Care Home: St Andrews Care Home

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What the care home does well See comments below in the What has improved since the last inspection. What has improved since the last inspection? The manager and staff of the home clearly have worked very hard to improve the service to the people who live in the home. The area of the home where people who have highest needs was calm but with a high level of activity and interaction. Staff were observed to interact with the residents in a calm, dignified and unhurried manner. There was clearly affection between the residents and staff. We observed laughter and fun in the lounge area. Snacks are freely available to people to take as and when they wished. The residents were free to move about as they wished and staff were able to respond to their needs.We observed staff attending to all the residents who were in the sitting room to ensure that they were included in what was happening. All the residents had an opportunity to have one to one time with staff and the opportunity to make requests if they needed anything. Care we observed was unrushed and the staff appeared to know the residents and their needs. The staffing levels have been reviewed and more staff have been put on duty between 10.30 and 13.30 hours which means peoples needs are now better met. Staff have now been trained in care of people who have dementia and how to respond to people who have challenging behaviour. Care plans have more information of how to meet the needs of the residents. This was evident throughout the inspection as the care of people had improved and the level of care was delivered in a ore person centred manner. Here are some things people told us about living in St. Andrews `Staff know me and call me by my name, its lovely that I don`t have to keep telling them my name`, `This is so nice`, `all the staff are lovely` and `they take really good care of us`. What the care home could do better: The manager is aware that she does not have a qualification or training in the care of people who have dementia. She is currently trying to access a suitable qualification. CARE HOMES FOR OLDER PEOPLE St Andrews Care Home Great North Road Welwyn Garden City Hertfordshire AL8 7SR Lead Inspector Marian Byrne Unannounced Inspection 11:00 31st July – 8 August 2008 th 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 Andrews Care Home DS0000019533.V370387.R02.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 Andrews Care Home DS0000019533.V370387.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Andrews Care Home Address Great North Road Welwyn Garden City Hertfordshire AL8 7SR 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) 01707 324208 01707 324248 www.bmcare.co.uk Colley Care Limited (Trading as B & M Care) Carol Georgina Wynn Care Home 70 Category(ies) of Dementia - over 65 years of age (39), Old age, registration, with number not falling within any other category (31) of places St Andrews Care Home DS0000019533.V370387.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th June 2007 Brief Description of the Service: St. Andrews is a care home for 70 older people, 39 of whom may also have a dementia. The building has three floors and a passenger lift. The bedrooms are all single occupancy and have en-suite facilities. There is ample parking to the front of the home and extensive landscaped gardens with courtyards and well maintained flowerbeds. St. Andrews is located in a semi-rural area, between the villages of Digswell and Lemsford. It is near the A1(M) road and a short drive from Welwyn Garden City, with its wide range of shops and facilities. There is limited public transport nearby but the home has its own vehicle for the benefit of the residents. The fees of the home range from £600 to £650. St Andrews Care Home DS0000019533.V370387.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. One inspector carried out this inspection over a period that covered late morning and early evening. We spent time talking to the people who live in the home and to the staff who work there. Surveys were sent out to the residents and their families. The inspection period was extended to allow for the return of these surveys. Appropriate records were examined during the site visit to evidence that people’s needs were being safely met by the service. What the service does well: What has improved since the last inspection? The manager and staff of the home clearly have worked very hard to improve the service to the people who live in the home. The area of the home where people who have highest needs was calm but with a high level of activity and interaction. Staff were observed to interact with the residents in a calm, dignified and unhurried manner. There was clearly affection between the residents and staff. We observed laughter and fun in the lounge area. Snacks are freely available to people to take as and when they wished. The residents were free to move about as they wished and staff were able to respond to their needs. St Andrews Care Home DS0000019533.V370387.R02.S.doc Version 5.2 Page 6 We observed staff attending to all the residents who were in the sitting room to ensure that they were included in what was happening. All the residents had an opportunity to have one to one time with staff and the opportunity to make requests if they needed anything. Care we observed was unrushed and the staff appeared to know the residents and their needs. The staffing levels have been reviewed and more staff have been put on duty between 10.30 and 13.30 hours which means peoples needs are now better met. Staff have now been trained in care of people who have dementia and how to respond to people who have challenging behaviour. Care plans have more information of how to meet the needs of the residents. This was evident throughout the inspection as the care of people had improved and the level of care was delivered in a ore person centred manner. Here are some things people told us about living in St. Andrews ‘Staff know me and call me by my name, its lovely that I don’t have to keep telling them my name’, ‘This is so nice’, ‘all the staff are lovely’ and ‘they take really good care of us’. 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 Andrews Care Home DS0000019533.V370387.R02.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 Andrews Care Home DS0000019533.V370387.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service can be sure that their needs will be identified and met. EVIDENCE: We looked at four care plans for the most recently admitted service users. They contained details of the needs of the service users. All prospective users of the service are invited to visit the home prior to moving in and their placement at the home is reviewed after six weeks to ensure the prospective resident’s needs are met. St Andrews Care Home DS0000019533.V370387.R02.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 good. This judgement has been made using available evidence including a visit to this service. People who live in this home can be sure that their personal care and social care needs are met and they can be sure that their dignity will be promoted. They can be sure that medication is administered and stored appropriately to ensure that they are kept safe from harm. EVIDENCE: Care plans have improved since the last inspection and they contain daily needs and overall needs assessment. We looked at four care plans. They were easy to read and to follow. There was information on the needs of the residents, how the needs present themselves and instructions how staff were to meet the needs. The instructions to staff were clear. There were no tick sheets in the care plans they were all individually written and were person centred. By person centred we mean that all the residents are assessed individually and that no assumptions are made about them. They are consulted on how they want their care given. All care plans contained risk assessments. St Andrews Care Home DS0000019533.V370387.R02.S.doc Version 5.2 Page 10 The home has good relations with local health professionals and they are called in to meet the health needs of the residents when needed. Throughout the inspection we observed staff interact with residents with respect, gentleness and affection. We saw that the dignity of the residents was upheld at all times. The recording and administration of medications was found to be in order to ensure that people are kept safe. St Andrews Care Home DS0000019533.V370387.R02.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. People who live in this home can be sure that their individuality is recognised and respected. The home encourages and welcomes visitors. People can be assured that they receive a wholesome diet, which meets their needs and expectations. EVIDENCE: On the day of the inspection there was a constant stream of visitors to the home. Visitors are welcomed to the home at all reasonable times. The home explores the needs of the residents and endeavours to meet these needs. On the day of the inspection staff were spending one to one time with residents we observed them reading the daily newspaper together, chatting and in some cases singing together. The atmosphere in the home was relaxed and residents were setting the pace of life. St Andrews Care Home DS0000019533.V370387.R02.S.doc Version 5.2 Page 12 The staff were observed to be vigilant in their supervision of the residents particularly at lunch time. All the residents appeared to enjoy their lunch. On the day it was served hot and was of good appearance and was found to be tasty. We saw that snacks are freely available to the residents. St Andrews Care Home DS0000019533.V370387.R02.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. People who live in this home can be sure that their complaints are listened to and investigated. The policies and procedures in place ensure people are kept safe and protected from abuse. EVIDENCE: The home has a complaints procedure and investigates all complaints. We saw that the home has received 11 letters and cards of compliments from families and friends of people who live or have lived in the home thanking them for the care their relative has received. All staff spoken with were aware of their obligations in relation to the safeguarding of adults. St Andrews Care Home DS0000019533.V370387.R02.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 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live in this home can be sure that the environment is clean, pleasant and hygienic and meets their needs and expectations. EVIDENCE: The home is well maintained and on the day of the inspection was clean, fresh and odour free. The upstairs floor makes a loud creaking sound when walked on we were told by the manager that this was being address in the near future. St Andrews Care Home DS0000019533.V370387.R02.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 good. This judgement has been made using available evidence including a visit to this service. People who live in this home can be sure that the staff are competent and are trained to meet their needs. Staff are recruited appropriately which ensures that they are suitable to work with vulnerable people. EVIDENCE: The numbers of staff have been increased in the mornings. The Registered Manager informed us that this allows staff to have more one to one time with the residents. Staff have received mandatory training and other training including: Abuse Awareness, Fire Safety, Food Hygiene, First Aid and Moving and Handling, the Administration of Medication and Infection Control. Some of the training is provided via DVDs. The manager of the home further validates this training through observation. Staff are recruited appropriately and the files inspected contained all the required information including two references, a Criminal Records Bureau St Andrews Care Home DS0000019533.V370387.R02.S.doc Version 5.2 Page 16 check and identity checks which ensures that people are suitable to work with vulnerable people. St Andrews Care Home DS0000019533.V370387.R02.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 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this home can be sure that it is well managed and run in their best interests. EVIDENCE: The results of this inspection indicate that the home is well managed. The home is run in the best interests of service users, this was evident throughout the inspection. The home has a relaxed atmosphere and staff ensures that all interactions are done at the pace of the service users. Service users were St Andrews Care Home DS0000019533.V370387.R02.S.doc Version 5.2 Page 18 offered choices at all times. The home has policies and procedures in place to ensure that the protection of all service users. Residents are surveyed annually to ensure that their views on all aspects of the home are known and responded to. St Andrews Care Home DS0000019533.V370387.R02.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 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 3 X X X X X X X 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 X X 3 St Andrews Care Home DS0000019533.V370387.R02.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations St Andrews Care Home DS0000019533.V370387.R02.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Andrews Care Home DS0000019533.V370387.R02.S.doc Version 5.2 Page 22 - 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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