Care Home: St George's Home

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What the care home does well The manager and staff appeared to have a good relationship with those under their care. People seemed to be at ease in their surroundings and the atmosphere was relaxed and friendly. Once developed the information recorded in care files was detailed and gave staff information on how to meet people`s needs taking into account their personal preferences. The range of activities on offer helps to ensure that people receive both mental and physical stimulation which should help give a sense of wellbeing. The manager was aware of issues that required addressing and was keen to ensure that the Home is run in the best interests of those that live there. What the care home could do better: High standards continue to be maintained and no requirements have been made following this inspection. Some good practice recommendations are detailed. Random inspection report Care homes for older people Name: Address: St Georges Home 116 Marshall Lake Road Shirley Solihull West Midlands B90 4PW two star good service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Deborah Shelton Date: 0 2 0 8 2 0 1 0 Information about the care home Name of care home: Address: St Georges Home 116 Marshall Lake Road Shirley Solihull West Midlands B90 4PW 01217454955 01217454955 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Magda Gleeson Type of registration: Number of places registered: Conditions of registration: Category(ies) : St Georges Care Limited care home 29 Number of places (if applicable): Under 65 Over 65 29 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users who can be accommodated is: 29 The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) 29 Date of last inspection Brief description of the care home St Georges is a purpose built, two-storey residential home providing care for up to 29 older people. The home is close to local amenities, is on a local bus route and the main route through to Solihull and Birmingham. There are 23 single bedrooms and 3 double. Care Homes for Older People Page 2 of 12 Brief description of the care home Television and telephone points are available in all bedrooms. The home has a large communal area, with a dining area. A quiet area is located on the first floor, with a balcony area to the roof. There is a shaft lift for access to the first floor, providing wheelchair access to all parts of the home. Two of the bathrooms provide assisted bathing facilities. The rear garden is lawned, with some shrubs. Ample parking facilities are available to the front of the property. The manager advised that the fees are GBP364.00 to GBP450.00. The Service User Guide states that fees do not include the cost of private services such as chiropody, dentistry, optician, hairdressing, personal toiletries, newspapers, dry cleaning, clothing or other personal effects. Care Homes for Older People Page 3 of 12 What we found: We, the Care Quality Commission (CQC) undertook this random inspection visit to monitor standards of care at the home, which was rated as good at the last key inspection on 14 August 2009. This random inspection was unannounced, which meant the home was not given notice of our visit. We wanted to gain an assessment of peoples experience within the home. This was to make sure that the standards highlighted within our previous report continue to be maintained. Before the visit we looked at information we received since our last inspection. This includes notifications of any incidents and how the service dealt with any complaints. During the visit we spoke with the senior care and the manager. We looked at information about people who use the service. We looked around the buildings to make sure they were clean, safe and comfortable. Two good practice recommendations made at the last inspection to the Home were discussed with the manager. The first related to giving people information about the Home such as the Service Users Guide. The manager said that everyone has a copy of this document but sometimes their family takes it away to read. The manager is considering asking people to sign a document to confirm that they have had the Service Users Guide. We saw a Service Users Guide and information pack in one bedroom. The second good practice recommendation related to ensuring care plans contain information about peoples religious and cultural needs. We were shown one care plan which recorded the special needs of this person which included the type of food they are able to eat, prayer time, getting books from the library in a specific language and religious pictures which are to be on display in their bedroom. These two good practice recommendations had been met at this inspection. Two care plans were seen, one of these was detailed and contained sufficient information to enable staff to provide the care and support needed by people. The other was for a person who had been admitted to the Home in June but there was no care plan available. The manager confirmed that she had not been available at the Home for a few weeks and had been unable to complete the care file. A daily assistance and risk assessment sheet was forwarded to us following this inspection. These records give staff the information they need to provide daily care for this person. The manager confirmed that full care plans will be developed within the next few days and will be forwarded to us as confirmation that the task has been completed. Information recorded in the care plan seen was detailed, personal preferences and choices, needs and abilities and details of the number of staff and equipment needed to provide care were recorded. We discussed complaints with the manager and found that any complaints received are recorded in a log book with details of the action taken and the outcome of any investigation. There were no complaints recorded for 2010. There is a suggestions box in the entrance hallway for people to record any issues or suggestions for improvements. Next to the box is a document holder which should hold copies of suggestion/complaints forms, however, this was empty on the day of inspection. The manager was aware of this and confirmed that new forms would be put in place as soon as possible. Care Homes for Older People Page 4 of 12 There is a visitors signing in book in the entrance hallway of the Home. Next to the signing in book was some hand gel which should be used to prevent the spread of infection. There was a small sign by the visitors book requesting that people sign the book upon entering and leaving the building. People were seen entering the building without signing this book. The hand gel was not seen in use by anybody entering the building. There was no signage instructing people to use the hand gel and the gel was not clearly visible, particularly if the person did not sign the visitors book. A number of bedrooms were seen, these were clean and no unpleasant odours were noted. We were told by the manager that all beds are hospital type beds. Two of the beds seen in a shared room were easy to move at the foot end which suggested that there was a problem with the breaking mechanism on the wheels. The head end of the bed appeared to be stable. A bed that is not secured in place and could move if weight were put on it could present the risk of accident. The manager agreed to check all of the beds throughout the Home to see if they were in good working order and to record any that need repair. This list would be given to the handyman upon his return from annual leave. The manager confirmed that she would ensure that all of those beds that are in need of repair would be attended to as soon as possible. The double glazed window in another room seen had two large cracks in the external pane. We were told by the manager that these have been checked by the handyman and declared safe, however he is going to replace the glass in this window on his return from leave. Bathrooms and toilets seen were all in good working order but were in need of redecoration as they looked shabby and did not give a homely feel. Flooring in some bathrooms is also in need of replacing as it is coming away from the sides of baths. We were told that the electric hand dryers in bathrooms are all in good working order and the ones we checked worked. However, they were all turned off at the wall by a switch. The manager said that is because when anyone walks past them the hand dryer starts working. We were told that those people who are able to use the toilets without staff assistance are all aware that the hand dryers need turning on at the wall and the staff would turn on the hand dryers for those people who need staff assistance. In addition to the hand dryers, in some bathrooms, there are disposable hand towel dispensers. Some of which were full on the day of inspection and some empty. The manager instructed a member of staff to check all disposable hand towel dispensers and fill those that were empty. This task was completed whilst we walked around the Home. The laundry was clean and hygienic and there was no backlog of items waiting to be laundered. There is a commercial washing and a commercial drying machine and both were in good working order. We discussed laundry to identify whether there was a problem with items being misplaced. The manager said that occasionally things are misplaced but since the new laundry assistant started this issue of missing items has greatly reduced. From walking around the Home it was noted that there appeared to be a limited amount of storage space, the manager confirmed that they would like a garden shed to be able to store some equipment such as ladders, which were chained to the wall in a corridor. There is a ramp to the front door of the Home giving easy access to those people who use a wheelchair. The Home has an entrance porch which was open on the day of Care Homes for Older People Page 5 of 12 inspection and a front door which was locked by a key. Access to the rear gardens is via the front door using the ramp. The gardens are secure and people would not be able to leave the premises without requesting staff to open the electric gates. The rear garden was neat, there were tables and chairs out on the grass which appeared to have been cut but which had tall buttercups growing through. The manager said that they planned to make a patio on an area of uneven stones/cobbles which could be used by people to sit out in the garden. The garden may benefit from some brightly coloured flowers making the area more appealing to the eye. On the first floor of the building there is a small roof terrace. The door from the corridor on to the terrace was left open giving people free access to this area. There were tables and chairs out and some plants in pots. Unfortunately some of the plants had died and the pots had weeds growing in. The roof terrace is a nice additional outside seating area which we were told is often used by some people to sit with visitors or sit with friends in the sun. The lounge and dining area is open plan and seating in the lounge area has been arranged to create three smaller areas. This enables small groups of people to chat amongst themselves without having to shout across the large room. People appeared to be at ease in their surroundings and had formed good relationships with each other. There was a television in each of the seating areas. We were told by the manager that each television was in good working order, although only one television was in use on the day of inspection. This was a large television which was playing age appropriate music via a karaoke machine. This music could be heard in each of the seating areas and it would therefore be difficult for people to watch the television at the same time that the music was being played. The manager said that people ask to have the television on when they no longer wish to listen to the music or some people may choose to watch their own televisions in their room. People seen on the day of the visit were wandering freely around the Home and appeared to be comfortable in their surroundings. The kitchen was clean and the chef said that all equipment was in good working order. Meals are provided in two sittings, this enables staff to help those people who need assistance at the same time. The chef said that he orders the food with the manager and people have a choice of meal each day. We looked at the activity records for people. These records are used to demonstrate that people are offered activities to provide mental and physical stimulation each day. There is an activity list on display outside the lounge area. The manager said that this is used as a guide for staff. People would be offered the activity recorded but if nobody is interested they are offered alternatives. The manager said that there is an activity co-ordinator who works each Tuesday, Wednesday and Friday. An external entertainer provides progressive mobility each Thursday. Care staff also undertake activities with people when the activity co-ordinator is not available. A hairdresser visits once per week. Records are kept to show what activity took place, who joined in, and any scores from quizzes or games. These records are also used to demonstrate that activities regularly take place and whether people have enjoyed them or not. Records show that there are set times for activities each afternoon but in addition to this people undertake their hobbies in the mornings such as reading the newspaper or books, Care Homes for Older People Page 6 of 12 knitting or crochet. The Home also have DVD mornings where people can watch a film of their choice. They are also able to go out for a stroll in the gardens or the local garden centre accompanied by staff. During the inspection one person said that he was going for a walk to the shops. The staff personnel file of a newly employed staff member was seen. This showed that robust recruitment processes had been followed. The file contained evidence of criminal records bureau (CRB) and independent safeguarding authority (ISA) checks, written references, work history and application form. The manager confirmed that every staff member has a CRB and ISA check on their personnel file. A discussion was held regarding supervision and observation of staff working practices. The manager said that both supervision and observation takes place. We were shown notes made which demonstrated that the manager observed working practices and noted areas that need improvement. The manager said that issues identified are discussed with the staff immediately and then recorded on their supervision records to be discussed at their next supervision meeting. We were told that spot checks of night staff take place and the senior carer observes night staff working practice during the early morning when she is on shift. We were told that the Home do not use agency staff, as their own staff prefer to work additional shifts if needed. There are no care staff vacancies currently. It was a recommendation of the last inspection that the manager complete the Registered Managers Award. We were told by the manager that she is still in the process of undertaking this qualification and is approximately half way through. Unfortunately the Award has changed and she is unsure as to whether she needs to start again or will be able to continue with the current award. What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Older People Page 7 of 12 following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 8 of 12 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 9 of 12 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 Care plans that detail the action to be taken by staff to meet peoples care needs should be available upon admission to the Home. Complaints/suggestions forms should be available next to the suggestions box in the entance hallway of the Home. Bedroom furniture should be of a satisfactory standard and in good working order. People should be made aware by appropriate signage or other means that they should use liquid hand cleansing gel upon entering the Home to reduce the risk of spread of infection. The manager should complete the Registered Managers Award as soon as possible. Work should be undertaken to ensure that all beds in the Home are safe for use and wheels are able to be locked in place to ensure beds do not move accidentally. Work should be undertaken on the pane of glass in the double glazed window identified during this inspection. This Page 10 of 12 2 3 4 16 19 26 5 6 31 38 7 38 Care Homes for Older People Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations window should be made safe and repaired. 8 38 Staff should ensure that all people sign in and out of the Home when they visit. This should be completed to meet fire regulations. The manager should ensure that people are aware of the need to sign the visitors register. Care Homes for Older People Page 11 of 12 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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