Care Home: St Michaels View Care Home

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What the care home does well The people living at St Michael`s View and their representatives are generally very satisfied with the services provided. One person said in their satisfaction survey " everywhere here his lovely you couldn`t fall out with it at all" another person said " it is the ideal place for me". The home is well managed and run in the best interests of the residents. Residents and staff spoken with during the inspection confirmed that they have confidence in the manager`s abilities and that they are involved in the decisionmaking within the home. People said that they are very satisfied with their bedrooms and confirmed that they had been encouraged to personalise and with small items of furniture photographs etc. The care staff are well-trained and over 73% have completed National Vocational Qualifications to level 2 or above. The experienced and well-trained staff helped to provide continuity and stability for the residents.Care plans a comprehensive and reviewed frequently enough to ensure that staff always know what assistance and support each resident requires. Health care records are also well maintained. Residents said that the staff are always friendly and respectful and ensure that their privacy and dignity is maintained at all times. One person said that although the staff are always busy they do ensure that all her needs are met. The observed interaction between residents and staff was of a very good standard. There were many aspects of good practice highlighted in the main body of this report. What has improved since the last inspection? All of the requirements and most of the recommendations made following the last inspection have been implemented. Medication is now being stored at the appropriate temperatures and the laundry door is kept locked when there is no staff in situ, to ensure that residents health and safety is not put at risk. Fire drills are being completed at least twice a year. A new programme of activities has been devised and posters detailing the activities are displayed throughout the home. Where residents require a liquefied diets each element of the meal is being liquidised separately to preserve flavour and appearance. The homes complaints procedure is now prominently displayed. New carpets, curtains, profiling beds and chairs have been purchased and several areas of the home have been redecorated. Thermometers are been provided in the residents lounge areas to monitor the temperature and the ventilation in some of the toilets has been improved. What the care home could do better: There were no requirements made as a result of this inspection. It was recommended that the manager should display details of how residents, their relatives and friends, can contact local advocates who will act on their behalf. The manager should use the information gathered as part of the quality assurance system to produce an individual development plan for the home. CARE HOMES FOR OLDER PEOPLE St Michaels View Care Home Hallcroft Road Retford Nottingham Nottinghamshire DN22 7NE Lead Inspector Richard Ramsden Unannounced Inspection 1st November 2007 10:00 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 Michaels View Care Home DS0000036238.V352088.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 Michaels View Care Home DS0000036238.V352088.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Michaels View Care Home Address Hallcroft Road Retford Nottingham Nottinghamshire DN22 7NE 01777 702218 01777 710318 louise.gladwin@nottscc.gov.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) Nottinghamshire County Council Mrs Louise Shirley Gladwin Care Home 34 Category(ies) of Dementia (14), Dementia - over 65 years of age registration, with number (14), Old age, not falling within any other of places category (34), Physical disability (5) St Michaels View Care Home DS0000036238.V352088.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Out of the total number of beds (34), there will be 14 beds for DE 55 and over and/or DE(E) Out of the total number of beds (34), 5 may be used for PD 55 and over Service users shall be within category OP Date of last inspection 9th November 2006 Brief Description of the Service: St Michaels View is a purpose-built care home owned and managed by Nottinghamshire County Council. It provides care and accommodation for up to 34 older people including 14 people who have dementia. The home also has a day centre, which operates seven days a week. The day centre was not included as part of this inspection. The accommodation is provided over two floors with a shaft lift to assist independent access. All bedrooms are for single occupancy and none have ensuite facilities. There are two lounges, two dining rooms and a separate lounge for people who wish to smoke. Additional communal areas compensate for some bedrooms that do not fully meet National minimum standards size requirements. There are small gardens which are accessible to service users. The home is situated in a residential area relatively close to Retford town centre. The weekly accommodation charges for those residents who are self funding would be £377.00. A copy of the most recent inspection report was displayed in the home. St Michaels View Care Home DS0000036238.V352088.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One Inspector completed this unannounced visit over one day it took approximately 5 1/2 hours. It included the inspection of care and other records, a discussion with the manager and a member of care staff. The inspector spoke with three residents and one relative. Three residents satisfaction questionnaires and three relative/advocates satisfaction questionnaires were received prior to this inspection. A partial tour of the building was also completed. Two residents were case tracked, which means that their care plans were examined against the actual care they receive. Prior to completing this visit the inspector assessed the home service history, the Pre-inspection information provided by the homes manager and the last inspection report. What the service does well: The people living at St Michaels View and their representatives are generally very satisfied with the services provided. One person said in their satisfaction survey “ everywhere here his lovely you couldnt fall out with it at all” another person said “ it is the ideal place for me”. The home is well managed and run in the best interests of the residents. Residents and staff spoken with during the inspection confirmed that they have confidence in the managers abilities and that they are involved in the decisionmaking within the home. People said that they are very satisfied with their bedrooms and confirmed that they had been encouraged to personalise and with small items of furniture photographs etc. The care staff are well-trained and over 73 have completed National Vocational Qualifications to level 2 or above. The experienced and well-trained staff helped to provide continuity and stability for the residents. St Michaels View Care Home DS0000036238.V352088.R01.S.doc Version 5.2 Page 6 Care plans a comprehensive and reviewed frequently enough to ensure that staff always know what assistance and support each resident requires. Health care records are also well maintained. Residents said that the staff are always friendly and respectful and ensure that their privacy and dignity is maintained at all times. One person said that although the staff are always busy they do ensure that all her needs are met. The observed interaction between residents and staff was of a very good standard. There were many aspects of good practice highlighted in the main body of this report. What has improved since the last inspection? All of the requirements and most of the recommendations made following the last inspection have been implemented. Medication is now being stored at the appropriate temperatures and the laundry door is kept locked when there is no staff in situ, to ensure that residents health and safety is not put at risk. Fire drills are being completed at least twice a year. A new programme of activities has been devised and posters detailing the activities are displayed throughout the home. Where residents require a liquefied diets each element of the meal is being liquidised separately to preserve flavour and appearance. The homes complaints procedure is now prominently displayed. New carpets, curtains, profiling beds and chairs have been purchased and several areas of the home have been redecorated. Thermometers are been provided in the residents lounge areas to monitor the temperature and the ventilation in some of the toilets has been improved. St Michaels View Care Home DS0000036238.V352088.R01.S.doc Version 5.2 Page 7 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 Michaels View Care Home DS0000036238.V352088.R01.S.doc Version 5.2 Page 8 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 Michaels View Care Home DS0000036238.V352088.R01.S.doc Version 5.2 Page 9 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): 2,3. Staff are ensuring that they can meet the needs of prospective residents by obtaining preadmission assessments. Residents are provided with written terms and conditions of residence documents. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two residents records were assessed as part of this inspection. Both of the records contained preadmission assessments, which had been completed by a social worker. St Michaels View Care Home DS0000036238.V352088.R01.S.doc Version 5.2 Page 10 Terms and conditions of residence documents, which had been signed by the residents, where possible, were available on each of the files view during this visit. The home does not provide intermediate care. St Michaels View Care Home DS0000036238.V352088.R01.S.doc Version 5.2 Page 11 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. Residents individual care plans contain sufficient information and are reviewed regularly enough to ensure that staff are always aware of what support and assistance each resident requires. The homes medication is very well-managed and residents believe they are treated with respect. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two residents care plans were viewed as part of this visit. The care plans contain sufficient information and were reviewed frequently enough to ensure that staff have up-to-date information about the care and support each resident requires. St Michaels View Care Home DS0000036238.V352088.R01.S.doc Version 5.2 Page 12 Where possible individual residents have signed their care plans to confirm their involvement in the care planning and review process. (This is good practice). All of the care plans viewed, during this visit contained, photographs of the individual residents; this helps staff to identify, which residents the care plans referred to. Records show that resident’s health care needs are being appropriately met, this was confirmed by the three residents and one visitor who were spoken with during the inspection. The homes medication systems have been very well maintained. The manager stated that none of the current residents have been assessed as safe to administer their own medication however appropriate risk assessments are available should they be required. All medication administration records had been appropriately signed each time the medication is given to the resident for whom it was prescribed. The records of receipt and disposal of medication had been well maintained and medication is stored securely. Since the last inspection air-conditioning units have been fitted in the two rooms were medication is stored to ensure that the temperatures do not exceed those recommended by the manufacturers. Staff are recording the temperatures in the refrigerators where medication is stored however staff were unaware what temperatures are acceptable, the homes medication policies did not contain any guidance on this issue. During the inspection a member of staff phoned the homes contract pharmacist to ascertain what temperature the refrigerator should be maintained at to ensure that the medication is safe. The homes controlled medication was checked at random and had been well maintained. It was noted that the controlled medication is still being stored in the main office where there are no air-conditioning units in situ. The manager stated that the controlled medication cupboard would be relocated into an airconditioned room in the near future. All of the residents spoken with said that the staff are friendly and respectful and ensure that their privacy and dignity is maintained at all times. The visitor spoken with during the inspection also confirmed this. The observed interaction between staff and residents was of a very good standard. The St Michaels View Care Home DS0000036238.V352088.R01.S.doc Version 5.2 Page 13 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. The lifestyle experienced in the home appears to match the residents expectations and preferences. People are encouraged to maintain contact with family and friends and residents are satisfied with the food provided. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection staff have started to prominently display details of the activities and entertainment available to the residents. The residents spoken with confirmed that the home does provide a variety of activities although one person stated that they tend to spend the majority of the time with their husband watching the television in one of the small lounge areas. St Michaels View Care Home DS0000036238.V352088.R01.S.doc Version 5.2 Page 14 One resident stated on their satisfaction survey that the home only sometimes provides activities. One relative stated that it would be beneficial if the home provided ‘short trips out’. Other residents said that they were very satisfied with the level of entertainment and activities provided. One person said “ we have entertainment and quizzes and we have the right to choose what we would like to do, there are concerts and outings at Christmas”. Residents and visitors confirm that visitors are made welcome in the home at any time and the refreshments are always provided. Individual residents care plans give details of how residents can be encouraged to make decisions about their daily lives. (This is good practice). There are also residents meetings where people are encouraged to express their opinions about the way in which the home is run. None of the current residents had contact with external agents such as advocates. The manager stated that the home provides leaflets to inform residents’ relatives and friends how they can contact advocates, however none of the leaflets were available at the time of this inspection. All of the residents spoken with said that they are very satisfied with the meals provided by the home and that alternatives will be provided if they do not want food suggested on the menu. The meal on the day of inspection was well balanced and appeared appetising. Several people were having a soft diets, each element of the food had been liquefied separately to preserve flavour and appearance. Where staff were assisting residents to eat their meals this was done in a friendly respectful and unhurried manner. However one resident, who does not require assistance from staff, stated that she wishes she had more time to eat her meals as she feels like the staff are “hovering” waiting for her to finish. The manager said that she would address this issue with the staff immediately. St Michaels View Care Home DS0000036238.V352088.R01.S.doc Version 5.2 Page 15 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. The home has an accessible complaints procedure and staff are ensuring that residents are protected from abuse. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a book in which staff records all informal complaints, this was observed during the inspection and the issues raised appeared to have been dealt with appropriately. There have been no formal complaints since the last inspection. However there was a complaint prior to the last inspection, which the inspector was not informed about. The service manager initially investigated the complaint but failed to complete the investigation within the appropriate time scales. An independent investigation was then completed which upheld some aspects of the complainant. Issues relating to residents safety were not upheld. Since the last inspection the complaints procedure has been prominently displayed throughout the home. St Michaels View Care Home DS0000036238.V352088.R01.S.doc Version 5.2 Page 16 The manager stated that there have been no Safeguarding Adult issues at the home in the last 12 months and no staff have been referred for inclusion on the Protection of Vulnerable Adults list. All staff receive basic training in safeguarding adults as part of their induction training. The home has an appropriate a whistle blowing procedure, which is displayed, in the main entrance hall. The member of staff spoken with during the inspection was unsure about the Whistle blowing policy however she was clear about her responsibility to report any possible abuse she may observe. St Michaels View Care Home DS0000036238.V352088.R01.S.doc Version 5.2 Page 17 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): 19,26. The accommodation is purpose built and maintained to a good standard. At the time of inspection the premises were pleasant and hygienic. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A partial tour of the premises was completed as part of this visit. The accommodation has been maintained to a good standard. The residents bedrooms viewed during this visit were comfortably furnished and people had clearly been encouraged to personalise the rooms with photographs, ornaments and small items of furniture. St Michaels View Care Home DS0000036238.V352088.R01.S.doc Version 5.2 Page 18 All of the resident spoken with stated that they liked their bedrooms and confirmed that they can use them at any time. One person said that she would have liked an ensuite facility in her bedroom but recognises was not possible. The homes laundry is well equipped with washable wall and floor coverings. There were copies of the appropriate cosh data sheets and a copy of the homes infection control policy displayed in the laundry. (This is good practice). The laundry door is being kept locked when there is no staff in situ, to ensure that residents are not at risk from the laundry equipment and potentially soiled or infected linen. All of the residents and the visitors spoken with during the inspection confirmed that the home is always clean and hygienic. St Michaels View Care Home DS0000036238.V352088.R01.S.doc Version 5.2 Page 19 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. There are sufficient, competent and qualified staff to support the residents. The homes recruitment policies and practices are supporting and protecting residents, the registered person was able to demonstrate a commitment to staff training and development Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The rota provided for the week of this inspection showed that adequate staffing levels are being provided to meet the assessed needs of the residents. President stated that although staff are always busy they do find time to ensure that residents individual needs are always met. The personal records of two members of staff were assessed as part of this visit. The records each contained two satisfactory references; appropriate criminal records bureau clearance forms and proof of identity. The staff recruitment process ensures that appropriate equal opportunity policies and procedures are followed to ensure that there is no discrimination. St Michaels View Care Home DS0000036238.V352088.R01.S.doc Version 5.2 Page 20 The manager confirmed that 74 of the staff have NVQ level 2 or above. (This commitment to staff training is a good practice). Staff training records observed during the visit show that a considerable amount of training has been provided. The member of care staff spoken with during the inspection confirmed this. St Michaels View Care Home DS0000036238.V352088.R01.S.doc Version 5.2 Page 21 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): 31,33,35,38. The home is well managed and run in the best interests of the residents. Where checked the health and safety residents and staff is promoted and protected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager is well qualified and a very experienced. St Michaels View Care Home DS0000036238.V352088.R01.S.doc Version 5.2 Page 22 Residents staff and visitors said that the manager is very approachable and that she seeks their views about the way in which the home is run. One relative said in their satisfaction survey “ the needs of the residents are always first and foremost”. The home participates in Nottinghamshire County Councils quality monitoring systems, however to date the information gathered has not been used to produce a development plan for the home. A development plan would help residents and relatives to see that the information they’re providing is being used to develop the service. Staff do manage some residents personal money, the records were checked at random and were well maintained. The areas of health and safety checks during this visit had been well maintained. The homes Fire records and water temperature testing records were up-todate and accurate. Two fire drills have been completed at the home since the last inspection. (This is good practice). St Michaels View Care Home DS0000036238.V352088.R01.S.doc Version 5.2 Page 23 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 X 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 St Michaels View Care Home DS0000036238.V352088.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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. 2. Refer to Standard OP14 OP33 Good Practice Recommendations Residents and their relatives and friends should be provided with information on how to contact external agents such as advocates who will act in their interests. The registered person should produce a development plan for the home based on the findings of the Quality Assurance System. St Michaels View Care Home DS0000036238.V352088.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Michaels View Care Home DS0000036238.V352088.R01.S.doc Version 5.2 Page 26 - 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. 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