Care Home: St Michael`s

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What the care home does well St Michaels is a nice house with a garden at the front. The Manager and his family live upstairs. He listens to what the residents say. Everybody who lives at the home has their own bedroom. Nobody has to share a room.There are bus routes nearby. This means that the people who live at the home can get around easily. They can be taken by car as well.Torquay football stadium is next door. Shops and a swimming pool are nearby.Staff help people do what they want. They go to interesting places, and have nice holidays.St Michael`sDS0000070730.V362341.R01.S.docVersion 5.2Page 7 What has improved since the last inspection? The dining room has been redecorated and has new furniture, including a television, to give people better choice. Residents are helped to do more for themselves in the house.Medicines are given more safely. What the care home could do better: When the new staff arrive, more training will be needed. CARE HOME ADULTS 18-65 St Michael`s St Michaels Bronshill Road Torquay Devon TQ1 3HA Lead Inspector Stella Lindsay Key Inspection (unannounced) 15th April 2008 10:00 St Michael`s DS0000070730.V362341.R01.S.doc Version 5.2 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 Michael`s DS0000070730.V362341.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 Adults 18-65. 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 Michael`s DS0000070730.V362341.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Michael`s Address St Michaels Bronshill Road Torquay Devon TQ1 3HA 01803 325189 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) mandkmagson@blueyonder.co.uk Mrs Helen Marie Harris Mark Steven Magson Care Home 6 Category(ies) of Learning disability (6), Physical disability (6) registration, with number of places St Michael`s DS0000070730.V362341.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service: Care home providing personal care - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Learning disability (Code LD) 2. Physical disability (Code PD) The maximum number of service users who can be accommodated is 6. Date of last inspection This is the first inspection under new ownership. Brief Description of the Service: St. Michaels is a well-maintained family run Home providing care for up to 6 adults with Learning Disabilities who may also have a physical disability. The Home is in Torquay, in easy walking distance to local shops, and very close to Torquay United Football Club and a swimming pool. There is a garden at the front of the house, and a small patio area at the back. There are two parking spaces at the back of the house, and a disabled parking space on the road at the front. The ground floor of the Home is accessible to people with mobility problems, with a lounge, dining room and kitchen, one bedroom, and a bathroom which includes an accessible shower. Stairs lead to the first floor, where there are five single bedrooms, a bathroom and shower room with toilet. Three rooms are of a good size, three are slightly below the National Minimum Standards. This is included in the information given to prospective residents. Part of the garage has been converted for use as a laundry and storeroom. The Home owners live on the second floor. Fees range from £380 per week upwards, depending on care needs. The home’s inspection report can be obtained from the Manager. St Michael`s DS0000070730.V362341.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 inspection took place over two days in April 2008. It included a tour of the premises, and discussion with the home owner and Registered Manager, and all six residents. Care records, health and safety records and the medication system were examined. Information about the service had been supplied by the Registered Manager prior to the inspection. What the service does well: St Michaels is a nice house with a garden at the front. The Manager and his family live upstairs. He listens to what the residents say. Everybody who lives at the home has their own bedroom. Nobody has to share a room. St Michael`s DS0000070730.V362341.R01.S.doc Version 5.2 Page 6 There are bus routes nearby. This means that the people who live at the home can get around easily. They can be taken by car as well. Torquay football stadium is next door. Shops and a swimming pool are nearby. Staff help people do what they want. They go to interesting places, and have nice holidays. St Michael`s DS0000070730.V362341.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? The dining room has been redecorated and has new furniture, including a television, to give people better choice. Residents are helped to do more for themselves in the house. Medicines are given more safely. St Michael`s DS0000070730.V362341.R01.S.doc Version 5.2 Page 8 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 Michael`s DS0000070730.V362341.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection St Michael`s DS0000070730.V362341.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Clear information is available, and a good procedure is in place for assessment of prospective residents. EVIDENCE: A Statement of Purpose had been produced. This contains all the information required by the regulations, is clear, well organised and informative. It includes the ‘Contract of residence’ offered, to be clear about what is included in the fee. The Service User Guide was displayed on the wall in the entrance hall. It included photos of all rooms, diagrams were used to portray activities and local facilities, and symbols used for other health professionals who are involved in care of residents at St Michaels. No residents had been admitted since the new owners and Registered Manager arrived, as there had not been a vacancy. There was an admissions policy in place, which started with the focus on the prospective resident, and their wish to move into St Michaels. They will be invited to visit the home and meet the other residents, and stay for a trial period. The Manager would expect to visit the person in their original home as part of the admission process, to build up a picture of their former life. St Michael`s DS0000070730.V362341.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are encouraged to think about what they want, and records are kept clearly. EVIDENCE: The Registered Manager had introduced new care plans, which were seen to be clear, concise and up to date. Daily diaries were kept for each resident, to record health, personal, social and emotional events and concerns, to give attention to detail and make sure needs were met. Risk assessments showed how people could remain safe while doing what they wanted. Incident forms were available, though none had been needed under the new management. We recommended that they be revised to include anything that might have triggered any disturbance. St Michael`s DS0000070730.V362341.R01.S.doc Version 5.2 Page 12 Residents had been involved in decisions about the home. This included discussions about the refurbishment of the dining room as well as arrangements in their own rooms. Residents were aware of the home owners plans for building work. The system for managing residents’ money was examined, and it was found to be carefully and accurately administered. The Manager helps the residents to spend their money in order to enhance their own lives. Residents are enabled to handle their own money to the extent that this is assessed as safe and in their own interests. St Michael`s DS0000070730.V362341.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are enabled to maintain good links with the community and lead interesting and meaningful lives, with plenty to look forward to. EVIDENCE: The Manager said that he was increasing the involvement of the residents in helping around the house, with making their own drinks, going shopping, choosing menus, helping prepare meals and doing their own laundry, if they wished. All residents had some regular weekly activities. Two went daily to the local Community Resource Centre, and one was returning after a break for health reasons. Another was retired, but went for day care twice a week, and found the friendships most rewarding. St Michael`s DS0000070730.V362341.R01.S.doc Version 5.2 Page 14 One resident was pleased to show us the certificate just received for computer work, and another for Horse Care. They had photos showing good times spent recently in many activities including sailing, cookery and gardening. Another does voluntary work at the local hospital. Two residents said they were looking forward to being involved in working in the garden. All they were pleased with the pets that have accompanied the Manager’s family – a dog, two cats and a parrot, who had been made welcome. Social activities were provided at home, including a Nintendo Wii. One resident was going to a club on the evening of this visit, but two others were choosing to stay at home and watch football. They had been keen supporters of the local team for many years, and come and go freely to the stadium next door. They told us they were looking forward to going to Wembley with the Manager the following month to watch their team in a big match. When we arrived for the first day of this inspection, one of the residents was just leaving, with the Registered Provider, to catch a plane for a holiday in Turkey. Two others were looking forward to a holiday at Disneyland Paris, and the others were going to Lanzarote. A three weekly menu had been introduced, after discussion with residents. They each have a dish of choice on the menu each week, at tea-time, which is the main meal of the day except for Sundays. One person preferred to choose a pudding. Menus had been portrayed with photos. A luxury buffet had been provided the previous week to celebrate a resident’s birthday. St Michael`s DS0000070730.V362341.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive personal support appropriately, and physical and emotional needs are met. Medicines are administered safely. EVIDENCE: Help and encouragement was given as necessary to maintain residents’ personal hygiene, and to help them with their appearance. There are accessible bathing facilities are downstairs, and there are also a bath and a separate shower room upstairs. Residents said they could bathe or shower when they want. One resident had developed problems with mobility following an accidental injury. A bath seat had been obtained, and she had been helped to obtain a suitable wheelchair. Another was receiving on-going treatment for a serious condition, and receiving good support. St Michael`s DS0000070730.V362341.R01.S.doc Version 5.2 Page 16 There was evidence of dentist attendance, and of preventative measures. A monitored dosage system had been introduced, for safer administration of medicines. We examined the records and found them to be accurate. Medicines were checked on arrival either by the Registered Provider or the Registered Manager, and a Returns book was kept. The pharmacist had visited in January 2008 and given advice on the home’s policy which had been implemented. The advice for staff included what to do if a resident were to refuse, and what to do in the event of a mistake being discovered. The Registered Provider is qualified in delivering training in dealing with medication. The Manager said that when the newly recruited staff are in post he will also arrange training from the pharmacy. St Michael`s DS0000070730.V362341.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory procedure for complaints, and residents feel that their views are listened to and acted upon. EVIDENCE: The complaints procedure had been produced using symbols and displayed on the wall in the entrance hall. A formal complaints policy was on file. None had been received by the home or by the Commission for Social Care Inspection. We saw letters from three relatives, all in appreciation of the care given and in particular they were pleased to have received a Newsletter. Residents said that they would be able to speak to the Manager or his wife if they were worried about anything. There was a policy on recognising and dealing with abuse of any sort, which was clear and included the duty to report to Social Services and to the CSCI. We saw that appropriate action had been taken when an issue of staff conduct had arisen. Advice was given with regards to training provided locally including implementation of the Mental Capacity Act 2005. The Manager had previously attended a training session on the MCA. St Michael`s DS0000070730.V362341.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26,28, and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment is good, providing residents with an attractive and homely place to live. EVIDENCE: St Michaels is an attractive house and garden, and providing a homely and comfortable environment, with personal effects or interesting features in every room. There is a comfortable lounge, with a television and various games. A new conservatory was being planned, to give residents more choice in living areas. New furniture and a flat screen television had been provided in the dining room, to give more choice. There are accessible bathing facilities downstairs, and an electric powered bath seat had been obtained for the upstairs bath due to the reduced mobility of one of the residents. There was another separate shower upstairs. St Michael`s DS0000070730.V362341.R01.S.doc Version 5.2 Page 19 The management had plans to build two new bedrooms with en suite toilets and showers in the garage area, and will provide a new laundry, better suited to residents being involved. The home has a policy on the control of infection, and the house was sweet smelling throughout. St Michael`s DS0000070730.V362341.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good practice was followed with respect to recruitment. Good policies were in place for staff support and training. EVIDENCE: There were no staff at this time. The Registered Manager and his wife lived on the premises and provided all support. His mother, the Registered Provider, came to the home to help and provide cover as necessary, and also provided staff as necessary from the other home that she runs. The residents were generally happy with this interim arrangement, though it does not meet the standard for residents being involved in staff selection. The Manager was in the process of recruiting staff at the time of this inspection. The checks necessary to assure the safety of residents had been sent for, and their employment was not starting until safety was assured. A resident said that they had sat in on the interviews, and been able to tell the Manager which candidates they liked. St Michael`s DS0000070730.V362341.R01.S.doc Version 5.2 Page 21 One of the new recruits was experienced in care work. The Manager had a short induction ready for their introduction. The other was new to this work, and would be provided with a LDAF induction, overseen by the Registered Provider, a qualified trainer. The Manager’s wife was working towards NVQ2 in care, and had attended training including safe administration of medication, epilepsy, de-escalation, and health and safety. When the staff team has been recruited, it would be good practice to provide equal opportunities training, to raise awareness of ways of helping residents in overcoming barriers in society, and to carry out a training needs assessment for the team. The Manager said it was his intention to introduce a programme of annual staff appraisals and 6 – 8 weekly supervision sessions with staff. St Michael`s DS0000070730.V362341.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This service supports the residents to live the lives that they want, with attention to their health and safety. EVIDENCE: Mrs Helen Harris has been the Registered Provider of St Michaels since 15th October 2007. She has been a registered manager for many years. In 2002 she was registered as manager of a home (Alston Court) with the same client group as St Michael’s, and she has been its Registered Provider since 2005. She has achieved the Registered Managers’ Award and level 4 certificate in further education teaching. She had undertaken to carry out the monthly visits to monitor the quality of care at the home, and had provided a report on such a visit in January 2008. St Michael`s DS0000070730.V362341.R01.S.doc Version 5.2 Page 23 At the time of this inspection she was working in the home regularly, pending the arrival of the newly recruited staff, and therefore able to monitor performance and continued well being of the residents. The Registered Manager, Mark Magson, had worked in care homes continuously since 1994. He had achieved NVQ level 3 care and was working towards level 4. He had enrolled on the Registered Managers’ Award. He had achieved other training necessary for his role, including the Institute of Occupational Standards for Safety & Health certificate, foundation in Total Communication (2003), Protection of Vulnerable Adults, Boots medication, and infection control. He expressed an interest in undertaking training as a trainer, and also training in supervision skills, which would be good for developing skills of monitoring, supporting and giving useful feedback to the new staff team. The focus of this service is on listening to residents, and encouraging them to work out what they want and to express their views. Bi-monthly House Meetings have started. The minutes of the most recent one were displayed in the entrance hall. These showed that all the residents had joined the Manager and his wife to discuss menus, holidays, activities, ways of becoming more independent in their home, and refurbishment of the dining room. Feedback from relatives was seen. They were pleased to have received the newsletter. We were given a business plan for the coming year. Residents were aware of the developments planned for the home. The management were taking action to ensure safety in the home. The electrical circuit had been checked professionally, and remedial work carried out. The Fire alarm system had been serviced prior to the new management, on 27/09/07, and extinguishers checked on 23/08/07. The Manager had updated the Fire risk assessments on 15/12/07. The most recent fire drill had taken place a fortnight before this inspection, and had included two residents who had been in at the time. St Michael`s DS0000070730.V362341.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 x St Michael`s DS0000070730.V362341.R01.S.doc Version 5.2 Page 25 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA35 Good Practice Recommendations A training plan should be developed for the team, which would include equal opportunities training for all, and supervision skills for the Manager. St Michael`s DS0000070730.V362341.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection South West 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 Michael`s DS0000070730.V362341.R01.S.doc Version 5.2 Page 27 - 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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