Care Home: St George`s Court Care Centre

Similar services:

• Claremont House
• Oak Ridge
• Sun Court Nursing Home
• Ashville House
• Bilney Hall
• Hill Barn
• Mabbs Hall Nursing Home
• Henrietta House

What the care home does well Staff interact with people who live in the home and listen to them in a way that makes them feel valued.St George`s Court Care CentreDS0000015238.V377228.R01.S.docVersion 5.2Minutes of the meetings involving people in the home and their relatives are sent by post to the next of kin and by e mail to those living abroad. All areas of the home were calm throughout the day. Ten people went on a trip to the coast, accompanied by staff. What has improved since the last inspection? An activities co-odinator has been employed and she is making a difference to those living in the home with the availability of a more varied activities schedule. What the care home could do better: Since there have been some security issues it was disappointing that staff did not check our identity, call a senior member of staff or remain on the ground floor with us. There are still difficulties with understanding some staff from abroad and their understanding of English. Details of activities could be more widely circulated to ensure those who spend a lot of time in their rooms are informed. People need to be able to reach their emergency call cords so they can summon help if necessary. Where fluid charts are being completed the care plans need to show how much fluid staff should be encouraging that person to drink. Staff need to understand their roles and responsibilities in safeguarding people in the home. Key inspection report CARE HOMES FOR OLDER PEOPLE St George`s Court Care Centre Russell Street Cambridge Cambridgeshire CB2 1HT Lead Inspector Alison Hilton Key Unannounced Inspection 18th August 2009 07:10 DS0000015238.V377228.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. St George`s Court Care Centre DS0000015238.V377228.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address St George`s Court Care Centre DS0000015238.V377228.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St George`s Court Care Centre Address Russell Street Cambridge Cambridgeshire CB2 1HT 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) 01223 712135 01223 712138 St George`s Court Healthcare Ltd Manager post vacant Care Home 76 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (56) of places St George`s Court Care Centre DS0000015238.V377228.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of service users who require nursing care is 29 Date of last inspection 1st September 2008 Brief Description of the Service: St George’s Court Care Centre is a care home for up to seventy-six older people. The home is built on three floors, and each floor offers a home to a different resident group. The majority of residents on the top floor need nursing care: there is at least one registered nurse working on this floor at all times of the day and night. The middle floor is divided into two separate units: one offers care to twenty people with dementia (including one respite bed); and one has twelve places for older people who need assistance because of physical frailty. There are ten rehabilitation beds on the ground floor, and five places which are used for interim care (people waiting for places elsewhere). Half of St George’s Court was built in 2005/6 as an extension to the original 1970s building, which was fully refurbished at the same time. Each of the four units has its own lounge and dining areas with a small kitchenette, a number of single bedrooms, and bathroom and toilet facilities. All of the new bedrooms have an ensuite shower room with toilet and washbasin. Some of the bedrooms in the original building have ensuite facilities, and the seventeen other bedrooms have a washbasin. There are two passenger lifts and staircases for access to the upper floors. On the ground floor there is a large kitchen where all the meals are prepared; a small rehabilitation kitchen; a laundry, which serves the whole home; and offices. There are staff facilities on each floor and a smoking area for residents and visitors on the ground floor. There is a central courtyard garden accessible to wheelchair users. St George’s Court is in a residential area close to the centre of the city of Cambridge. There are local shops, churches, pubs, restaurants, banks and a post office within a few minutes walk; the city centre is a short bus ride away; and the main-line station with direct links to London and the North is in walking distance. The majority of places at St George’s Court are ‘block-purchased’ by Cambridgeshire County Council. The current local authority fees (as at August 2009) are £386 for frail elderly; £475 for dementia care; and £577 for nursing. Fees for privately funded places are available on request. Copies of the CQC (formerly CSCI) inspection reports are available in the entrance foyer of the home. St George`s Court Care Centre DS0000015238.V377228.R01.S.doc Version 5.2 Page 5 St George`s Court Care Centre DS0000015238.V377228.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that people who live in the home experience good quality outcomes. We, the Care Quality Commission (CQC) carried out a key unannounced inspection at St Georges Court Care Centre on Tuesday 18th August 2009 between 07:10 hrs and 16:45 hrs using the Commission’s methodology described below. This report makes judgements about the service based on the evidence we have gathered. Staff (including night staff); people who live in the home, the deputy manager and the administrator were spoken to as part of this inspection. The manager arrived when we were giving feedback as she was on annual leave. A number of records were seen including staff files, care files for people living in the home together with other relevant documents and charts, medication administration records and training information. A short observational tool for inspection (SOFI) was undertaken in the dementia unit. This is an observation of interactions between people who live in the home and any other person, and whether these are positive or not. The outcomes are noted every five minutes over a period of two hours and we use the details as evidence in the body of the report. An Expert by Experience was part of the inspection. They are someone who has either experienced care or have had a relative in care and therefore have first hand knowledge of care systems. They talk to people living in the home or visiting a relative and they sit and observe and listen to the way staff talk to people. The evidence provided by the expert is detailed in the report. Surveys were sent to staff and people who live in the home. Four surveys were returned by people living in the home and eleven by staff. Information from these will be in the body of the report. The last Key Inspection was on 01/09/08. What the service does well: Staff interact with people who live in the home and listen to them in a way that makes them feel valued. St George`s Court Care Centre DS0000015238.V377228.R01.S.doc Version 5.2 Page 7 Minutes of the meetings involving people in the home and their relatives are sent by post to the next of kin and by e mail to those living abroad. All areas of the home were calm throughout the day. Ten people went on a trip to the coast, accompanied by staff. What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is St George`s Court Care Centre DS0000015238.V377228.R01.S.doc Version 5.2 Page 8 taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. St George`s Court Care Centre DS0000015238.V377228.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 George`s Court Care Centre DS0000015238.V377228.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,4,5,6 this area. People using the service experience good quality outcomes in The Statement of Purpose and Service User Guide provide enough information for people to decide if the staff and accommodation can meet their needs. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: There was a comprehensive Statement of Purpose and Service User Guide in the entrance hall of the home. Theses contained all the necessary details for someone to decide if the home and the staff working there could meet their needs. Information in the AQAA showed that where possible people are encouraged to visit the home and have a meal there so that they can have first hand knowledge of what it is like. There was also an acknowledgement that during the assessment process ‘families need to be made aware that their placement at St Georges during the first six weeks is subject to the settling in St George`s Court Care Centre DS0000015238.V377228.R01.S.doc Version 5.2 Page 11 period and that if the service provided does not meet the client’s needs then an alternative placement needs to be sought’. Two of the four surveys returned by those living in the home showed they had not received enough information to help decide if the home was the right place for them. People spoken to in the rehabilitation beds said they were not given a choice, but other people in the main home said they had an element of choice. There were assessments on files that were completed before a person was admitted to the home. The AQAA showed that staff had received training on gathering information to assess how a person’s holistic needs can be met. People in the intermediate and rehabilitation care beds have dedicated rooms on the ground floor. There is input from the specialist services such as physiotherapy and staff are clear about their role of promoting independence. St George`s Court Care Centre DS0000015238.V377228.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 area. People using the service experience good quality outcomes in this Care plans are updated regularly, which means staff have current information on how to meet a person’s needs. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The care plans for five people were seen. The care plan for one person showed they had been referred for nutritional support and an assessment had been completed. This person had lost some weight although their weight remained fairly stable. There was a care plan in place regarding promoting an adequate diet and fluid intake. We asked if this person had fluid or food charts in place and they had not, so it was difficult to see how the home was monitoring this. Throughout our observation they drank plenty of fluids but refused their meal St George`s Court Care Centre DS0000015238.V377228.R01.S.doc Version 5.2 Page 13 despite lots of encouragement. On their care plan there was no information about their dietary preferences. We case tracked one person and the file was well organised and information easy to follow. There was a clear pre admission assessment. There was reference to a specific religion but there were no details on file to evidence that the person’s religious needs had been assessed or were being met. The staff said this person refused some things they had previously been involved in (including attending religious services and seeing people who were associated with it) but this had not been documented to show it was their choice. There was nothing about this persons Parkinson’s and how it may impact on them, in particular their mobility, but there were good records relating to other areas of their health care. The person’s social needs were clearly described but participation in social events was not on their individual file. It would be difficult to know what she liked to take part in and how positive this was. Other areas of the care plan were detailed and had been reviewed monthly. There was no evidence of when this person had their last statutory review. There was a date of 2007 when they last saw the care manager but no corresponding report. The placing authority has a statutory obligation to undertake a review of care annually. Another file had the necessary information and care plans. There was evidence that dependency had improved and the corresponding care plans had been updated. There was a lot of information about the person’s life history, including that they do not wish to attend chapel, which they had done previously. Social activities they had participated in included music for health, one to one time, a sing along, old time music hall, painting and nails cleaned and cut. There were details of visits from other professionals such as the Community Psychiatric Nurse and GP ensuring their health and wellbeing. The daily notes were comprehensive and gave a good idea of the person’s day. Another file showed an increase in dependency and this was well documented, including moving and handling updates where there now need to be two staff to assist with washing and dressing. The GP had been involved and the person has expressed the wish not to go to hospital as their health declines. The placing authority had reviewed the placement on 29/09/08. Although the expert by experience explained in very simple terms none of the people he spoke to were aware of the existence of a Care Plan or being involved in it. Resident comments included “not seen don’t bother about it”; “difficult to say”; “not seen ever to my knowledge”; “not heard of”. Staff need to evidence people are involved in the creation of their plan of care and whenever it is updated/reviewed, or record that they do not wish to be. Information in files showed that food and fluid charts are completed and daily amounts recorded. There were no details about the daily amount each person should drink to ensure their wellbeing and avoidance of dehydration from any St George`s Court Care Centre DS0000015238.V377228.R01.S.doc Version 5.2 Page 14 professional therefore staff could not know if the amount of fluid taken was sufficient. One food chart showed that the person had a soft diet but did not show what had been eaten. St George`s Court Care Centre DS0000015238.V377228.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 in this area. People using the service experience good quality outcomes People living in the home have more choice of activities to ensure their preferences, social and cultural needs are met. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: We carried out a short observation of four people in the dementia care unit, all of whom had some form of cognitive impairment. This gave us some insight into the experiences of people living in a care home who may not be able to verbally comment on the standards of care. We watched the interactions and frequency of interaction between care staff and those being observed. The observation took place over two hours starting at 11.10 and finishing at 13.10. We then stopped observing and joined a small group for lunch. The unit was well staffed and there were often three staff in the one unit we were observing in. We had been informed at the start of the inspection that a group had gone St George`s Court Care Centre DS0000015238.V377228.R01.S.doc Version 5.2 Page 16 on a day trip to Hunstanton so the unit was unusually quiet. Some people were in the other communal area and others were in their bedrooms. Throughout our observations people were able to get up freely and move about. One person (not being observed) paced the unit frequently and staff would often join them on their walk and chat to them. Throughout the observation there were examples of positive interaction when staff would maintain eye contact with people and speak with them. They gave clear, simple instruction and if the person resisted instruction such as being asked if they wanted a drink, go to the toilet or have lunch, staff repeated the request. If this was refused staff went away and came back a few minutes later to repeat the request. This was consistent with the care plan we saw. One person used a lot of non verbal communication and staff mimicked this which was positive and helped establish lines of communication. We saw some examples of poor communication including staff talking or answering people whilst walking away from them or with their back to them. One staff member referred to a person as naughty but generally the language used by care staff was appropriate. People were usually referred to by their first name, which was in line with information in their care plan. During our observations there was a lot of staff interaction, which initially was quite task focused; giving people drinks and assisting them to the toilet. Staff demonstrated a lot of kindness and patience in carrying out these tasks. Some people found it difficult to understand staff accents and this was complicated further by the same requests being made by different staff with differing accents. There was a lot of information around the home about forthcoming events. One member of staff spent some time manicuring and painting the nails for two people in the home. One person refused. Two staff members spent some time looking at books with people although one person was particularly resistant to this. The staff persevered and she was able to contribute positively to the activity. There was a lot of conversation between people and staff about their past lives and experiences and the care plans included details of the life story/history of people living in the home. The chairs were arranged in a way which made it possible for persons to sit quietly in small groups. Some chairs were back to back. Throughout the morning there was soothing, old time music playing in the background. The expert by experience found the activities organiser had departed on a trip with some residents to Hunstanton. In her absence he talked to a member of staff who said that the organiser “is very good, going with full throttle”. There was evidence on the notice board of activities and mentioned bingo, Pat dog events, tea in the garden, quizzes, visiting musicians including sedentary exercises to music, visit of a theatrical group, church services, painting club, St George`s Court Care Centre DS0000015238.V377228.R01.S.doc Version 5.2 Page 17 pub lunch and visits to a garden centre with a tea room and the Botanical Gardens. In the Organiser’s room a current weekly schedule was seen, with a good range of activities am and pm from Monday to Friday; there was no reference to the weekend so it was not clear if any activities took place then. (The activities co-ordinator said she worked 30hrs per week and another 10 hours were undertaken by another member of staff and some of these were over the weekend). Some people and their relatives seemed unaware of the activities available. For example one person when asked about tea in the garden: “didn’t know they did”; this is someone who stays in her room and doesn’t always look at the notice board. Most people were not too interested in the activities saying “no, trouble with my back”; “don’t bother” and “women’s things”. Overall there has been a very encouraging development of a range of activities. Publicising these offerings to everyone could be more comprehensive than the notice boards and verbal communication. On speaking to the manager she said that activities are detailed on white boards in each unit, but she would ensure everyone received a copy in their room each week so people had the information to hand and could decide if they wanted to participate. On the day of inspection the meal was tuna salad, chicken in mushroom sauce or roast chicken with fresh vegetables followed by fresh fruit mousse or yoghurt. Some comments in the surveys received from people living in the home were about choice of food being limited, and although there were three main course alternatives there was a minimal choice of dessert. One person commented “I shall soon look like a yoghurt. Too much sweet ice cream, cream and tinned peaches”. One person would like more savoury food like scrambled eggs and Sunday Roast with Yorkshire pudding. The chef said there had been an increase in choice and that there were now two deliveries a week of fresh fruit and vegetables, which provided a better diet for people in the home. There was fresh fruit available around the home but often people need to be encouraged to eat it and if it was peeled and cut and offered to people this may increase the amount people eat. On the dementia unit lunch arrived at 12.45. Staff had set the tables, an activity that people on the unit could have participated in. The tables were nicely set and there were bowls of fresh fruit on the table and plenty of drinks. People were encouraged to drink throughout the morning. All the other people sat at the table. This took some time and a lot of encouragement from staff. All ate independently and staff offered choices and asked if people wanted a second helping. Salt and pepper were on the table. There was very little wastage. The meal was served at relaxed and appropriate pace. People were asked if they enjoyed their food. It would have been nice if staff had joined people for meals to create a ‘normal’ environment similar to a restaurant. St George`s Court Care Centre DS0000015238.V377228.R01.S.doc Version 5.2 Page 18 The expert by experience noted that plastic cups were used for juice both in the lounge and at lunchtime. This could be thought about and where possible glasses used (as they would be in most people’s homes), subject to risk assessments. St George`s Court Care Centre DS0000015238.V377228.R01.S.doc Version 5.2 Page 19 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 this area. People using the service experience good quality outcomes in People who live in the home are safeguarded from abuse by the policies and procedures in the home, but staff need to understand their roles and responsibilities within that framework. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Details in the AQAA showed that the manager had received 5 complaints since January 2009, two of which are in the process of being investigated. The complaints log and safeguarding information was seen and it showed that the manager follows the policies and procedures necessary. The manager is aware of the local joint protocol and the details of the Safeguarding team in Cambridge. The manager does notify the Commission when there are any concerns in the home under Regulation 37 of the Care Standards Act 2000. There is information in the home to show people how to complain and those spoken to said they would speak to staff if they weren’t happy. Details in one of the surveys returned showed the person would “speak to a carer”, but two St George`s Court Care Centre DS0000015238.V377228.R01.S.doc Version 5.2 Page 20 other’s had ticked the box to say they were not aware of how to make a complaint, but did know of someone they could speak to informally if they were not happy. The details of how to complain are contained in various documents given to people when they come to live in St George’s Court, but staff need to check that people understand the information. Training has been provided in the form of E Learning, which does not ensure staff competency. On the day of inspection night staff were asked what they would do if a registered nurse on duty was seen to abuse a person living in the home. They did not provide us with an answer that ensured people in the home would be protected and the issue was discussed with the manager. It was suggested that further training with the local authority safeguarding training team would be advisable. St George`s Court Care Centre DS0000015238.V377228.R01.S.doc Version 5.2 Page 21 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,23,24,25,26 outcomes in this area. People using the service experience good quality The home is clean and free from offensive odours, making it a pleasant and comfortable place to live. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The communal room where the SOFI was undertaken was at a pleasing temperature and the room was light and airy. It was well maintained and decorated. We observed that the room was cleaned to a high standard. A spillage was made whilst we were observing and this was cleared up St George`s Court Care Centre DS0000015238.V377228.R01.S.doc Version 5.2 Page 22 immediately. The room had local pictures of Cambridge and some art work completed by people on the unit. Other areas also had local historical pictures and we were directed by some people living in the home to ‘have a look. I live near there’. The expert by experience spent most of his time in the unit for the physically frail on the middle floor. Arriving from the lift there were no notices indicating this unit or the dementia unit on the same floor. There was a pleasant through room with a small lounge leading to another small lounge combined with a dining area in a soothing, light décor with pictures on the wall and some artwork from those living in the home. In the dining room there was suitable background music at a sensible volume and a TV on in the other lounge all the time he was there; even when no one was there. There were some newspapers and several books on tables. A bowl of grapes was on the dining table together with 2 containers of juice; the residents were well supplied with drinks. An air conditioner was in the unit and an electric fan was on. The 3 bedrooms he went into had a name and a photo on the door and in some of the rooms were nice laminated notices saying who the key worker was and what he/she could do as well as information on the resident and the complaints procedure. The bedrooms seen were personalised with some people exercising their wish to be there at that time. One communal bathroom also with a toilet had a mattress in it, which could make it difficult for people to use. St George`s Court Care Centre DS0000015238.V377228.R01.S.doc Version 5.2 Page 23 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 this area. People using the service experience good quality outcomes in The recruitment process ensures people who live in the home are protected and staff receive statutory training to ensure they are competent to do their job. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Comments from staff surveys included “staff are very friendly, responsible and hard working”; “need more trained staff, concerns about pay”; “staff need more training”; “need more staff to do my duties well”; “we need more staff rest rooms and changing rooms”; two people said the maintenance could be better in the home; one person commented that a lot of the staff are students gaining experience, which results in a higher staff turnover. The expert by experience found there was a calm atmosphere while he was on the unit and the staff were attentive to the residents and speaking to them in a respectful way. Generally people were happy with the staff and had no complaints. Typical comments were “I like it, friendly, help me a lot. Help me St George`s Court Care Centre DS0000015238.V377228.R01.S.doc Version 5.2 Page 24 get up, go to bed, some don’t speak English very well but get by”; “Home all right, staff are all right and I understand them, no complaints”; “Staff are all right”; one relative commented “He likes it they treat him very well…good to me mostly offer a cup of tea. Another person said he was satisfied with the staff generally but “last week collapsed near bed, couldn’t reach the emergency cord … 2 hours on the floor until 2 staff passed by”. He showed the big bruise on his leg, and emergency cord was not very accessible, being wound up behind the headboard. This was discussed with the manager who was not aware of any incident but would investigate. Some people living in the home have a problem understanding and being understood by some staff. The AQAA showed that staff are encouraged to attend English courses to overcome this issue. One person commented that the spotlight above their bed was still not working “mentioned about a fortnight ago” and the lamp by the chair was also not working. There is a maintenance book and the manager needs to ensure all requests for repairs are completed. On the individual rota’s seen for nurses, carers, rehab and night staff the numbers were :1 RGN on each floor during the day. 5 carers am and 4 carers pm on the dementia unit. 6 carers am and 4 carers pm on the nursing floor. 3 carers am and 2 carers pm on the rehabilitation unit. At night there is 1 RGN and 7 carers to cover the home. These figures were correct on the day of inspection. The files for three staff were seen and all contained at least two references, PoVA First, and necessary work permit and evidence of identity. Two staff had full Criminal Record Bureau (CRB) disclosures before they started work in the home. One staff member had started work under the PoVA First but there was evidence on file of the dialogue between the administrator and CRB centre in relation to this person (last contact 17/08/09). A comprehensive risk assessment was in place for this member of staff and evidence that she was supervised at all times. There was evidence of an induction, training (including e learning) in areas such as dementia, challenging behaviour, catheterisation, infection control and diabetes. St George`s Court Care Centre DS0000015238.V377228.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,38 People using the service experience good quality outcomes in this area. People living in the home can be confident that the home is managed by someone fit to be in charge to ensure they have a good quality of life in safe surroundings. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Details in the AQAA showed that the manager is a Registered Mental Nurse and has been at St George’s since June 2008. St George`s Court Care Centre DS0000015238.V377228.R01.S.doc Version 5.2 Page 26 Comments from the staff surveys included “Very good management”; “I feel the home has moved forward….high staff morale with a strong leader. I really enjoy working here”. Comments made on the day of inspection included “the best (manager) we have ever had, excellent, everyone likes her”. Minutes of a variety of meetings were seen such as care staff (last 8/7/08); Heads of Department (last 14/07/09); Administration (last 08/04/09); Night shift (last 02/07/09); Clinical (to be held the day of inspection) and residents/relatives (last 30/07/09). It emerged from interviews by the expert by experience that whilst most people knew of the resident/relatives meetings some did not. On speaking to the administrator she said that minutes of meetings (together with the date of the next meeting) are sent by post to the next of kin and in some cases (where requested) to people abroad via e mail. There is a newsletter that is due to come out shortly. To ensure the safety of people in the home staff must be clear about people entering the home, who they are and why they are there. On the day of inspection we were let in by a member of staff who did not check our identity, call a senior member of staff or remain on the ground floor with us. St George`s Court Care Centre DS0000015238.V377228.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 3 3 3 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 2 3 3 X X 3 3 3 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 3 3 X 3 X X 3 St George`s Court Care Centre DS0000015238.V377228.R01.S.doc Version 5.2 Page 28 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 OP18 Regulation 13 (6) Requirement Staff must receive appropriate training and tests in competency in relation to safeguarding, to ensure people living in the home are not placed at risk of harm or abuse. Timescale for action 31/10/09 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 OP38 OP8 Good Practice Recommendations To ensure the safety of people living in the home staff should be aware of security of the premises. Food and fluid charts should be completed where people are at any risk of malnutrition or dehydration. St George`s Court Care Centre DS0000015238.V377228.R01.S.doc Version 5.2 Page 29 Care Quality Commission East Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. St George`s Court Care Centre DS0000015238.V377228.R01.S.doc Version 5.2 Page 30 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!