Care Home: St Michael`s View

Similar services:

• The Highlands
• Turret Villa Retirement Home
• Blenheim House
• 1 Lanark Close
• Mendip House
• Beaconsfield Court Care Home
• Ann Charlton Lodge

What the care home does well The SRN requirements to undertake a comprehensive review of staff training and to produce individual training needs had been complied with.The SRN requirement to ensure staff received training in five key areas has been complied with for one new nurse and the carers but not for the bank nurses or fully for the ancillary staff. Care staff said they were better trained and understood their role. They felt that people receiving care were now experiencing a better quality of life. What the care home could do better: The SRN requirement to ensure that all nurses who give medications were trained to do so had not been complied with. Evidence of the training status of bank nurses working at the home must be readily available. The SRN requirement to provide evidence of structured inductions had not been fully complied with. In addition some induction records were being held away from the home and therefore could not be examined. The SRN requirement to ensure that a person trained in first aid was on duty at all times had not been fully complied with. The presentation of duty rotas need to be improved. The records and evidence of training must provide accurate detail of exactly what has been provided. Investigations into staff training requirements are continuing. Random inspection report Care homes for older people Name: Address: St Michael`s View St. Michaels Avenue North South Shields Tyne And Wear NE33 3BP zero star poor service 01/03/2010 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: Irene Bowater Date: 1 9 0 8 2 0 1 0 Information about the care home Name of care home: Address: St Michael`s View St. Michaels Avenue North South Shields Tyne And Wear NE33 3BP 01914551215 01914551238 stmichaels@schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Sonia Pharoah Type of registration: Number of places registered: Conditions of registration: Category(ies) : Ashbourne Homes Ltd care home 64 Number of places (if applicable): Under 65 Over 65 0 31 0 dementia old age, not falling within any other category physical disability Conditions of registration: 33 0 2 The maximum number of service users who can be accommodated is: 64 The registered person may provide the following category of service only: Care home with Nursing - Code N 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 - Code OP, maximum number of places 31 Dementia Code DE, maximum number of places 33 Physical Disability - Code PD, maximum number of places 2 Date of last inspection 0 2 0 6 2 0 1 0 Care Homes for Older People Page 2 of 12 Brief description of the care home St Michaels View Care home is owned by the Southern Cross, which was first registered in November 1994 and now accommodates 32 older people of mix gender for general nursing care and another 32 persons with mental ill health, 2 of who may also have a physical disability. The home does not provide intermediate care services. It is situated in a residential area and convenient for the town centre of South Shields. It is close to local train and bus transport. The coast, shopping outlets, local theatres and social amenities are close by. The local shops and a post office are within easy walking distance of the care home. St Michaels View is a modern single storey care home, custom designed and built to provide facilities and services in 2 distinct separate units. There are in total 4 lounges, 2 dining areas and 27 bedrooms with en-suite facilities. There are 2 internal courtyards both with wheel-chair access. Care Homes for Older People Page 3 of 12 What we found: We carried out this inspection to check whether the provider had complied with the requirements of a Statutory Requirement Notice (SRN). This SRN was issued on 7 May 2010 and was one of six served on the provider following the random inspection of 23 April 2010. This SRN detailed failures to ensure that staff had received training appropriate to their work in order to meet the health and welfare needs of the people living at the home. The timescale for compliance with the requirements made within the SRN was 31 July 2010. Before the visit we examined information, responses and action plans from the provider and checked details of any changes in how the home was being operated. We also checked information that had been shared with us by other professionals with an interest in the service. We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future if a requirement is repeated it is likely that enforcement action will be taken. Two compliance inspectors carried out an unannounced visit to the home on 19 August 2010 which started at 9:30 and was completed at 16:30. During the visit we talked to all grades of staff, support managers and staff from the senior management team. We examined an overall staff training matrix, a sample of individual staff members personal training records together with new individual staff training needs assessments. We looked particularly for evidence of structured induction training to include certain key areas. We also examined medication training for the qualified nurses and training for all staff in dementia care and topics relevant to the safety and protection of people living at the home. We also sought evidence that there was always someone on duty who held a relevant first aid qualification. We referred to the duty rotas for all grades of staff and randomly chose staff on duty who we could talk to and then cross check information with their own training records. However access to information proved difficult as the rotas were poorly set out with some muddled and inaccurate information as to who was on duty. In particular the night nursing rotas contained deletions and additions which made it difficult to identify the full names of agency nurses and which agency they were from. The ancillary staff rota was better although we established that the rota presented to us was inaccurate as one domestic rostered to be on duty was actually on holiday. Care Homes for Older People Page 4 of 12 The new staff training matrix was extensive and appeared up to date. This met the SRN requirement to undertake a comprehensive assessment of training provision and provide an accurate record of what had been provided. We saw newly devised individual staff training needs assessments where a lot of the details such as full name, start date and designation had been left blank. However these did contain the detail of what training had been received and what was still required which met the SRN requirement to produce an assessment of the training needs of each staff member. Both inspectors examined training files for various grades of staff including carers, ancillary staff, qualified nurses including three newly employed qualified nurses. We found that records for the ancillary staff showed that they had all received training from the acting manager in the safety of vulnerable adults (SOVA) dementia awareness and the management of challenging behaviour plus the Mental Capacity Act (MCA) and the Deprivation of Liberty Safeguards (DOLS) all in one day on 11 August 2010. When we talked with the staff they confirmed that they had attended this training which they recalled had taken place over two hours. Although some were a little unclear as to what they had learned from this session their understanding was that training in these topics had been sufficient and was now complete. We saw that the written records within their training files all indicated that this training had been given and certificated. Also that confirmation of this training had been added to the staff training matrix. We were shown the training plans for the trainer to use at these training sessions and saw that they were intensely detailed with planned time lengths for each session which together would have taken at least a day to provide. The service quality manager confirmed that the ancillary staff had not actually completed this training and that only introduction sessions had been provided prior to delivery of full training which was scheduled for a later date. The service quality manager acknowledged that the available information was misleading and that certificates had been issued which indicated that full training had been completed. Also that these staff were under the impression that this training was now complete. Evidence was in place which confirmed that three carers had all received training in fire safety, SOVA, moving and handling, emergency first aid, health and safety, dementia awareness and person centred planning. Health and safety training included reference to Legionnaires disease, 5 steps to risk assessment and RIDDOR following which staff had completed a quiz which they had all passed. In some staff files the quiz result was the only evidence of the health and safety training session. Training in continence care, DOLS - valid for three years - and feeding and swallowing had been provided by Local Authority, Primary Care Trust or other external training Care Homes for Older People Page 5 of 12 providers. The staff were also undertaking courses in Dementia Care Mapping. One senior carer had been nominated Dignity Champion and was undergoing further training. She was clear about her role and the amount of training she had completed and said the home was better than it had ever been. She provided strong examples of where the standards of care delivery had improved and problems with managing difficult and challenging behaviours had reduced as a result of improved staff support and appropriate training. In addition staff and people living in the home were getting to know each other well and everyone was much happier and more relaxed. One newly appointed registered nurse who had qualified in 2008 was on duty. Prior to commencing work at the home this nurse had attended a full week of training which had included manual handling, nutrition and wellbeing, infection control, food awareness, fire safety, DOLS, dementia awareness, palliative care, health and safety and SOVA all of which had been certificated by Southern Cross trainers. The nurse said she still had to complete first aid and medicines training. Findings indicated that the SRN requirement to ensure that, as a minimum, all staff received training in SOVA, DOLS and MCA, dementia awareness and challenging bahaviour had been partly met apart from the bank staff where no records were available and the ancillary team where only introductory sessions had been given and further training was planned. Findings indicated that the SRN requirement to ensure that all nurses with responsibility for administering medication were trained to do so had not been met. The majority of nurses working at the home were still either agency, bank or staff on loan from other homes within the group. There was no clear evidence of the medicines competencies or training status for the agency nurses most of whom covered the night shifts. This is the primary responsibly of the supplying Nurses Agency however records held at the home made little or no reference to medicines. In view of the SRN requirement this information should have been sought as evidence of compliance. There were no training records available for the bank nurses who were regularly working at the home and no information in relation to their medicines competencies. Attempts by the support manager on duty to obtain evidence from head office proved unsuccessful during the visit. The one newly appointed nurse on duty said that she was not yet confident or competent to administer medicines alone but regularly shadowed the agency or bank staff who she was on duty with and was busy working through training and competency literature. Findings indicated that the SRN requirement to ensure that all new and current staff received structured induction training had not been fully met. The structured induction programme for a new nurse who commenced 26 July 2010 was not available on her file but was later produced by the support manager. Sections relevant to the training undertaken pre-commencement had been completed at the time Care Homes for Older People Page 6 of 12 by the trainer but the rest of the induction booklet had only been completed and dated during this inspection visit. The practice competency assessment sheets at the back of the booklet were all blank. Both the nurse and support manager on duty confirmed that they had completed the booklet during the inspection. Two senior nurses had commenced employment at the home on 16 July 2010. Their employment files indicated that they were well qualified for the roles as clinical leads. Induction records and the staff handbook had been given ,however no training had started and the manager confirmed that one of the nurses was currently only shadowing other nursing staff and had no actual nursing responsibility. The other nurse was qualified as a first aid and medications trainer. She was also currently shadowing staff and had no training file in place. The senior managers advised that new starters have a three month probationary period during which they complete their induction period which would provide evidence that they had been successful. Discussion took place as to whether staff should hold their own induction records or whether these should be held at the home. It was agreed that in view of the current enforcement activity and the need to demonstrate what training staff had received that records should remain at the home. One carer had recently returned from maternity leave. However, there was no evidence of any return to work interview, evidence of fitness to return to full duties or refresher training and update. This persons old training file contained minimal detail and indicated that mandatory training topics were either overdue or had not been received. This was discussed with the support manager who confirmed that return to work assessments and reviews had not been done. A support manager who was seconded to the home from the Local Authority and who also assisted with the inspection was unable to say who were the first aiders on duty but identified that three ancillary staff held accredited first aiders qualifications, one of whom gave a good account of first aid care relevant to the homes activities. However there was no-one working on the late or night shift that day with a current first aid qualification. Training had been provided to some staff but not yet sufficient to cover every shift. This indicated that the SRN requirement to ensure that at all times a minimum of one person who had received first aid training was on duty had not been met. A senior manager later gave an assurance that this matter would be dealt with straightaway and that the future plan was for all nurses to receive training in current first aid practice. The inspectors acknowledged Care Quality Commission guidance which states that certain registered nurses can be classed as first aiders. What the care home does well: The SRN requirements to undertake a comprehensive review of staff training and to produce individual training needs had been complied with. Care Homes for Older People Page 7 of 12 The SRN requirement to ensure staff received training in five key areas has been complied with for one new nurse and the carers but not for the bank nurses or fully for the ancillary staff. Care staff said they were better trained and understood their role. They felt that people receiving care were now experiencing a better quality of life. What they could do better: If you want to know what action the person responsible for this care home is taking 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 R No £ 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 1 30 18 Ensure that all nurses with 31/07/2010 responsibility for administering medication are trained to do so. Ensure there are sufficient staff employed at the home that are trained in first aid so that there is at all times a minimum of one person on duty who has received first aid training. This is to ensure that the staff receive training appropriate to their work in order to meet the health and welfare needs of the service users accommodated at the home. 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 1 30 18 Ensure that all nurses with responsibility for administrating medication are trained to do so. This is to ensure service users receive their medication promptly and correctly. 01/11/2010 2 37 17 Ensure that the staff rota is 01/11/2010 kept up to date and specifies the name and designation of the member of staff and the nominated first aider on duty. The records and evidence of training must provide accurate detail of exactly what has been provided. Ensure that all induction records for all grades of staff are available for inspection. The training status of bank nurses working at the home must be readily available. Care Homes for Older People Page 10 of 12 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 This is so service users rights and best wishes are safeguarded by the homes record keeping policies and procedures. 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 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. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 12 of 12 - 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!