapel, which is open to everyone, and services are held there regularly. Residents told the inspectors they are happy with the visiting arrangements and that they can see their visitors socially in the communal rooms and privately in individual’s accommodation. Information about arrangements for visiting is included in the homes information pack. The home benefits from a small visitors lounge, which can be used for over night stays if needed. Lunch was served at the time of the inspection and all residents spoken to commented on how tasty the food was, there appeared to be no change to the standard of food despite the regular cook being unavoidably unavailable on the day of the inspection. St Vincent`s D52-D04 S3609 St Vincents V235158 070905 Stage 4.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 Residents have confidence that their concerns will be listened to. The lack of a vulnerable adults procedure does not ensure that the people living in the home are protected from abuse. EVIDENCE: The home has a detailed complaints procedure, this was found displayed on a notice board in the hall as well as in the information pack. Residents said they had nothing to complain about. The commission has not received any complaints about this home. The home has a policy on abuse, which was reviewed in January 2205 as well as a whistle blowing policy. The registered manager confirmed that she is still working on a procedural document to include local contacts to whom incidents of suspected or actual abuse should be reported and actions for the homes staff to take in such circumstances. St Vincent`s D52-D04 S3609 St Vincents V235158 070905 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,26 The décor and furnishings are adequate. Dangerous practises in connection to cleaning materials were observed - this poses a risk of harm to residents. EVIDENCE: A tour of the home revealed a clean and mostly well - maintained environment. There was evidence of water ingress from a leaking roof in the visitors lounge. The plumber was in attendance at the time of the inspection, draining the central heating system in order that radiators can be replaced by those with low temperature surfaces. Hand washing facilities are available through out the home and supplies of disposable gloves and body wipes appeared to be available in ample proportions. The inspectors found cleaning fluids un- attended in every bathroom and in a bedroom as well as cleaning equipment such as vacuum cleaners and carpet shampooers. Tubs of skin creams were also found in bathrooms this is poor practise. It was noted that residents are able to bring items of furniture and personal belongings into the home with them. All of the residents spoken to were satisfied with the environment. The gardens looked safe and well maintained St Vincent`s D52-D04 S3609 St Vincents V235158 070905 Stage 4.doc Version 1.40 Page 16 and residents said how much they have enjoyed spending time in the garden through the summer months. St Vincent`s D52-D04 S3609 St Vincents V235158 070905 Stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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) 27,29, The procedures for the recruitment of staff are robust and offer protection to people living in the home. The deployment and number of staff available is sufficient to meet the needs of current residents. EVIDENCE: The inspectors looked at the personnel records held on behalf of 5 Staff these provided evidence that the information and documentation required to ensure the safety of residents is obtained before an offer of employment is given. The inspectors spoke to a recently employed member of staff who spoke of how much they were enjoying their employment and how helpful and supportive senior staff had been. Residents spoken to said that the staff at the home were ‘’kind and caring’’ they said that when they used their call bell they were usually answered quickly. During the inspection two alarm bells were tested one of these was responded to very quickly. Residents confirmed they are able to rise and retire at times that suit them and confirmed they receive the care they need. St Vincent`s D52-D04 S3609 St Vincents V235158 070905 Stage 4.doc Version 1.40 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 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) 33,35,38 The home is being managed properly there is leadership, guidance and direction for staff to ensure residents receive consistent care. Some of the care and domestic practises observed in the home caused concern and may be a hazard to residents and/or staff. EVIDENCE: Residents made positive comments about the senior staff in the home. The inspectors did witness poor lifting practise during the inspection which may have posed an injury to the staff member and resident, this was discussed with the matron and registered manager at the time of the inspection it was felt that the staff member had forgotten their safe manual handling training in their effort to speedily meet the need of the resident. Both managers said they would take action to prevent a reoccurrence. Cleaning fluids were seen unattended in areas of the home. A folding table was seen lent against a wall in a fire exit not only causing a risk of injury from falling on someone but also possible blocking of the exit. St Vincent`s D52-D04 S3609 St Vincents V235158 070905 Stage 4.doc Version 1.40 Page 19 The inspector examined the process of holding money on behalf of residents. Records were checked against actual balances and found to be correct. All receipts are retained and the records are readily auditable. A door leading to steep stairs off the 1st floor lounge is not well signed to communicate the hazard they may pose to residents or staff falling, these doors were found open during the inspection with a resident who is blind and also mobile sat beside them. St Vincent`s D52-D04 S3609 St Vincents V235158 070905 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x x 3 x 3 x x 2 St Vincent`s D52-D04 S3609 St Vincents V235158 070905 Stage 4.doc Version 1.40 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 38 Regulation 13(4) Requirement Timescale for action immediate 2. 38 13(4) Substances that may be hazardous to health must be stored securely when not in use and not left unattended at any time. Where a resident has been immediate assessed as requiring mechanical transfer due to being unable to weight bear this must be done. 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 7 Good Practice Recommendations A consistent aproach should be taken to ensure all residents care plans are reviewed regularly and where a change of need is identified a plan to meet this need is clearly documented to ensure a consistent standard of care. Wher a chronic risk to a persons health such as weight loss is recognised referal to appropriate specialists should be undertaken. The home should have robust procedures for responding to suspicion or evidence of abuse or neglect which includes when and how to report such incidents to the CSCI and other agencies including Local social services vulnerable D52-D04 S3609 St Vincents V235158 070905 Stage 4.doc Version 1.40 Page 22 2. 3. 8 18 St Vincent`s 4. 19 adults department and police. The visitors lounge ceiling should be repaired and redecorated. St Vincent`s D52-D04 S3609 St Vincents V235158 070905 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP 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`s D52-D04 S3609 St Vincents V235158 070905 Stage 4.doc Version 1.40 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. 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