Care Home: St. Margarets

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What the care home does well St Margaret`s provides a very good standard of accommodation for people living there and a pleasant working environment. The home is decorated and furnished to a good standard and provides ample personal and communal space for people living there to enjoy. The home provides a good standard of care delivered by a trained and competent staff team who are supported by a qualified and competent manager. Comments from visiting health care professionals include, "St Margaret`s care home appears to be a friendly, professionally run establishment where the needs of the residents are paramount". What has improved since the last inspection? The home has met all of the requirements made at the last inspection including an assessment by a Registered Occupational Therapist and implemented many of the findings. What the care home could do better: There are no requirements arising from this inspection. The recommendation remains that the home considers installing a sluice facility. CARE HOMES FOR OLDER PEOPLE St Margarets St Margarets Care Home 99 Carlisle Road Eastbourne East Sussex BN20 7TD Lead Inspector Paul Stibbons Unannounced Inspection 13:00 14 December 2007 th X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address St Margarets DS0000046888.V343209.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 Margarets DS0000046888.V343209.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Margarets Address St Margarets Care Home 99 Carlisle Road Eastbourne East Sussex BN20 7TD 01323 639211 01323 639211 office@saint-margarets.co.uk 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) Total Support Solutions Ltd Miss Teresa Howell Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22) of places St Margarets DS0000046888.V343209.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users to be accommodated is twenty-two (22). Service users must be older people aged sixty-five (65) and over on admission. Date of last inspection Brief Description of the Service: St Margaret’s is registered to provide residential care to twenty-two older people. At the time of the inspection, sixteen people were accommodated. The home is a large, detached, three-storey, Grade 2 listed building situated in the Meads area of Eastbourne. The home is located within walking distance of local amenities and the main seaside town is a few minutes drive away. Resident accommodation consists of sixteen single rooms and three shared rooms. Many of the bedrooms have en suite facilities. Communal areas comprise of a lounge, reception and landing seating areas and a large dining room. The external grounds offer an attractive and well-maintained garden to the rear of the property. Parking facilities are available at the front of the home. The home has a series of chair lifts, which enable residents to access all three floors of the home. The current fees are from £428.00 to £744.00 per week and there are additional charges for hairdressing, chiropody and newspapers. St Margarets DS0000046888.V343209.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection was conducted over a period of three hours and the manager of the home was present. A completed AQAA (Annual Quality Assurance Assessment) had been returned to the Commission prior to the inspection. A tour of the building was conducted and a variety of records and documents were examined. Feedback was gained through informal talks with residents, relatives, staff and QA surveys from visiting health care professionals. What the service does well: What has improved since the last inspection? What they could do better: There are no requirements arising from this inspection. The recommendation remains that the home considers installing a sluice facility. St Margarets DS0000046888.V343209.R01.S.doc Version 5.2 Page 6 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 Margarets DS0000046888.V343209.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection St Margarets DS0000046888.V343209.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People considering moving into the home have sufficient information on which to make an informed decision and are offered a trial period to see if the home meets their expectations. No prospective resident is offered a permanent placement in the home without first having their needs assessed and been assured that these can be met. St Margarets DS0000046888.V343209.R01.S.doc Version 5.2 Page 9 EVIDENCE: The home has produced a Statement of Purpose and service user guides for the home that clearly states the aims and objectives of the service and includes information about the staff team and their qualifications. The facilities that the home can provide are clearly documented and relevant information about the home is displayed in the main entrance. People have access to the most recent CSCI report if they wish to view it. Three care plans viewed evidenced that comprehensive assessments of need had been undertaken by the home in addition to the social work history prior to admission. The home manager is a qualified nurse and undertakes a full assessment of people considering moving into the home prior to admission to ensure the available facilities and staff skills can meet their needs. The AQAA states that prospective residents are offered two weeks trial period and this is confirmed by a notification to the Commission about a transfer to a more suitable placement of one individual on a trial period. Following any trial period people who choose to stay at the home are given a written contract detailing the fees and terms and conditions of residency. St Margarets DS0000046888.V343209.R01.S.doc Version 5.2 Page 10 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): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health care needs of people living in the home are met and they are protected by the home’s policies and procedures for dealing with medication. People living in the home are treated with dignity and respect. EVIDENCE: Three individual care plans were examined and were found to clearly detail support requirements. The home’s manager states that care plans are reviewed annually with residents and relatives and monthly internally. St Margarets DS0000046888.V343209.R01.S.doc Version 5.2 Page 11 Evidence was noted of reviews having been carried out, the most recent review date being October 2007. Care plans revealed that people living in the home have access to other health care professionals such as GPs, Chiropodists, District nurses, Opticians and Dentists. The home has recently employed the services of an Occupational health Therapist to conduct an assessment of the home and have implemented her recommendations. There are currently three people living in the home who manage their own medication and there is evidence of appropriate risk assessments having been carried out to ensure the safety of these individuals. There are five members of staff responsible for administering medication and records viewed confirm they have received training in the “Care of medicines” and further assessment by the home’s manager who is a qualified nurse. Medication is appropriately stored in a drugs cabinet and administering records viewed were legible and complete. During the visit interaction between staff members and people living in the home was observed and it was evident that staff treat people with dignity and respect. Residents spoken with confirmed, “wonderful staff, they can’t do enough for you”, and, “like living in a hotel”. St Margarets DS0000046888.V343209.R01.S.doc Version 5.2 Page 12 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): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home are offered a range of activities to meet their social and recreational interests and needs. People living in the home are supported in maintaining contact with family and friends and the local community as they wish. People living in the home enjoy a varied and healthy diet that is of their choosing. EVIDENCE: A discussion was held with a group of residents about activities they participated in within the home. Examples given included quizzes, boules, St Margarets DS0000046888.V343209.R01.S.doc Version 5.2 Page 13 films and exercise classes. Some residents go out independently and visit friends and relatives when they are able. On the afternoon of the visit it had been arranged for a singer to entertain and many relatives arrived to participate with residents in a sing along. Relatives and friends spoken with said they were always made welcome in the home and invited to lunch if they wished. The comments about the home were positive and it was felt that their relatives were very well cared for. A mealtime was observed and the food was of an excellent standard and well presented in pleasant surroundings. The home has been decorated to embrace the Christmas festivities that added to the social occasion. Residents spoken with stated how much they enjoyed the meals and confirmed that their choices were taken into account in devising menus. The home employs a qualified chef and the kitchen is organised in a professional manner with relevant records for food safety and hygiene in place. Menus were viewed and demonstrated a varied and balanced diet that took into account alternative diets and food preferences. The chef states that all meals are freshly cooked and local produce is used where possible. St Margarets DS0000046888.V343209.R01.S.doc Version 5.2 Page 14 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): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home and their relatives can be confident that their complaints will be listened to and acted upon. People living in the home are protected from abuse and neglect. EVIDENCE: The home has a complaints policy and procedures that clearly guides people making or receiving a complaint. A copy is made available in the entrance hall of the home and accessible to all. There have been no complaints received about the home by the Commission since the last inspection. Two residents spoken with said they had no complaints but would feel comfortable in raising any issues with staff. The training matrix for staff was viewed and indicated that all staff have received training around safeguarding vulnerable adults. Two members of St Margarets DS0000046888.V343209.R01.S.doc Version 5.2 Page 15 staff spoken with demonstrated a good understanding around recognising and reporting safeguarding issues. The home manager states that the Adult protection policy and procedures have been reviewed as advised in the last inspection. St Margarets DS0000046888.V343209.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,24,25,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home benefit from living in a safe, comfortable and wellmaintained environment with ample personal and communal space to meet their needs. People living in the home have bedrooms that are comfortable and have their personal possessions around them. St Margarets DS0000046888.V343209.R01.S.doc Version 5.2 Page 17 EVIDENCE: The home is decorated to a very good standard and retains the grandeur of its era. Furnishings are of a good standard providing a comfortable and pleasant environment for people living in the home. The home has a comfortable dining area as well as a large lounge that allows people to sit in groups or individually as they wish. The home is a Grade 2 listed building and some of the original windows are in need of repair or replacement. The manager states the replacement of the windows is within the home’s planned schedule of maintenance, as they have to match the originals. The home has three floors and access to all floors is via a stair lift. The stair lifts were replaced in 2006 and there is evidence of service records. As required in the last inspection the home has been assessed by a registered Occupational Therapist and many of the findings implemented. The report viewed from the Occupational Therapist concludes, “St Margaret’s Care Home appears to be a friendly, professionally run establishment where the needs of the residents are paramount. The home appears to be meeting the needs of the current residents”. Several bedrooms were viewed that were well decorated and furnished and reflected the interests and possessions of individuals. Residents spoken with were happy with their rooms and felt that they met their needs. The home has a large secluded rear garden for people living in the home to enjoy weather permitting. Within the garden is a vegetable patch and produce is used by the home. At the time of the visit the home was very clean and tidy with no offensive odours or obvious health and safety hazards. St Margarets DS0000046888.V343209.R01.S.doc Version 5.2 Page 18 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): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home, are supported by adequate numbers of trained and competent staff at all times, and they are protected by the home’s robust recruitment policy and procedures. EVIDENCE: The staff training matrix and three supporting individual records viewed indicate that staff receive all necessary mandatory training to equip them with the skills and knowledge they require to competently fulfil their roles. A recently employed member of staff confirmed that they had received a thorough induction and other mandatory training and that they were fully supported by the manager. Over 50 of the staff team have achieved an NVQ qualification in care and one member is an NVQ Assessor. Staff rotas viewed indicated that sufficient numbers of staff are on duty to meet the needs of residents and staff members spoken with support this view. St Margarets DS0000046888.V343209.R01.S.doc Version 5.2 Page 19 Three staff files viewed demonstrated that the appropriate checks had been carried out prior to employment that included a CRB/POVA check and satisfactory references. A member of staff spoken with confirmed that staff meetings and supervision regularly takes place and staff members are kept up to date with relevant information. Supervision records viewed showed the last date of formal supervision was 20/10/07. St Margarets DS0000046888.V343209.R01.S.doc Version 5.2 Page 20 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): 31,32,34,33,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home benefit from having a qualified and competent manager in charge of daily operations and running of the home. The home is run in the best interests of people living in the home and their health, safety and welfare is promoted and protected. St Margarets DS0000046888.V343209.R01.S.doc Version 5.2 Page 21 EVIDENCE: The manager is a qualified nurse and has a Registered Manager Award and Train the Trainer Award. Required notifications to the Commission are made promptly and staff members spoken with state that the manager is supportive and approachable and acted on issues raised. As required by the previous inspection the provider conducts monthly visits and records viewed in the home confirm this. A number of QA surveys from visiting healthcare professionals were viewed and all were of a positive nature. People living in the home are consulted through resident meetings, one was viewed dated 31/10/07 where discussions took place around menus and Christmas. Discussions with the manager evidences that they work to continuously improve services and involving residents in shaping service delivery. The manager returned the AQAA when we asked for it and it was clear and gave us all the information we asked for. The health, safety and welfare of people living and working in the home is promoted and protected as evidenced throughout the report through training, consultation with others, access to other healthcare professionals, servicing records, records appertaining to food safety and hygiene, needs assessments and risk assessments. People are supported to manage their own money where possible and have access to their records whenever they wish. The home has access to professional business and financial advice and has all the necessary insurance cover to enable it to fulfil any loss or legal liabilities. St Margarets DS0000046888.V343209.R01.S.doc Version 5.2 Page 22 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 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 4 X X X 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 3 X X X 3 St Margarets DS0000046888.V343209.R01.S.doc Version 5.2 Page 23 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 Home’s Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP26 Good Practice Recommendations That the home considers the need for future sluicing facilities. St Margarets DS0000046888.V343209.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Margarets DS0000046888.V343209.R01.S.doc Version 5.2 Page 25 - 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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