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Care Home: St Nicholas

  • Harepath Hill Seaton Devon EX12 2TA
  • Tel: 0129720814
  • Fax: 0129720814

St Nicholas is registered to provide personal care for up to 3 older people who may also have a physical disability. The property is a detached bungalow set in a third of an acre of land on the outskirts of Seaton. The accommodation consists of three bedrooms one of which is en suite. There is also a kitchen diner, separate dining room and lounge. There is parking on site and pleasant level gardens both to the front and rear of the property. The home is owned and managed by Mrs K. Roberts. The home`s statement of purpose and service user guide, which includes details about the philosophy of the home and about living at the home, is available at the home on request. A copy of the most recent inspection report is available upon request. Information received from the home indicates that the current fees are GBP 330 - 525 weekly Services not included in this fee include hairdressing, chiropody, toiletries, videos, bird food, transport and some continence aids. General information about fees and fair terms of contracts can be accessed from the Office of Fair Trading web site at httpwww.oft.gov.uk

  • Latitude: 50.72200012207
    Longitude: -3.0780000686646
  • Manager: Mrs Karen Roberts
  • Price p/w: £393
  • UK
  • Total Capacity: 3
  • Type: Care home only
  • Provider: Mrs Karen Roberts
  • Ownership: Private
  • Care Home ID: 14697
Residents Needs:
Old age, not falling within any other category, Physical disability

Previous Inspections

This may not be the latest inspection for this service as we are having techinical problems updating from CQC - please check directly on the regulators website for the most recent report; bestcarehome hopes to be back to regular updates shortly.

For extracts, read the latest CQC inspection for St Nicholas.

Key inspection report Care homes for older people Name: Address: St Nicholas Harepath Hill Seaton Devon EX12 2TA     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Michelle Oliver     Date: 2 1 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 33 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought 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 The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 33 Information about the care home Name of care home: Address: St Nicholas Harepath Hill Seaton Devon EX12 2TA 0129720814 0129720814 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Karen Roberts care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home St Nicholas is registered to provide personal care for up to 3 older people who may also have a physical disability. The property is a detached bungalow set in a third of an acre of land on the outskirts of Seaton. The accommodation consists of three bedrooms one of which is en suite. There is also a kitchen diner, separate dining room and lounge. There is parking on site and pleasant level gardens both to the front and rear of the property. The home is owned and managed by Mrs K. Roberts. The homes statement of purpose and service user guide, which includes details about the philosophy of the home and about living at the home, is available at the home on request. A copy of the most recent inspection report is available upon request. Information received from the home indicates that the current fees are GBP 330 - 525 weekly Services not included in this fee include hairdressing, chiropody, toiletries, videos, bird food, transport and some continence aids. General information about fees Care Homes for Older People Page 4 of 33 Over 65 3 3 0 0 Brief description of the care home and fair terms of contracts can be accessed from the Office of Fair Trading web site at httpwww.oft.gov.uk Care Homes for Older People Page 5 of 33 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 1 star. This means that people who use this service experience adequate quality outcomes. This inspection was undertaken on one day in January by one inspector who spent 5 hours at the home. Prior to this inspection we sent surveys to 1 person living at the home, who responded. We also received responses to surveys from 2 members of staff [ however the incorrect survey was completed] and 3 health care professionals. Their comments and views have been included in this report and helped us to make a judgment about the service provided. To help us understand the experiences of people living at this home, we looked closely at the care planned and delivered to the only person who is currently living at the Care Homes for Older People Page 6 of 33 home. We spoke to the person in depth to hear about their experience of living at the home during our visit. We also spoke with staff, including the manager and a carer. A tour of the premises was made and we inspected a number of records including assessments and care plans and records relating to medication, recruitment and health and safety. We were told that fees ranging from £330- £525 are currently charged at St Nicholas. General information about fees and fair terms of contracts can be accessed from the Office of Fair Trading web site at /www.oft.gov.uk . Copies of the inspection report are available from the manager at St Nicholas and are also displayed in the entrance hall of the Home Care Homes for Older People Page 7 of 33 What the care home does well: What has improved since the last inspection? What they could do better: One requirement and 13 recommendations have been made as a result of this Care Homes for Older People Page 8 of 33 inspection: Not all of staff working at the home have had police checks undertaken to ensure that people living at the home are safe. Since the last inspection the service has not admitted people to the home. It is recommended that when people are admitted an assessment of their health and social care needs is undertaken. Health and social care needs are not set out in individual plans of care. Assessments of risks presented by the use of bed rails are not undertaken before they are fitted. People living at the home continue to be at risk of their privacy not being respected at all times.This relates to visitors and friends of the provider visiting the home and accessing the providers private accommodation, only through the care home. Information about people living at the home should include details of interests or hobbies and contact with the community they enjoyed prior to moving to the home. All parts of the home to which people living at the home have access should be as reasonably practicable free from hazards. Assessments of risks presented by objects, animals and children should be undertaken to further promote the safety of people living at the home. Laundry floors should be impermeable and these and wall finishes should be easily cleanable. The home should be free from offensive odours at all times. A recorded rota showing which staff are on duty at any time during the day and night and in what capacity is kept. This relates to members of staff being on the rota but not working at the home. The registered person should ensure that risk assessments are carried out for all safe working practice topics and that the outcomes of the assessments are recorded. This relates to the assessment of risks presented by the use of bed rails, and of dogs, children and objects around the home that could present risks. 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our Care Homes for Older People Page 9 of 33 order line 0870 240 7535. Care Homes for Older People Page 10 of 33 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 11 of 33 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has policies and procedures to ensure that people are admitted to the home only after a full assessment of their health and social care needs can be met. The home does not admit people who need intermediate care. Evidence: Since the last inspection the service has not admitted anyone to the home. The manager has completed details of the health and social care needs of a person currently living at the home, which were not available at the last inspection. We were unable to fully assess this standard as we were unable to speak to any people who have been admitted to the home since the last inspection. This will be looked at during the next inspection to assess the process. Care Homes for Older People Page 12 of 33 Evidence: During this inspection we noted that the manager has developed a pre admission assessment form, which complies with the National Minimum Standards. The manager told us that the procedure followed at St Nicholas when approached by people considering making it their home, would be to visit them either in hospital or in their own homes to undertake an assessment of individual health and social care needs. The manager said that people would be notified in writing that their needs could be met. This means that before a person is admitted to the home they can be assurred that their assessed needs can be met by the environment, number and competency of staff and the homes registration category. During the visit the manager would also tell them about the service, give them written information about the home, including statement of purpose, service user guide, the last inspection report and a brochure. People would be invited to the home, have a meal and meet others living there. We were told that all people who are admitted to the home would be given a contract, which would include details of trial periods and also responsibilities and rights of the service and the person. Care Homes for Older People Page 13 of 33 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home benefit from their health and social care needs being met. Continuing with the development of care planning will further promote person centred care. Medication is well managed. Evidence: Since the last inspection the service has not admitted anyone to the home so we were unable to assess the standard fully. We were told that all l those living at St Nicholas would have individual files that included information relating to the admission, assessments of their health and social care needs, assessments of risks and care plans. We looked at the information recorded for a person who has been living at the home for some time and found that the manager and staff have worked hard to develop and Care Homes for Older People Page 14 of 33 Evidence: improve the information recorded since the last inspection. Included in the file we looked at we noted some very detailed information, including how the person was given choices to enable them to live their life as they chose, how they chose to be assisted with personal care and details of liaising with health care professionals. However, the information, although detailed did not include care plans about how specific health and social care needs would be met. Care plans are the end point of the assessment of the persons health and social care needs and should show what care must be delivered in accordance with the service user plan for that individual. The plan becomes the yardstick for judging whether appropriate care is delivered to the individual and will reflect changes as regular assessment of the person shows changing needs. We discussed this with the manager and a member of staff during this inspection. The person whose file we looked at has health care needs that care plans have not been developed to monitor, assess or review. This means that people could be potentially at risk of the health and social care needs not being met. Assessments of risks to people living at the home are generally undertaken. A person has been assessed as needing bed rails to maintain their safety, and these have been fitted. However, an assessment of the risk the bed rails present actually present to this person have not been assessed. This means that people could be at risk of harm from the rails. Prior to the last inspection the service admitted a person to the home whose health and social care needs were not within the homes registered category. We were told by a health care profession, during this inspection, that the service has met this persons needs well. Prior to this inspection we sent surveys to 2 people who were living at St Nicholas at that time. One survey was not fully completed but one person living at the home felt confident that the home always met their needs. One person wrote Treats each individual as cherished and important and couldnt think of anything that the home could do better. Comments received from a health care professional included staff at St. Nicholas appear to have supported my client well, their needs have been considered and well Care Homes for Older People Page 15 of 33 Evidence: met. Despite my clients health issues St. Nicholas has provided the ideal setting. the relaxed informal and respectful approach has been beneficial to my client and promoted their overall wellbeing. Comments in response to what does the service do well, from another health care professional included, family atmosphere, caring manager and staff, always ask advise from community nursing team for support etc. In response to what could the service do better commented it may be that some of the technicalities of care, documentation etc. may need more attention. Medication management at the home has improved since the last inspection. We looked at records of medication given to a person living at the home and these were accurate and up to date. the person currently living at the home not not manage their own medication. Medication was safely stored at the home and is only administered by the manager. The providers private accommodation is attached to St Nicholas and following the last inspection the provider told us that there were plans to fit an outside door so that family do not come through the home to access this accommodation. This had not been done at the time of this inspection, during which a family member came to the care home for lunch. This person has had a police check, as recommended at the last inspection, but using the Registered Care Home as part of their accommodation potentially puts the rights of privacy of the people living at the home at risk. Care Homes for Older People Page 16 of 33 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at St Nicholas benefit from being encouraged and supported to live their lives as they choose and to have access to a range of activities. Meals are nutritious and varied and people are encouraged to choose what they like to eat. Improvement in assessing individuals hobbies and interests people engaged in before they made the decision to live at the home would further promote person centred care. Evidence: St. Nicholas is a small domestic style family home and as such does not provide organised activities. A record is maintained of activities that people take part in, and the manager told us these include board games, puzzles, puzzle books, going for walks, going out in a car or wheelchair. The home is visited by a hairdresser regularly and at the time of this inspection the person living there told us they had recently had their hair done. People can spend time in the homes lounge, dining room or kitchen diner if they wish. Care Homes for Older People Page 17 of 33 Evidence: At the time of this visit the only person living at the home person chose to spend most of their time in their room. they told us they enjoyed watching the television, reading and receiving visitors, who are welcome at the home at any time. They also told us they frequently go out with their family. We were told there are no routines at St Nicholas and that people can do what they want when they like. the person we spoke to confirmed this and told us she was looked after as an individual. Some information about individuals past hobbies and interests have been recorded in individual plans of care and a record is kept of activities the person currently living at the home has taken part in. St Nicholas is a family orientated service and the managers daughters are employed as carers. The managers granddaughter visits the home often and we were told that people living at the Home enjoy seeing her. The manager has a dog, and one of the managers daughters also has a dog that accompanies her to the home when she is on duty. We were told that people living there also enjoy seeing both dogs around the Home. Meals are prepared in the Homes domestic style kitchen. The manager told us they strive to provide organically home grown vegetables and locally sourced meat whenever possible. The home has an area where vegetables are grown and free range chickens are kept for their eggs. Although the home does not have a set menu the manager has maintained a comprehensive list of main meals, puddings and snacks available. This has been compiled with the involvement of people living at the home. We asked one person whether they are told what they are going to be served at meal times. They said that they were not told but are asked what they would like. During this visit the person living at the home was asked what the fancied for lunch and their choice was freshly prepared for them. Care Homes for Older People Page 18 of 33 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home are confident that any issues or complaints they may have would be taken seriously and acted upon. They are also protected by the knowledge staff have in safeguarding adults to protect them from harm or the risk of harm. Evidence: The home has a complaints procedure that is included in the homes statement of purpose. Details of the contact details of the Care Quality Commission have been updated since the last inspection. One person spoken to told us they have no complaints about the home but confirmed that if they were unhappy about anything they would feel comfortable making a complaint. They were confident that their concerns would be taken seriously and the manager would do something about it. We were also told that they felt safe and protected living at the home. Forms are available in the hall, beside a visitors book, so that people can make suggestions or complaints anonymously if they wish. The manager told us that because St Nicholas is a small family home staff have daily contact with people and felt sure that any concerns would be dealt with before they became an actual complaint. Care Homes for Older People Page 19 of 33 Evidence: The manager told us that no complaints have been made to the home since the last inspection. A referral had been made to Devon Adult Services Safeguarding Adults Team prior to the last inspection and is now near to completion. Since the last inspection staff have received Safeguarding Adults training and during this inspection the manager and a carer spoke of what they had learned during this training. Both said they would not hesitate to report poor practice. Care Homes for Older People Page 20 of 33 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. St. Nicholas offer a domestic, family style accommodation. Improvement in assessing risks presented to people living there should be assessed to ensure they are safe. The home is generally clean although attention to freshness would further improve the environment. Evidence: The Home provides a domestic, homely environment set in well tended gardens. St. Nicholas is a bungalow and all accommodation is on the level. The accommodation provided consists of 3 individual bedrooms, a spacious dining room, lounge, kitchen diner, cloakroom and one bathroom. Owner accommodation is situated through a door at the end of a corridor in the home. The home is run as a family home and as such childrens toys, dogs beds and food trays are kept in the kitchen and lounge.We were told that often the managers grandchild came to the home but that the person living there enjoyed this, and the person confirmed this. No assessments of risks in relation to objects, people or animals have been undertaken to ensure people living, working and visiting the home are safe. Care Homes for Older People Page 21 of 33 Evidence: The manager has employed a cleaner for 9 hours a week. During this inspection the cleaner was not on duty at the home. We were told that the manager and staff undertake the cleaners duties when they are not available. At the time of this inspection the home was generally clean but the kitchen floor was dirty. We were told this was because the cleaner was not working on this day and that because of the bad weather 2 dogs at the home brought in a lot of mud. The manager said they were just about to clean the floor, which they did. An area of the flooring continues to be roughly repaired.We were told that the only person living at the home does not come out into the kitchen area, however this continues to present a trip hazard. During this inspection the weather was poor and both dogs had been out, resulting in them smelling damp and unpleasant, resulting in some parts of the home being less than fresh. Laundry facilities are situated outside the building in a garage where a freezer and fruit and vegetables are also stored. The laundry was not clean, mainly due to it being in a garage and the walls and floor not being easily cleanable. We were told that a carpet that had been put down in the laundry at the time of the last inspection had been removed, but we found that only a small area, immediately in front of the door into the laundry, had been removed. We also saw several items of furniture etc. being stored in the laundry. we were told this was due to be removed soon. We were told the area is regularly cleaned but this was not reflected at the time of this inspection. The manager told us how good standards of hygiene are maintained at the home although no training has been provided. The owner/manager described how soiled linen is dealt with, as this is taken through the kitchen to the garage, and this complies with good practice. The manager told us that they were considering moving the washing machine into the kitchen, which would remove the need for staff to go outside with laundry. We discussed laundry procedures to be undertaken if this takes place, to protect people living at the home from the risk of cross infection. The service has a contract with a carpet cleaning company and carpets were cleaned at the home in July 2009. We saw equipment and aids to assist people living at St. Nicholas. These included a Care Homes for Older People Page 22 of 33 Evidence: portable hoist, which was serviced on the 2nd day of this inspection, bath grips, pressure relieving cushions and mattress and a bath aid. We looked at a persons rooms during this visit, with their consent. It was personalised and comfortable. Care Homes for Older People Page 23 of 33 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at St. Nicholas receive support from a small staff group. Staffing levels at the home are usually sufficient to ensure peoples needs are met in a timely and proper way but continue to be at risk of their needs not being met when only one person is on duty. The Homes recruitment procedure is not robust and does not fully protect people living at the Home. Evidence: At the time of this inspection one person was living at the home and the manager and one member of staff were on duty. We were told that there are always at least two carers on duty in this home, and according to the rota we looked at this was the case, but later found this not to be so. During the night, there are no waking night staff but the owner is available if needed. The only person living at the home confirmed that they have a call system that can be used at night, but have not needed assistance. We looked at the homes staff rota showing the number of staff and the times they are on duty at the home. We noted that the owner/manager is on duty from 6:15am Care Homes for Older People Page 24 of 33 Evidence: -midnight, when they are then available for people to call upon if needed, 7 days a week. However, information provided by the manager prior to this inspection stated that staff will work together to afford the manager time off. The rota did not reflect this. On the day of this visit a member of staff had come on duty at 8:45am to assist the manager and was scheduled to be on duty until 4pm. According to the rota another family member was due to be on duty at 4 pm. However, the manager said this was not correct; this person was a volunteer and although available if needed at short notice, as they also live on the premises, they do not actually work between these times.This then leaves only the manager on duty until midnight. This could potentially put people at risk of their needs not being met. The manager said that when the home was fully occupied adjustments would be made in staff levels to ensure that assessed needs could be met. We were told that the current staffing level is sufficient to meet the needs of the one person currently living at the home. If an emergency situation arose there are people who can be called to the home. We were told that these people had previously been employed at the Home, had undergone appropriate training and recruitment procedures. During this inspection we looked at 6 staff recruitment files, including that for a recently recruited member of staff. The recruitment file for one staff member did not include the required police check. We were told that this person was a volunteer. We told the manager that despite this a CRB was required for any person working at the home. We were told that this person did not actually work at the home, but when we looked at the rota they were scheduled to each afternoon and had worked at the home on at least 3 occasions in December, covering weekend shifts, and were, according to the rota, to be on duty over the weekend following this inspection. The manager told us that the member of staff would not be working these shifts and would not work at the home again until an up to date police check had been undertaken. Another member of bank staff did not have an up to date police check. The manager told us they had not been required to work at the home for some time and would no longer be a member of bank staff. Care Homes for Older People Page 25 of 33 Evidence: The homes recruitment procedures continue to put people living at the home at risk of being cared for by people who have been employed without following a robust recruitment procedure. No care staff have been recruited at the home since the last inspection and therefore no induction training had been undertaken at the home. These were inspected during the last inspection. Prior to this inspection the manager sent us copies of training records for staff working at the home. The manager and one member of permanent care staff have completed training related management of dementia, safeguarding adults and first aid. The permanent member of staff is undertaking a nationally recognised qualification [ NVQ] at level 3, which will mean that people living at the home will benefit from being cared for by staff who have received appropriate training to meet their health and social care needs. The person living at the home described the staff as friendly and caring and during this inspection the manager and carer were respectful and kind to them. Care Homes for Older People Page 26 of 33 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living and working at the home benefit from an open system of management. The home continues to carry out some practices that do not fully promote good health, safety and welfare for people living at the home or staff. Evidence: The manager/owner has attained a National Vocational Qualification, [NVQ] level 4 in care and has completed a Registered Managers award. The manager promotes an open style of management at the home. The atmosphere at the home is domestic with grandchildren, dogs and friends of the manager and family visiting freely. assessments have not been undertaken for the risks this may present. This could potentially compromise the privacy of people living at the home. Recruitment practices are poor, which means that staff may be unsuitable to work at Care Homes for Older People Page 27 of 33 Evidence: the home, and potentially places people at risk. The home does not look after finances for any of the people who currently live at the home. Accounts for any items not covered in the weekly fee are calculated monthly and sent to the person or their representative. Peoples individual records would be made available to them, or their representatives with their consent,if they wished. Records were securely stored. Records show that staff have received recent moving and handling training, which means that people living at the Home will be assisted to move and transfer by staff who are aware of safe techniques. Information received before this inspection showed maintenance or servicing of gas and electrical systems was up-to-date and that a hoist was serviced regularly. Prior to this inspection the provider/manager was asked to complete an annual quality assurance assessment (AQAA). This is a self-assessment that is filled in by the owner and is one of the main ways that we will get information about how they are meeting outcomes for people using their service. The information provided was brief and did not consistently provide us with relevant information in relation to how the home is working to meet, and improve, National Minimum Standards. The manager told us that due to the size of the home people are consulted on all aspects of their life at St Nicholas on a daily basis when staff chat with them. A quality audit has been undertaken since the last inspection to gather the views of the person currently living there, relating to the running of, and the quality of life experienced at the home. The results of the survey showed that people living at the home continue to be happy with the care they receive. A basic summary of the last satisfaction surveys has not yet been collated for people to see. Care Homes for Older People Page 28 of 33 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 29 of 33 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, Care Homes 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 29 19 The registered person must 09/03/2010 not employ a person to work at the care home unless they have obtained information and documents specified in paragraphs 1-7 of schedule 2. This relates to police checks. To ensure that people living at the home are protected and kept safe. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 3 4 3 7 7 10 To ensure that the pre assessment procedure, which has been developed since the last inspection, is complied with. Assessments of risks presented by the use of bed rails should be undertaken before they are fitted. The service users health and social care needs should be set out in an individual plan of care. People living at the home should have their privacy Page 30 of 33 Care Homes for Older People Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations respected at all times. This relates to visitors and friends of the provider visiting the home and accessing the providers private accommodation only through the care home. 5 12 Information about people living at the home should include details of interests or hobbies and contact with the community they enjoyed prior to moving to the home. Attention should be made to the kitchen flooring to ensure safety to people living and working at the home. All parts of the home to which people living at the home have access should be as reasonably practicable free from hazards. Assessments of risks presented by objects, animals and children should be undertaken to further promote the safety of people living at the home. 8 9 26 26 The home should be free from offensive odours at all times. Laundry floors should be impermeable and these and wall finishes should be easily cleanable. A recorded rota showing which staff are on duty at any time during the day and night and in what capacity is kept. This relates to members of staff being on the rota but not working at the home. 11 27 The ratio of staff to people living at the home should be determined according to the assessed needs of individuals. This relates to some times during the day when there is only one member of staff on duty at the home. 12 33 The outcomes of quality assurance surveys should be made available to those living at the home and other interested parties. The registered person should ensure that risk assessments are carried out for all safe working practice topics and that the outcomes of the assessments are recorded. This relates to the assessment of risks presented by the use of bed rails, and of dogs, children and objects around Care Homes for Older People Page 31 of 33 6 7 19 19 10 27 13 38 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 the home that could present risks. Care Homes for Older People Page 32 of 33 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. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 33 of 33 - 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!

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