Inspection on 12/09/05 for St Vincents

This inspection was carried out on 12th September 2005.

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 Vincents 15/02/06

St Vincents 02/09/04

St Vincents 01/06/04

Similar services:

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Langdale Nursing Home

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

CARE HOMES FOR OLDER PEOPLE St Vincents Binstead Road Ryde Isle Of Wight PO33 3NB Lead Inspector Clare Hall Unannounced Inspection 12 September 2005 10:00a 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 Vincents DS0000012538.V264095.R01.S.doc Version 5.0 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 Vincents DS0000012538.V264095.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service St Vincents Address Binstead Road Ryde Isle Of Wight PO33 3NB 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) 01983 563248 01983 567714 stvincents@ssafa.org.uk SSAFA Mrs Sharon June Atter Care Home 18 Category(ies) of Dementia - over 65 years of age (2), Old age, registration, with number not falling within any other category (18), of places Physical disability over 65 years of age (4) St Vincents DS0000012538.V264095.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd September 2004 Brief Description of the Service: St Vincents is a registered care home for 18 residents over 65 years of age. The registered provider is SSAFA Forces Help. St Vincents is set in its own grounds on the main Binstead to Ryde road. It is close to all amenities. The home is spacious, well maintained and has attractive gardens and roof terrace. All 18 rooms are en-suite and decorated to a high standard. There is a large passenger lift providing access to all floors. The home has a mini-bus and a car; these are used to take residents out for activities and appointments. St Vincents DS0000012538.V264095.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was conducted over one day by one inspector. The inspector spoke with ten service users and eleven staff members including the manager, maintenance staff, kitchen and domestic staff care, one administrative member of staff and one healthcare professional. The clients were observed making full use of the facilities, taking their meals, and enjoying the privacy of their own rooms. Staff were spoken with individually and in groups and were observed throughout the day providing support to the clients. A tour of the premises was undertaken. What the service does well: The service has consistently provided a service to residents which has been commended due to exceeding the standards and the manager and staff continually demonstrate that they are always looking for new and innovative ideas to how they can further improve the way that the care is provided. Residents informed the inspector “the home is so nice because the staff are always the same, not like the old place when they were always leaving and this makes a difference” and that “you have a choice and are respected as individuals” One client said, “it’s such a lovely place and everything goes along swimmingly” and “I can have a bath when I like” and the “standards are excellent”. All service users spoken with described the staff as caring, helpful and well trained. One visiting health care professional also stated that the home was considered to be providing a good standard of care with staff appropriately seeking the assistance of other heath care professionals appropriately. The inspector was informed that “the home has had some very sick residents who were looked after beautifully”. All staff spoken to felt supported by the manager and felt they had all the equipment necessary to meet the demands of the job and that the home was well staffed. One service user informed the inspector “the garden looks beautiful and the gardener works very hard at it. He brings in beautiful plants to the lounge which is very much appreciated”. The gardener also supports catering services by providing a large range of homegrown fruits and vegetables, which are supplied and served freshly to service users. St Vincents DS0000012538.V264095.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? 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. St Vincents DS0000012538.V264095.R01.S.doc Version 5.0 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 Vincents DS0000012538.V264095.R01.S.doc Version 5.0 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): 1, 2, 5 The manager continuously aims to improve the way service users have the information they require to make informed choices and the service users are provided with the necessary information regarding contracts and conditions of residency. EVIDENCE: The statement of purpose and service user guide was seen in the service user’s rooms. Discussion with residents indicated that the guide covers information about resident’s rights, the home’s objectives and service to be offered. The complaints procedure is set out in the statement of purpose and residents stated they would refer any complaints through the manager. The revised document has been further improved by offering information in a pictorial format. Resident files demonstrated that residents are provided with a statement of terms and conditions. The manager explained these are sometimes delayed St Vincents DS0000012538.V264095.R01.S.doc Version 5.0 Page 9 when social services need to confirm funding arrangements and these are usually completed by the end of the six week trial period. Discussions with staff and review of documents indicate that the homes preplacement assessment is very thorough and only after all relevant information has been received the prospective resident is offered a place in writing subject to a trail period to ensure suitability. One resident described a visit made to the home prior to making decision to become resident. St Vincents DS0000012538.V264095.R01.S.doc Version 5.0 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 the following standard(s): 7,8,9,10 The service consistently aims to improve the way the service is provided and seeks to find innovative ways to monitor and deliver the care. The organisation implements a thorough computerised record keeping system which offers the staff a good resource for documenting the care needs of individuals while supporting the core values of promoting service user choice, fulfilment and respecting individual privacy and rights. EVIDENCE: Observation and discussion with staff during review of care plan documents identified that care plans are drawn up using the information gathered during the pre-placement assessment and the information had been agreed and signed by the residents. It was explained that the care plans are changed whenever there is a need and that regular reviews are undertaken by the key worker on a monthly basis. A senior care staff member was observed up dating care documents. St Vincents DS0000012538.V264095.R01.S.doc Version 5.0 Page 11 The care plans are well written clear and comprehensive and were observed being used as a working document. Staff demonstrated during discussion that they were fully aware of the information and actions identified within the care plans. Since the last inspection a new falls log has been developed and the manager’s audit of incidents and accidents were viewed on file. Residents explained how they could see their own GP and other healthcare professionals. One resident explained she could ring her own GP and ask for a telephone consultation if she has concerns regarding health and medication. The home has good relationships with the local surgeries and during the inspection there was a district nurse visiting. Staff were observed discussing wound management with the district nurse and reviewing service users health and well being. The manager explained that they are currently reviewing the homes procedures and risk assessments regarding weight and nutrition and that since the last inspection the home’s manual handling risk assessment has been reviewed and it has been decided to use a more user-friendly format. Care documents identified the ongoing review of sensory aids and requirements for renewal and also clearly identified the limitations of residents but also identified their individual abilities, promoting independence and maintenance of current skills and promoting self care which is commendable. A senior care staff member explained and demonstrated the process for the administration of medicines. Medication administration recording sheets were completed as required and recorded amounts received and doses administered. Training requirements and competency were explained and it was agreed that to demonstrate good practice photo ID would be included in the process for identification as well as using the name of the resident. One resident explained to the inspector the process for self-administration and for renewal of her prescriptions and supporting care documents identified dates for medication reviews and risk assessments supported self-administration. During a group discussion with residents they described how the staff respect their privacy by knocking on doors, seeking their views, permission and choices and speak to them in a respectful and dignified manner Service users were very complimentary regarding the professional attitudes of staff and regarding their caring manner. They also confirmed that they could seek the privacy of their own rooms when entertaining family and friends. Notices on doors allow the service users to remain undisturbed if they wish. Observation of staff actions confirmed that staff were respectful of service user privacy. Many residents visited had their own telephones and all had their own rooms. St Vincents DS0000012538.V264095.R01.S.doc Version 5.0 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 the following standard(s): 12,14 The services user’s expectations are representative of the service provided and individual preference is sought and respected. EVIDENCE: One resident explained that service users are able to go out independently and choose where to go and who to go with. One resident went out daily to the shop to buy herself a daily paper. The staff confirmed that the home employs drivers who take residents shopping and out for coffee. Notices around the home and discussions with residents and staff confirmed that the home arranges a number of activities. A log is kept of all activities provided and all residents spoken to were very satisfied with the activities and felt there was plenty to participate in should they wish. The inspector spoke with a three residents who were enjoying pre-lunch drinks from the resident’s bar. They confirmed that they are at liberty to make their own arrangements and to organise activities as they wish and stated that at least six of the sixteen residents currently resident were not in the home at that time as they were either out shopping or attending social events. St Vincents DS0000012538.V264095.R01.S.doc Version 5.0 Page 13 Discussions with staff, residents and review of service user meeting agendas strongly confirmed that residents are consulted regarding how they wish to spend their time and they are involved in the running of the home through consultation and regular residents meetings. Residents visited confirmed that are able to bring their personal possessions into the home and feel their preferences are respected. Care documents confirmed that consultation had taken place to establish the wishes and preferences of the service users in their everyday lives. St Vincents DS0000012538.V264095.R01.S.doc Version 5.0 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 the following standard(s): This section was not audited on this occasion. There have not been any complaints received by the Commission for Social Care since the last Inspection. EVIDENCE: St Vincents DS0000012538.V264095.R01.S.doc Version 5.0 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 the following standard(s): 19,20,21,23,34,26 The environmental space far exceeds the minimum standards, the home is clean, well furnished and maintained to a very high standard. Further improvement is necessary for the control of infection. EVIDENCE: The residents described their satisfaction with the location of the home. Residents described how they can access all local amenities and that they can also be taken by minibus to local shopping and restaurant café facilities. On a tour of the premises the inspector saw how spacious and attractive the home is. It is set in very large and well-maintained gardens. The manager informed the inspector that current work was being undertaken to make a small memorial garden in the grounds. The rooms visited were large, well decorated clean, beautifully finished and had well equipped en-suite facilities. St Vincents DS0000012538.V264095.R01.S.doc Version 5.0 Page 16 In the grounds there is a safe care parking area. The inspector was impressed by the large passenger lift, which can safely accommodate four chairs and gave access to all levels. Although the property is large, old and not purpose built the home has been appropriately developed and maintained to suit its purpose .The residents were very complementary regarding the home and stated it was “comfortable” and “homely”. All residents spoken to believed it was” the best home around “ and you would “never get a better home than this one”. The inspector visited the new training room and the new allocated smoking lounge. There is also an easily accessible and well-maintained roof terrace. The home features a large hallway and wide corridors. All areas are attractively furnished, comfortable and clean. All rooms visited are en-suite and most have been up-graded to ensure the doorways are large enough for wheelchairs and Zimmer frames. In addition to the en-suite facilities there are two assisted baths and one assisted shower. There are lavatories and washbasins close to all communal areas. All rooms have call facilities and some have tea-making facilities (offered on a risk assessment basis). The bathrooms toured had suitably placed handrails and there were neck pendants available on entrance to the roof terrace. There was no equipment seen inappropriately stored in communal areas. Rooms visited were personalized and inventories of personal effects were viewed on service user files. Residents visited confirmed they are provided with lockable space and have keys to their rooms. The home is centrally heated and has natural ventilation. Maintenance staff confirmed that residents can control the heat in their own rooms and some have doors that open out onto the garden. The radiators are covered and the water temperature is controlled to prevent scalding. The manager demonstrated a review of the homes water monitoring and described how new water checks will be undertaken including water temperature checks and that these changes were based on health and safety guidance recently obtained through training. The inspector was impressed by the cleanliness and standard of repair of the premises considering the age of the building. A concern identified during inspection was that domestic staff did not demonstrate they were fully knowledgeable regarding the procedures for the management for infection control and the safe storage of cleaning solutions. The issues raised for further improvement were St Vincents DS0000012538.V264095.R01.S.doc Version 5.0 Page 17 • • • The procedure for handling of soiled and/or infected linen The wearing of appropriate aprons and knowledge to why these must be worn and what the indications are for changing them. Safe storage of cleaning substances. Residents spoken to were very complimentary regarding the standard of cleanliness throughout the home. St Vincents DS0000012538.V264095.R01.S.doc Version 5.0 Page 18 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): 27,30 The manager employs an appropriate number of staff to meet the demands of the service and the care, maintenance and kitchen staff are equipped to undertake the role that they are employed for. Domestic staff require further development and training. EVIDENCE: The inspection was unannounced and the levels of care staff and ancillary staff available on the day appear to meet the needs of the service. Staff confirmed during a group discussion that they felt staffing levels were good. It was stated that agency staff were sometimes employed but did not take charge. It was stated that if senior care staff were unavailable for duty then other senior care staff would cover. On the day of inspection the three care staff on duty were supported by three maintenance staff, two kitchen staff, one domestic member of staff, one administrative member of staff, the manager and gardener. The staff explained that the manager prepares the rota every six weeks, taking staff requests for time off into consideration and that there are 2 staff members on duty each night with the manager or a senior member of staff on call. The manager showed and discussed the new formulated training profiles established for each member of staff. These files were currently being St Vincents DS0000012538.V264095.R01.S.doc Version 5.0 Page 19 revamped and not completed so it was agreed that these would be looked at with the newly developed records for supervision and induction during the next inspection. During interviews with maintenance staff, domestic staff, care staff and kitchen staff it was confirmed that there is a range of training provided by the organisation. Staff stated they had received training in medication, health and safety, manual handling, food hygiene and fire. The resources seen and available to staff included numerous references to text on health and medical conditions and there was also equipment to provide in-house training using the overhead projector and VCR. Video training programmes were seen on a numerous of subjects including challenging behaviour, protection of vulnerable adults and bereavement. St Vincents DS0000012538.V264095.R01.S.doc Version 5.0 Page 20 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): 32,33,37 The ethos of the home is inclusive and seeks the views of staff and residents Staff and residents are very satisfied with the management of the home and every opportunity is sought to ensure the care is provided in the safest environment. EVIDENCE: The inspector spoke with 11 members of staff during the inspection. All staff felt that the manager was approachable and sought the opinions of staff. Records identified that staff were consulted regularly and the inspector was informed, “issues raised were dealt with”. The manager demonstrated service user feedback forms, and minutes of resident’s meetings identified areas of consultation that take place regarding service user opinion of how the home is run and their expectations. St Vincents DS0000012538.V264095.R01.S.doc Version 5.0 Page 21 It was agreed that the current procedure to seek service user opinion would be expanded and feedback analysed to monitor the standards within the home as the majority of feedback is given on an informal basis through discussion. Feedback is not currently actively sought from other users of the service and the manager agreed that the views of healthcare professionals and others would be sought as part of the quality audit process. The inspector was able to sample the audit and procedural systems set up by the manager. All documents necessary for the inspection process were clearly indexed and very proficiently arranged and files held all information required in relation to each of the standards. The manager explained how she constantly endeavours to improve how care is provided and recorded and the inspector saw some really innovative ideas and improvements that have been made to improve the already good standard. Discussions clearly indicated how hard the manager and staff have worked and continue to work to continuously improve the way in which care is delivered. The manager appears very knowledgeable regarding the Care Standards and has recently improved and further expanded the homes process for risk assessments to ensure compliancy with areas for health and safety. St Vincents DS0000012538.V264095.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 4 X X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 4 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 x 4 4 4 X 4 X X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 3 X X X 3 X St Vincents DS0000012538.V264095.R01.S.doc Version 5.0 Page 23 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 26 Regulation 13(3) 16(2) Requirement The homes infection control procedure requires further review for the handling of infected materials/laundry using acceptable universal precautions and for the safe and appropriate wearing of aprons by staff. Timescale for action 31/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations St Vincents DS0000012538.V264095.R01.S.doc Version 5.0 Page 24 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 Vincents DS0000012538.V264095.R01.S.doc Version 5.0 Page 25 - 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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