Inspection on 05/02/07 for St Vincents House

This inspection was carried out on 5th February 2007.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

St Vincents House 16/03/09

St Vincents House 22/09/08

St Vincents House 30/06/08

St Vincents House 21/01/08

St Vincents House 16/07/07

St Vincents House 25/07/06

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE St Vincents House Queen Caroline Street Hammersmith London W6 9QH Lead Inspector Tony Lawrence Unannounced Inspection 5th February 2007 10:30 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 House DS0000066934.V319388.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 Vincents House DS0000066934.V319388.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Vincents House Address Queen Caroline Street Hammersmith London W6 9QH 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) 0208 600 0510 0208 748 5912 Care UK Community Partnerships Ltd Mrs Karen Madeleine Ottaway Care Home 92 Category(ies) of Dementia - over 65 years of age (48), Old age, registration, with number not falling within any other category (44) of places St Vincents House DS0000066934.V319388.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. On the Ground Floor Unit up to 10 people may be aged between 50 and 65. 25th July 2006 Date of last inspection Brief Description of the Service: St Vincent’s House is a purpose built registered care home providing nursing care for elderly frail people and people with dementia. There is also a separate unit on the ground floor for people aged 50-65. The home opened on 3rd April 2006. St Vincents House DS0000066934.V319388.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place on Monday 5th February 2007 from 10:30 – 16:30. Tony Lawrence, Regulation Manager and Jackie Derbyshire, Regulation Inspector, carried out the inspection. During this visit the Inspectors spoke with service users, nursing and care staff and the home’s Manager. The care received by four service users was tracked by talking with them and their key workers and checking care records. 12 service users, 11 relatives or visitors and 5 health and social care professionals returned confidential questionnaires and their comments are included in this report. What the service does well: 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. The summary of this inspection report can be made available in other formats on request. St Vincents House DS0000066934.V319388.R01.S.doc Version 5.2 Page 6 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 House DS0000066934.V319388.R01.S.doc Version 5.2 Page 7 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): 2, 3 and 6. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Each person living in the home has a contract that details the service provided. EVIDENCE: ‘We were able to see the home before any patients had been admitted and were accorded a full introduction to its future services which convinced us that this was the best possible place for our relative when they left hospital’. (Comment from a relative). Since the last key inspection in July 2006, the Manager has confirmed that each person living in the home has an individual contract that meets this Standard. Service users funded by Social Services have a local authority contract. Service users who are funding their own care have a Care UK contract. The Inspectors checked the care plan files of four people living in the home. Each file included a pre-admission assessment completed by a senior member of staff from the home. Two files also included a hospital discharge summary or care needs assessment completed by medical staff or a social worker. Falls, continence and handling assessments were not completed on two of the four St Vincents House DS0000066934.V319388.R01.S.doc Version 5.2 Page 8 care plan files reviewed during this visit. The Manager and staff must make sure that these assessments are completed for all service users before, or soon after admission. The Manager confirmed that the home does not provide intermediate care. St Vincents House DS0000066934.V319388.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is Adequate. This judgement has been made using available evidence including a visit to this service. Each person living in the home has a care plan that details their health and social care needs. There is a need to improve the management of prescribed medication. EVIDENCE: ‘Staff should check if my (relative) has heard important information. She has a hearing aid and can hear reasonably well when it is fitted correctly and the person talking to her talks clearly and near the appropriate ear, without too many background noises’. The four care plan files checked by the Inspectors during this visit each included a care plan that detailed the person’s health and social care needs. The care plans cover health and social care needs and how these will be met in the home. Daily progress notes completed by care staff are, in most cases, linked to identified care plan goals. However, the progress notes tend to focus on personal care needs and more detail is needed about how individual’s social care needs are met (See Standard 12). All four care plans clearly identified the person’s health care needs and there was evidence of good multi-disciplinary working with health care professionals. St Vincents House DS0000066934.V319388.R01.S.doc Version 5.2 Page 10 An Inspector checked the medication records for 7 people living in the home’s ground floor unit. The records contained a number of errors or omissions and nurses seem to be unsure about the home’s policy on recording PRN medication, resulting in records that are confusing. The Inspector was concerned that errors are not being identified at daily handovers or at monthly record audits. These concerns were discussed with the home’s Manager who confirmed that a serious medication error on another unit had resulted in the dismissal of a member of staff. There is an urgent need to improve the recording of prescribed medication in the home and the Inspector has asked the Commission’s Pharmacy Inspector to visit the home to advise the manager and staff. The four care plans reviewed by an Inspector each included references to maintaining service users’ dignity when supporting them with personal care and the importance of treating people with respect. While Inspectors saw some good examples of staff interacting with individual service users on the ground and first floors, this was not so evident on the third floor where 5 staff were supporting 20 people with dementia. Although the Manager confirmed that no individual service user needs 1:1 support, staff were constantly busy. As a result, groups of service users were left in the unit lounges with little or no staff support for extended periods. More work is needed in the dementia care unit to make sure that service users receive person centred care. 5 health and social care professionals returned confidential questionnaires sent out as part of this inspection. All said that staff communicate clearly, work in partnership and demonstrate a clear understanding of the care needs of service users. 4 of the 5 people said that there is always a senior member of staff on duty to confer with. All 5 people said they had received no complaints about standards of care in the home. St Vincents House DS0000066934.V319388.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. 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. Service users were very positive about the standard of food provided in the home. Activities are provided, although more work is needed to make sure this is done consistently. EVIDENCE: ‘I think there should be more activities as he gets bored sitting all day with just the TV on’. (Comment from a service user’s relative). ‘I would like more activities to be on offer’. (Comment from a service user). ‘The staff try very hard’. (Comment from a service user). ‘Because it is a relatively new home it takes time to arrange social events. Hopefully by Christmas they will have organised things on a weekly basis’. (Comment from a service user). ‘The food is very good’. (Comment from a service user). The home’s care planning systems include sections to record service users’ life histories, significant people and dates, interests and hobbies. Two care plans reviewed by an Inspector included some information about social care issues, but this was limited. On two care plan files the lifestyle and interests St Vincents House DS0000066934.V319388.R01.S.doc Version 5.2 Page 12 assessments were blank, even though the service users had been in the home for some time and there was contact with relatives. Photo albums on display in the home’s reception area are evidence of parties at Christmas and New Year and visits to the home by a local school choir and an entertainer. Photos of local outings are also included. One of the home’s Activities Coordinators told an Inspector that the activities team have started to compile life histories for some service users, but this needs to be extended to each person living in the home. There is also a need to make sure that daily progress notes include more detail about individual’s social care needs and how these are met in the home. Managers must also make sure that nursing, care and activities staff work together as a team to include social care needs in the provision of daily care. Details of service users’ relatives and other visitors were well recorded on each of the four care plans reviewed during this visit. Service users who spoke with the Inspectors were positive about the support provided by nursing and care staff. The inspectors also saw some good examples of staff offering individual service users choices about aspects of their care. Care plans also included information about individual’s preferred routines for getting up, personal care, activities and night time routines. There is a need to make sure that where care plans identify the need for monitoring of food and fluids, this is completed accurately by care staff. This issue was identified at the last inspection in July 2006 and while there has been some improvement, better standards of recording are needed. St Vincents House DS0000066934.V319388.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. 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. Complaints are well recorded and investigated. Appropriate employment and police checks are completed for all staff working in the home. EVIDENCE: An Inspector checked the home’s record of complaints received since the last inspection. Complaints are well recorded and records include details of actions taken in response. The records also show that complainants are satisfied with the outcome of investigations that have been completed. 5 of the 11 relatives / visitors who returned confidential questionnaires said that they were not aware of the home’s complaints procedures. The Manager should make sure that this information is given to all relatives / visitors. There have been no adult protection investigations since the last key inspection. An inspector checked the home’s record of Criminal Record Bureau (CRB) checks. All staff working in the home have applied for an Enhanced CRB Disclosure. The Manager confirmed that, where the Disclosure has not been processed, a POVA First check has been completed and the member of staff only works under supervision. St Vincents House DS0000066934.V319388.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 24 and 26. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The home provides good standards of private and communal accommodation. Service users told Inspectors that they are happy with their accommodation. EVIDENCE: ‘No nasty smells or untidy rooms’. (Comment from a relative). ‘It would be helpful if rooms had picture hooks and bookcases’. (Comment from a relative). St Vincent’s is a purpose built home that provides accommodation on the ground, first, second and third floors. During this visit the Inspectors saw communal areas and some bedrooms on each floor. All parts of the home were well decorated, comfortably furnished, clean and hygienic. The home has an enclosed garden with attractive sitting areas. Each unit has a number of communal lounges where service users can spend time, alone or in small groups. There is a smoking room on the third floor. Service users who spoke with the Inspectors said that they were very happy with the accommodation. St Vincents House DS0000066934.V319388.R01.S.doc Version 5.2 Page 15 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. The skill mix of staff is appropriate to meet the care needs of existing service users, but staffing levels must be kept under review. Staff have access to appropriate training opportunities. EVIDENCE: ‘The staff are excellent’. (Comment from a service user). ‘St Vincent’s is a most comfortable and well-run home. We hope the Manager and staff will receive the highest commendation’. The home has a large team of managers, nursing, care, catering, domestic and administrative staff. During this inspection, staffing levels were adequate to meet the needs of service users but staff on the third floor dementia care unit were stretched to provide person centred care to individual service users. Staffing levels in the dementia care unit must be kept under review to make sure that service users’ care needs are met. Staff also told the Inspectors that they were not always able to take breaks during 12 hour shifts as they were needed to support service users at all times. During this visit an Inspector checked the staff rota on the ground floor. This was evidence that one member of staff was due to work or attend training courses for 8 days in a row. This included 4 ‘long days’ when the person would work in the home for a 12-hour shift. The home’s Manager must make sure that staff take breaks during the working day and staff must not work for 8 days without a break. St Vincents House DS0000066934.V319388.R01.S.doc Version 5.2 Page 16 The last inspection report included Requirements that photocopies taken of passports and other documentation as part of the recruitment procedures should be signed and dated by the person making the copy and Home Office documentation must be obtained showing that staff have leave to remain and work in the UK. Checking staff files during this visit was evidence that these practices are not completed in all cases and the Requirements are repeated. St Vincents House DS0000066934.V319388.R01.S.doc Version 5.2 Page 17 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 Good. This judgement has been made using available evidence including a visit to this service. The home has a qualified and experienced Manager. Service users’ finances are well managed. EVIDENCE: ‘The Manager is very helpful and supportive’. (Comment from a service user). ‘St Vincent’s is a well-run care home’. (Comment from a relative). The home has a permanent, qualified and experienced Manager who has been registered by the Commission. The Manager and staff in the home have worked well together to implement Requirements made following the last key inspection in July 2006. The Inspectors are confident that standards have improved since the last inspection and the Manager is committed to maintaining this progress. The Commission should be kept informed of the organisation’s quality assurance procedures and a copy of any quality assurance report should be sent to the Lead Inspector. St Vincents House DS0000066934.V319388.R01.S.doc Version 5.2 Page 18 During this visit an Inspector checked service users’ finance records. These records are well maintained and receipts are obtained for any expenditure that involves service users’ personal monies. The last inspection report included a Requirement that all staff must receive formal supervision at least 6 times each year. During this visit, the Inspectors were not able to evidence that this Requirement has been met and the Requirement is repeated. No health and safety issues were noted during this inspection. St Vincents House DS0000066934.V319388.R01.S.doc Version 5.2 Page 19 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 3 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 3 X X X 3 X 3 STAFFING Standard No Score 27 2 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 2 X 3 St Vincents House DS0000066934.V319388.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? YES 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 OP3 Regulation 14 Requirement The Manager and nursing staff must make sure that falls, continence and handling assessments are completed for all service users before, or soon after, admission. Repeat Requirement. Original timescale of 30/09/06 not met. The management of service users’ prescribed medication must be improved. More work is needed in the dementia care unit to make sure that service users receive person centred care. The assessment and recording of service users’ social care needs must be improved. Managers must also make sure that nursing, care and activities staff work together as a team to include social care needs in the provision of daily care. Food and fluid charts must be completed accurately, with sufficient detail. Repeat Requirement. Original timescale of 30/09/06 not DS0000066934.V319388.R01.S.doc Timescale for action 31/03/07 2. 3. OP9 OP10 13 15 31/03/07 31/03/07 4. OP12 16 31/05/07 5. OP15 16 31/03/07 St Vincents House Version 5.2 Page 21 6. OP27 18 7. OP28 18 8. OP29 18 9. OP29 18 10. OP29 18 11. OP36 19 met. Staffing levels in the dementia care unit must be kept under review to make sure that service users’ care needs are met. The home’s Manager must make sure that staff take breaks during the working day. Staff must not work for 8 consecutive days without a break. Employment references on staff files must be checked and validated. Repeat Requirement. Original timescale of 30/09/06 not met. Where staff require a work permit to enable them to work in the UK, the home must make sure that all the relevant papers from the Home Office are included in the staff personnel file. Repeat Requirement. Original timescale of 30/09/06 not met. Where photocopies are taken of passports and other documentation as part of the recruitment procedures, they should be signed and dated by the person making the copy. Repeat Requirement. Original timescale of 30/09/06 not met. All staff must have formal supervision at least 6 times a year that includes all aspects of care and career development. Repeat Requirement. Original timescale of 30/09/06 not met. 31/05/07 31/03/07 31/05/07 31/05/07 31/05/07 30/09/07 St Vincents House DS0000066934.V319388.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. 1. 2. Refer to Standard OP16 OP33 Good Practice Recommendations The Manager should make sure that all relatives and visitors are aware of the home’s complaints procedures. The Commission should be kept informed of the organisation’s quality assurance procedures and a copy of any quality assurance report should be sent to the Lead Inspector. St Vincents House DS0000066934.V319388.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection West London Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE 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 Vincents House DS0000066934.V319388.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. 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