Care Home: St Annes Court

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What the care home does well St Anne`s Court provides an attractive, well-maintained home where the personal, health and social care needs of residents are met. The residents describe the home as a very relaxed and friendly place to live where the staff are helpful, cheerful and supportive.The home has a thorough admissions procedure to allow prospective residents to make informed decisions about coming to the home and ensuring that only those whose needs can be met are offered places there. Residents said the home had been very supportive during the admissions process. Residents commented: "I do not regret coming here. I found it much easier to settle in then I would have thought possible. Everyone was so helpful and understanding." "I thought about several different places, but this was head and shoulders above the rest. Everyone here helped me to settle in very quickly." A relative said: "We looked at many care homes but St Anne`s Court was the best of the bunch. We came to look round and the manager answered all of our many questions." The personal, health and social care needs of residents are well met. Staff treat residents with respect and provide encouragement for them to pursue their own lifestyles, wherever possible, and to make choices about their daily lives. Residents say that the varied social opportunities arranged by the home meet their social needs and provide an enjoyable quality of life. These include regular musical events and occasional sherry parties, coffee mornings and fundraising efforts for charities. Residents are supported to maintain contact with family and friends, enabling people living in the home to continue to enjoy relationships that are meaningful to them. A varied and nutritious menu provides residents with appetising meals, which are served in the convivial surroundings of their choice. Residents commented: "We have a lovely cook. She takes such pains to present everything so beautifully." "The food is really excellent, I can`t say fairer than that." "I like a kipper for breakfast. I just say when I fancy one and they do it for me." "Basically, with regard to food, we can have whatever we fancy." People who live at St Anne`s Court feel confident that they can raise any issues or concerns and these will be taken seriously and responded to. They are also protected from potential abuse. Residents benefit from living in an attractive, well maintained environment that is clean, pleasant and hygienic. Residents commented: "My room is kept spotlessly clean." "They keep this whole house very clean and tidy. It always looks nice and there are no nasty smells, like you find in some of the places I have visited." Satisfactory staffing levels are maintained, ensuring that residents` needs are satisfactorily met. The home has a robust recruitment procedure in place to St Annes Court DS0000003983.V357558.R01.S.doc Version 5.2 Page 7make sure only suitable staff are employed in the home. A well-trained and conscientious staff team ensure that residents are safely cared for. Residents commented: "This is a very friendly place. The staff are very helpful." "The staff were very caring and attentive when I was unwell recently." "I feel well looked after. I am very pleased to have found this place." Relatives said: "I am very pleased with the care. The homely environment suits my relative very well." "I am very satisfied with the care provided. I am always kept updated about progress or any changes in care needs." Residents` benefit from living in a well managed home. The manager is suitably qualified to carry out her responsibilities and demonstrates care and compassion in carrying out her duties. This is reflected in the commitment of staff members and the quality of life experienced by residents. Staff say that they like working at St Anne`s Court and feel valued: "I really enjoy coming to work. Everyone is very supportive. We all work well as a team. All the staff are important and we all have a role to play in looking after the residents." Resident`s comments include: "Our manager is excellent. She always makes herself available if I want to discuss anything." "This place is second to none." "We have an excellent person in charge." "This place is very well managed. I can`t recommend it enough." A quality assurance system is in place, to ensure that the home is run in the best interests of people living there. People are encouraged to comment on the service provided and make suggestions for any improvements. In order to protect residents, the home prefers to have no involvement in personal finances. Therefore, all residents who are unable or have no wish to handle their own affairs have a relative or other representative to deal with their finances. Good practice ensures that the health and safety of residents is suitably safeguarded in the home. What has improved since the last inspection? Since the last inspection, the entrance hall and kitchen have been redecorated. Several bedrooms have also been redecorated and recarpeted. New vinyl floor covering has been fitted in a number of bathrooms. A ramp has been fitted to the door onto the rear patio, to assist access to and from the garden. This ramp is portable and can be used elsewhere if needed.Work has been carried out to renew the electrical certificate, to ensure the electrical installation is safe. (A copy must be forwarded to us as soon as possible.) All four requirements and the one recommendation from the previous key inspection in January 2007 and the two requirements and one recommendation from our Pharmacist Inspector`s Random inspection in June 2007 have been met. What the care home could do better: Care must be taken to ensure that any important information supplied to the home as part of a pre-admission assessment is always incorporated into the care plan and other relevant documentation, such as Medicine Administration Records, to ensure all care needs can be met. A photograph of each member of staff must be held on file. The present system of attaching these to the outer covers of each file is not working, as the photos are becoming detached and getting mislaid. CARE HOMES FOR OLDER PEOPLE St Annes Court St Anthonys Road Meyrick Park Bournemouth Dorset BH2 6PD Lead Inspector Marjorie Richards Key Unannounced Inspection 17th January 2008 09:55 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 Annes Court DS0000003983.V357558.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 Annes Court DS0000003983.V357558.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Annes Court Address St Anthonys Road Meyrick Park Bournemouth Dorset BH2 6PD 01202 551208 01202 551551 amanda.billington@ntlworld.com 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) Mr Ian Billington Mrs Pamela Billington Miss Amanda Billington Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places St Annes Court DS0000003983.V357558.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th January 2007 Brief Description of the Service: St Annes Court is situated in a pleasant residential area of Bournemouth. The property backs onto Meyrick Park and is a short drive from the town centre and all its amenities. Off road parking is provided to the front of the house although parking on the driveway is discouraged in order that the outlook from some residents’ rooms is not obscured. Roadside parking is permitted outside the home on St Anthonys Road. St Annes Court is registered to provide care and accommodation for up to 26 older people. Nursing care is not provided, although arrangements can be made through the community nursing services and General Practitioners for those requiring some nursing or medical support. There are 20 single rooms and 3 double rooms on ground and first floor levels, all with en-suite facilities. A stair lift and passenger lift provide access between floors. A pleasant lounge and separate dining room overlook mature, secluded and well-maintained gardens, which are accessible to residents. Twenty-four hour care is provided. Laundering of personal clothing is carried out on the premises. Activities and entertainments are arranged. Meals are freshly prepared and cooked within the home. A choice of menu is offered and a variety of alternatives made available to suit individual taste and preference. Special diets can be catered for. Current fees, as confirmed at the time of the inspection, are £510 to £620. Additional charges include hairdressing, chiropody, dry cleaning, toiletries and newspapers. For further information on fee levels and fair contracts you are advised to refer to the Office of Fair Trading website: www.oft.gov.uk. We have published ‘A fair contract with older people? A special study of people’s experiences when finding a care home’ and this can be accessed on our website www.csci.org.uk St Annes Court DS0000003983.V357558.R01.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 stars. This means the people who use this service experience good quality outcomes. This unannounced inspection took place over 8.5 hours on the 17th January 2008. As the manager was away at this time, the inspection was completed during a further 3.5 hours on 3rd March. The main purpose of this unannounced inspection was to review all of the key National Minimum Standards, check that the residents living in the home were safe and properly cared for and to look at progress in meeting the requirements and recommendations made following the previous inspection. On the first day of the inspection, twenty-four residents were accommodated. A tour of the premises took place and records and related documentation were examined, including the care records for three residents. Time was spent observing the daily routine during the inspection, as well as talking with residents and the staff on duty. Discussion also took place with Miss Billington the registered manager and her deputy. The Annual Quality Assurance Assessment (AQAA) form had been completed by Miss Billington and provided to us in advance of the inspection. Recent legislation has made it a legal requirement for all registered services for adults to complete an AQAA every year. The completed assessment is one of the ways in which we assess how well the service is delivering good outcomes for the people using it. For the purposes of this report, people who live at St Annes Court are referred to as residents as this is the term generally used within the care home. Throughout the inspection the management and staff team demonstrated a positive and proactive commitment to addressing any issues raised and continuously improving the quality of life for people living at St Anne’s Court. The Inspector was made to feel very welcome in the home on both days of the inspection. What the service does well: St Anne’s Court provides an attractive, well-maintained home where the personal, health and social care needs of residents are met. The residents describe the home as a very relaxed and friendly place to live where the staff are helpful, cheerful and supportive. St Annes Court DS0000003983.V357558.R01.S.doc Version 5.2 Page 6 The home has a thorough admissions procedure to allow prospective residents to make informed decisions about coming to the home and ensuring that only those whose needs can be met are offered places there. Residents said the home had been very supportive during the admissions process. Residents commented: I do not regret coming here. I found it much easier to settle in then I would have thought possible. Everyone was so helpful and understanding. I thought about several different places, but this was head and shoulders above the rest. Everyone here helped me to settle in very quickly. A relative said: We looked at many care homes but St Annes Court was the best of the bunch. We came to look round and the manager answered all of our many questions. The personal, health and social care needs of residents are well met. Staff treat residents with respect and provide encouragement for them to pursue their own lifestyles, wherever possible, and to make choices about their daily lives. Residents say that the varied social opportunities arranged by the home meet their social needs and provide an enjoyable quality of life. These include regular musical events and occasional sherry parties, coffee mornings and fundraising efforts for charities. Residents are supported to maintain contact with family and friends, enabling people living in the home to continue to enjoy relationships that are meaningful to them. A varied and nutritious menu provides residents with appetising meals, which are served in the convivial surroundings of their choice. Residents commented: We have a lovely cook. She takes such pains to present everything so beautifully. The food is really excellent, I cant say fairer than that. I like a kipper for breakfast. I just say when I fancy one and they do it for me. Basically, with regard to food, we can have whatever we fancy. People who live at St Anne’s Court feel confident that they can raise any issues or concerns and these will be taken seriously and responded to. They are also protected from potential abuse. Residents benefit from living in an attractive, well maintained environment that is clean, pleasant and hygienic. Residents commented: My room is kept spotlessly clean. They keep this whole house very clean and tidy. It always looks nice and there are no nasty smells, like you find in some of the places I have visited. Satisfactory staffing levels are maintained, ensuring that residents’ needs are satisfactorily met. The home has a robust recruitment procedure in place to St Annes Court DS0000003983.V357558.R01.S.doc Version 5.2 Page 7 make sure only suitable staff are employed in the home. A well-trained and conscientious staff team ensure that residents are safely cared for. Residents commented: This is a very friendly place. The staff are very helpful. The staff were very caring and attentive when I was unwell recently.” I feel well looked after. I am very pleased to have found this place.” Relatives said: I am very pleased with the care. The homely environment suits my relative very well.” I am very satisfied with the care provided. I am always kept updated about progress or any changes in care needs.” Residents’ benefit from living in a well managed home. The manager is suitably qualified to carry out her responsibilities and demonstrates care and compassion in carrying out her duties. This is reflected in the commitment of staff members and the quality of life experienced by residents. Staff say that they like working at St Anne’s Court and feel valued: I really enjoy coming to work. Everyone is very supportive. We all work well as a team. All the staff are important and we all have a role to play in looking after the residents. Resident’s comments include: Our manager is excellent. She always makes herself available if I want to discuss anything. This place is second to none. We have an excellent person in charge. This place is very well managed. I can’t recommend it enough. A quality assurance system is in place, to ensure that the home is run in the best interests of people living there. People are encouraged to comment on the service provided and make suggestions for any improvements. In order to protect residents, the home prefers to have no involvement in personal finances. Therefore, all residents who are unable or have no wish to handle their own affairs have a relative or other representative to deal with their finances. Good practice ensures that the health and safety of residents is suitably safeguarded in the home. What has improved since the last inspection? Since the last inspection, the entrance hall and kitchen have been redecorated. Several bedrooms have also been redecorated and recarpeted. New vinyl floor covering has been fitted in a number of bathrooms. A ramp has been fitted to the door onto the rear patio, to assist access to and from the garden. This ramp is portable and can be used elsewhere if needed. St Annes Court DS0000003983.V357558.R01.S.doc Version 5.2 Page 8 Work has been carried out to renew the electrical certificate, to ensure the electrical installation is safe. (A copy must be forwarded to us as soon as possible.) All four requirements and the one recommendation from the previous key inspection in January 2007 and the two requirements and one recommendation from our Pharmacist Inspector’s Random inspection in June 2007 have been met. 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 Annes Court DS0000003983.V357558.R01.S.doc Version 5.2 Page 9 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 Annes Court DS0000003983.V357558.R01.S.doc Version 5.2 Page 10 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 Standard 6 is not applicable at St Anne’s Court. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to St Anne’s Court. A thorough admissions procedure allows prospective residents to make informed decisions about admission to the home and ensures that only those whose needs can be met are offered places there. EVIDENCE: Pre-admission assessments for two residents who had recently moved into the home were viewed. Full details regarding the person’s medical, social and personal history were recorded to enable the manager, or the deputy, completing the assessment to make an appropriate decision as to whether the home was able to meet the prospective residents’ needs. In one case, this included specific information about a particular medical condition and the way this was to be managed by staff in the home. St Annes Court DS0000003983.V357558.R01.S.doc Version 5.2 Page 11 Those pre-admission assessments seen include details of the people contributing to the completion of the assessment. Following the pre-admission assessment, a letter is sent to the prospective resident or their representative confirming that the home feels able to meet the person’s needs. Residents said the home had been very supportive during the admissions process. Residents commented: I do not regret coming here. I found it much easier to settle in then I would have thought possible. Everyone was so helpful and understanding. I thought about several different places, but this was head and shoulders above the rest. Everyone here helped me to settle in very quickly. A relative said: We looked at many care homes but St Annes Court was the best of the bunch. We came to look round and the manager answered all of our many questions. St Annes Court DS0000003983.V357558.R01.S.doc Version 5.2 Page 12 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 St Anne’s Court. Residents are treated with respect and their personal care needs are met, with the home also ensuring they have access to a range of healthcare services to meet all assessed needs. EVIDENCE: We viewed care plans for three people living at St Anne’s Court. Assessments, including specific risk assessments are completed and care plans identify each resident’s needs and the actions required by staff to meet these needs. Discussion with staff and residents confirmed that care plans reflect the actual care provided. Miss Billington says that, wherever possible, initial care plans and any significant changes are agreed by the resident themselves, or if this is not possible, by a relative or representative. This was evidenced on the care plans examined. St Annes Court DS0000003983.V357558.R01.S.doc Version 5.2 Page 13 Care plans also demonstrate that regular reviews are taking place and care plans are updated as necessary to reflect any changing needs. However, on one care plan, information provided on a hospital transfer sheet regarding allergies to certain medication had not been fully carried forward into the care plan. This information was also not detailed on the Medicine Administration Record for the resident. This was discussed with Miss Billington, who gave an assurance that the relevant documentation would be immediately updated. Such information was contained in the other care plans checked. Assessments completed referred to residents’ healthcare needs. This includes a nutritional assessment. Good daily records are written by staff to evidence the care being provided. These show that residents have access to General Practitioners, district nurses, dentists, chiropodists, opticians etc and attend appointments as necessary. This was later confirmed in discussion with residents and staff. The last key inspection in January 2007 raised some issues of concern about the administration of medication within the home. Our Pharmacist Inspector made an unannounced random inspection in June 2007 to follow up on these issues and requirements and recommendations were made. Miss Billington responded promptly in addressing these matters and was able to demonstrate during this inspection that all requirements and recommendations have now been met. Medicines are stored securely, to ensure the protection of residents. A Monitored Dosage System is in use. Staff administration practice was observed and samples of the cassettes were checked with the Medicine Administration Records (MAR) charts, to ensure that medicines had been administered correctly, as prescribed and properly recorded. Residents have their own single bedrooms, thereby offering an opportunity to be on their own if they wish, or allowing privacy for any visitors or personal care needs. Miss Billington says the three double rooms would only be occupied as singles, or by people expressing a wish to share. Staff ensure that toileting activities are carried out with sensitivity and discretion. Continence products are stored out of sight so that visitors cannot see them. The home’s induction programme includes reference to the core values of care practice, including protecting people’s dignity. This was confirmed when speaking with staff. Staff were seen to knock at bedroom doors before entering residents’ rooms and to offer personal care discreetly. Staff interact with residents in a friendly, relaxed and respectful manner. It was clear from observation and the time spent with residents that they feel comfortable and at ease with staff. Staff remain vigilant and attentive to the needs of residents. Any requests for help, whether for assistance with toileting, cutting up food at St Annes Court DS0000003983.V357558.R01.S.doc Version 5.2 Page 14 lunchtime, requesting a drink or asking for a reminder about what was on the menu for lunch were responded to in a positive, courteous and helpful manner. Residents commented: If I want to spend time on my own, the staff respect my wishes and let me have privacy. When I first came here they asked me how I wished to be addressed. I feel the staff are well trained because they always have respect for their elders. The staff here are excellent. They are always very willing to help. You only have to ask and they seem pleased to be able to assist. I dont know how the staff keep so cheerful, looking after a lot of old people like us, but they always seem to have a smile for me. A visitor said: The staff here are always polite and very helpful.” St Annes Court DS0000003983.V357558.R01.S.doc Version 5.2 Page 15 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 excellent. This judgement has been made using available evidence including a visit to St Anne’s Court. The daily routine of the home is centred on the needs and wishes of residents, enabling them to retain control over their lives wherever possible. Residents enjoy a varied social life and are served with nutritious and appetising meals in the convivial surroundings of their choice. EVIDENCE: Activities available at St Annes court include board games, gentle armchair exercises to music, giant Scrabble and occasional quizzes and Bingo. The mobile library visits every month to provide a selection of books. Caring Canines visit monthly with dogs that residents can pat and stroke. Important dates and events are celebrated, including birthdays. Other social opportunities available to residents include regular musical events and occasional sherry parties, coffee mornings and fundraising efforts for charities. Miss Billington has been gathering information about residents background, social history, previous hobbies and interests etc and this is recorded in the care plan. St Annes Court DS0000003983.V357558.R01.S.doc Version 5.2 Page 16 Miss Billington says that arrangements are made to assist individual residents in practicing their religious beliefs if they so wish, either by attending services or arranging for clergy to visit them at St Annes Court. An interdenominational service offering Holy Communion is held in the home on a monthly basis and residents may attend if they wish. Residents are encouraged to continue with interests they had before moving into the home and to maintain links with the community. Residents, relatives and staff confirm that visiting times at St Annes Court are unrestricted and residents say that their visitors are always made welcome. A relative commented, I am always made to feel welcome when I visit the home. I am always well received and given refreshments. Residents records and the visitors book demonstrate contact with family and friends as well as visits by professionals. A telephone is available for residents but they may also arrange to have their own telephones installed if they wish, so they can easily maintain family and community links. Residents are offered choices about what they like to do during the day. Routines can be flexible to fit in with the needs and wishes of residents. During the inspection, people living in the home were observed either staying in their own rooms, sitting in the communal areas or going out of the home, according to their personal preferences. Care plans reflect people’s individual preferences. For example, Likes to watch golf on television, Likes to wear earrings and make-up to evening dinner and Likes to read ‘The Times’ daily. Residents spoken with confirm that they choose when to get up and go to bed and how they spend their day. They are regularly consulted about their wishes and the routines of daily living. Residents are able to bring their own possessions into the home to personalise their bedrooms and this was witnessed in the rooms viewed during the inspection. Residents are able to handle their own financial affairs for as long as they wish to do so. Information about advocacy is available for any residents requiring an independent person to act in their best interests. A choice of menu is offered and alternatives such as omelettes, fish, soup, jacket potatoes and salads are always available to suit individual taste and preference. Lunch on the first day of inspection offered a choice of venison à la carte, or roast chicken with potatoes, cabbage, peas and carrots. This was followed by mixed fruit sponge and custard, or baked egg custard, or black cherries in sauce. The meal was well presented and well received by residents. The dining room is attractively furnished and decorated, with tables set out to suit the preferences of residents. Care is taken to ensure that residents enjoy a pleasant dining experience in a relaxed, unhurried atmosphere. Gentle background music is played and attentive staff provide discreet and unobtrusive support where needed. Some residents prefer to eat their meals in their own bedrooms and this is accommodated. St Annes Court DS0000003983.V357558.R01.S.doc Version 5.2 Page 17 Residents are regularly consulted about the menus. A new style buffet lunch was tried recently and proved a great success. Feedback from residents in the home’s most recent quality assurance questionnaires shows they would like this to happen more often, so Miss Billington is currently arranging this. Fresh fruit and vegetables are used wherever possible and special diets are catered for. A bowl of fresh fruit is available in the dining room for residents to help themselves whenever they wish. Fresh fruit is provided in residents’ rooms upon request. The home has an excellent supply of high-quality foodstocks, all appropriately stored. The cook was observed chatting with residents regarding their individual menu choices. She takes great pride in her work and spoke to us about how much she enjoys coming to work and her enthusiasm for her role. The pleasure that she gives residents in the high standard of food prepared, is very evident from the comments received. For example, residents said: We have a lovely cook. She takes such pains to present everything so beautifully. The food is really excellent, I cant say fairer than that. You can have a cooked breakfast whenever you want. I suggested a lamb dish to the manager and she put it on the menu for the following week. Suggestions are always acted upon. I like a kipper for breakfast. I just say when I fancy one and they do it for me. Basically, with regard to food, we can have whatever we fancy. I am really looking forward to the evening meal today as I am very fond of the homemade cauliflower cheese. I enjoy my meals, we have a good variety. Relatives commented: I have seen the quality of the food and it is very good. My relative is eating better than she ever did at home and is looking really well now. St Annes Court DS0000003983.V357558.R01.S.doc Version 5.2 Page 18 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 St Anne’s Court. The systems in place provide residents with the confidence that their complaints will be listened to and acted upon and they are protected from possible abuse. EVIDENCE: The home has a complaints procedure, which is available in the Service Users Guide and in the Terms And Conditions of Residence document, a copy of which is signed and held by all residents. The Service Users Guide is also available to relatives, visitors etc in the office. Miss Billington explained that she is in the process of creating a new guide for visitors and prospective residents, which will be made available in the entrance hall for anyone to read. This will include a copy of the complaints procedure. The Annual Quality Assurance Assessment (AQAA) completed by Miss Billington states that the approach and the ethos of the home is open and inclusive, where all comments are taken seriously and any issues addressed as they arise. No complaints have been received in the home for some time and Miss Billington says complaints are very rare. Discussion with residents confirms that they are aware of the procedure and what to do if they have a complaint. They express confidence that they would be listened to and appropriate action taken. Residents commented: I have absolutely no complaints, quite the opposite. St Annes Court DS0000003983.V357558.R01.S.doc Version 5.2 Page 19 Any concerns and I would go straight to the manager. She would deal with it appropriately. If I was worried about anything I would tell the staff. If it was more serious, I would let the manager sort it out. I have every confidence that the manager would sort out any problems I may encounter. She always says we should talk to her and share any concerns. Staff members starting work in the home read relevant policies and procedures as part of the induction process for new employees. All but the most recently employed members of staff have now completed Protection Of Vulnerable Adults training as part of the home’s routine programme of training. A member of staff spoken with demonstrated an awareness of what to do should there be an allegation of abuse in the home. Further Protection Of Vulnerable Adults training has been booked so that all staff will be able to ensure a proper response to any suspicion or allegation of abuse. St Annes Court DS0000003983.V357558.R01.S.doc Version 5.2 Page 20 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 St Anne’s Court. Environmental standards are very good, providing residents with comfortable, clean and well-maintained surroundings in which to live. EVIDENCE: Communal areas are tastefully decorated and furnished, offering comfortable living areas including a pleasant dining room. The home benefits from an attractive, level garden to the rear of the property with a large paved patio area, offering a high degree of privacy and seclusion. Patio tables and chairs are available and residents say they enjoy having access to the garden when the weather permits. All bedrooms have en-suite facilities. Many residents have brought their own furniture so rooms are very individual and well personalised. All bedrooms have a lockable facility where residents may keep confidential documents and letters etc. St Annes Court DS0000003983.V357558.R01.S.doc Version 5.2 Page 21 There are sufficient baths and toilets around the home for the use of residents. Bathrooms are equipped with grab rails, raised toilet seats and toilet frames to assist residents where necessary. Five portable battery powered bath seats are available to aid residents in getting in and out of the bath. Residents say there is always plenty of hot water available for washing and bathing. Inspection of the premises confirms that routine maintenance is being carried out to keep the home and grounds in good condition. Detailed maintenance records are kept and prompt attention is paid to any minor defects and repairs whenever necessary. There is a constant programme of refurbishment and redecoration taking place, to ensure the home is always maintained to a high standard. Since the last inspection, the entrance hall and kitchen have been redecorated. Several bedrooms have also been redecorated and recarpeted. New vinyl floor covering has been fitted in a number of bathrooms. A ramp has been fitted to the door onto the rear patio, to assist access to and from the garden. This ramp is portable and can be used elsewhere if needed. Miss Billington is now assessing whether there is sufficient need to fit a permanent ramp at the front of the home, to permit easier access for more frail residents or visitors and those in wheelchairs. St Anne’s Court is clean and free from unpleasant odours. Residents confirm that this is always the case and that their rooms are regularly cleaned. Residents commented: My room is kept spotlessly clean. They keep this whole house very clean and tidy. It always looks nice and there are no nasty smells, like you find in some of the places I have visited. The only smells in this place are the lovely aromas coming from the kitchen. We have lovely fresh flower arrangements around the house. I love to see fresh flowers, it always raises my spirits. (Fresh flower arrangements are delivered every week.) Staff members seen during the inspection observed good practices in terms of infection control. Staff members were seen washing their hands and wearing protective equipment according to the tasks being undertaken. After some concerns were noted about the laundry service at the last inspection, Miss Billington carried out a survey of residents to look at ways in which the service could be improved. As a result, two additional tumble dryers have been purchased to help speed up the process. Residents spoken with at the time of this inspection said they are now fully satisfied with the laundry service. St Annes Court DS0000003983.V357558.R01.S.doc Version 5.2 Page 22 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 St Anne’s Court. St Anne’s Court has systems in place to ensure that staff are only recruited after a rigorous screening process and then receive suitable training to make sure they are able to meet the needs of the residents. EVIDENCE: Rosters seen and staffing levels on the day of the visit demonstrate that the home ensures there are sufficient staff members available throughout the day to meet the needs of residents. At night, there are two wakeful members of staff on duty. No Agency staff are used and any absence due to sickness or holidays etc is covered by the home’s own staff to ensure continuity of care for residents. Relationships between staff and residents were directly and indirectly observed throughout the course of the inspection. Staff were seen to respond to residents appropriately and work to protect their need for privacy and dignity. Staff demonstrate a friendly, relaxed and caring approach when dealing with residents. A key worker system is in place, based on choosing the member of staff that gets on best with a resident to provide personal care and additional support, such as assistance with shopping etc. Residents commented: St Annes Court DS0000003983.V357558.R01.S.doc Version 5.2 Page 23 This is a very friendly place. The staff are very helpful. The staff always do their best for you.” We are very well looked after.” Some staff do more than just look after us, they are also friends. I look on some of them like I would my own family. If I ring my bell, the staff always come very quickly.” The staff are very good, they help whenever needed.” The staff were very caring and attentive when I was unwell recently.” I feel well looked after. I am very pleased to have found this place.” Relatives said: I am very pleased with the care. The homely environment suits my relative very well.” I am very satisfied with the care provided. I am always kept updated about progress or any changes in care needs.” The home has achieved the target of 50 trained members of care staff with National Vocational Qualification (NVQ) level 2, to ensure residents are in safe hands. A further six members of staff are currently undertaking NVQ level 2 training. Miss Billington says it is her aim to ensure all care staff will be qualified to NVQ Level 2 by the autumn of 2008. Some of the domestic staff are also being encouraged to undertake NVQ training in care to expand their involvement with residents, as the roles of different staff members are broadened to create a more flexible service. The home has a thorough recruitment procedure in place, based on equal opportunities and ensuring the protection of residents. The recruitment files for two members of staff were examined. These included an application form with employment history, proof of identity, two written references and a contract. A satisfactory enhanced Criminal Records Bureau check and Protection of Vulnerable Adults (POVA) check had been received prior to the member of staff commencing employment. Staff files also contain copies of training certificates. However, the photographs of both staff members had become detached from the front covers and were missing from the files. Miss Billington undertook to rectify this as soon as possible. The home provides staff training as a means of improving the standard of care and ensuring residents safety. Training records and discussions with staff confirm that training courses have included Adult Protection, moving and handling, basic food hygiene, first aid and health and safety. Further training is being planned, including developing a greater understanding of dementia. All new staff receive induction training. This includes a short introduction to the home followed by a six-week induction, which is based on the Skills for Care Common Induction Standards. St Annes Court DS0000003983.V357558.R01.S.doc Version 5.2 Page 24 St Annes Court DS0000003983.V357558.R01.S.doc Version 5.2 Page 25 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 St Anne’s Court. The management arrangements at St Anne’s Court and the quality assurance systems now in place, ensure that the residents live in a home that is well managed and the service provided meets their needs. EVIDENCE: St Annes Court is a family run business. Miss Billington is very experienced in caring for older people and has been the registered manager for the last 20 years. She communicates a clear sense of direction and is always seeking to improve the service provided. Miss Billington has completed the Registered Managers Award and is on course to complete the NVQ Level 4 in care by the end of 2008. St Annes Court DS0000003983.V357558.R01.S.doc Version 5.2 Page 26 People feel confident that they live in a well-managed environment, which they can call home. Working relationships between management, staff and residents were directly and indirectly observed throughout the course of the inspection. They appear open and friendly, contributing to a relaxed atmosphere that is beneficial to all in the home. Residents and visitors were observed calling at the office door to pass on information to the manager or her deputy, or just to have a chat. They were always greeted warmly and given full attention. Staff say that they like working at St Anne’s Court and feel valued: I really enjoy coming to work. Everyone is very supportive. We all work well as a team. All the staff are important and we all have a role to play in looking after the residents. This is a good place to work. I like it here very much. Everyone is very helpful. You dont have to be afraid to ask questions. The management team are all very approachable. I have learned such a lot since I started working here. Residents’ comments include: Our manager is excellent. She always makes herself available if I want to discuss anything. This place is second to none. We have an excellent person in charge. This place is very well managed. I can’t recommend it enough. The Annual Quality Assurance Assessment (AQAA) completed by Miss Billington demonstrates a high level of understanding with regard to the management of the home and the need to listen to what residents want. She summarises the service as follows: “We are offering a service that places our residents individuality and personal needs above all else. It is one thing to be assisted to wash and dress each morning, it is another to find your day off to a good start by being assisted by a kindly friend who chats as the tasks are done and who comes back in a little while with a cup of tea and to see how you are getting on. It is the relationships in our setting that make the place a community.” The whole ethos at St Anne’s Court is open and transparent. A comments and suggestions box in the entrance hall enables anyone to make comments about the service the home provides. Regular Quality Assurance surveys also ensure that residents have every opportunity to comment on the service provided and make suggestions for improvements. Miss Billington is currently arranging for questionnaires to be sent to relatives and other visitors as well as staff to obtain their views. In addition, the management and staff team talk with residents continuously to check they are receiving the service they need and then take prompt action regarding any suggestions made. Miss Billington confirmed that it is the policy of the home not to have any involvement in residents’ personal finances. Therefore, all residents who are St Annes Court DS0000003983.V357558.R01.S.doc Version 5.2 Page 27 unable to handle their own affairs or choose not to, have a relative or other representative to deal with their finances etc. From touring the premises, looking at records and discussions with staff and residents, it is evident that measures are in place to promote the health and safety of residents, e.g. equipment, such as hoists, lifts, portable electrical appliances, gas appliances and boilers are regularly serviced and maintained. A water test has been carried out to ensure there is no risk from Legionella. All substances that could be potentially hazardous to health are handled and stored safely. Staff members receive regular training in aspects of health and safety. Work has recently been completed to renew the electrical certificate. A copy of this must be forwarded to us as soon as possible. Examination of the fire records shows that appropriate procedures are in place to ensure the safety of residents and staff. Regular maintenance of the fire warning system, emergency lighting and fire fighting equipment is arranged. Routine checks are carried out at appropriate intervals and staff confirm this. Staff fire training, including induction training for new staff, is taking place and fire drills are arranged so that staff are fully aware of the action to take in the event of a fire. A Fire Risk Assessment is in place, which was reviewed in September 2007. Dorset Fire and Rescue Service carried out a fire audit in August 2007. Three recommendations were made. Two of these have been completed and work is currently in progress to complete the third recommendation. St Annes Court DS0000003983.V357558.R01.S.doc Version 5.2 Page 28 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 St Annes Court DS0000003983.V357558.R01.S.doc Version 5.2 Page 29 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. 1. Standard OP7 Regulation 15(1) Requirement The registered persons must ensure that relevant information is always transferred to the care plan. The registered persons must ensure that all parts of the home are kept safe for residents and staff. A copy of the current electrical certificate must be forwarded to CSCI as soon as possible. Timescale for action 30/04/08 2. OP38 13(4) 30/04/08 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 OP29 Good Practice Recommendations It is recommended that the home employ a more secure method of keeping staff photographs on file. St Annes Court DS0000003983.V357558.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Annes Court DS0000003983.V357558.R01.S.doc Version 5.2 Page 31 - 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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