Care Home: St Peter`s Home

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What the care home does well The home provides a clean, well-maintained and homely environment for the residents to live in which meets the needs of the people who live in St Peters. The manager and the staff provide the residents with good quality personal and health care, which is well documented within the individual plans. The staff are knowledgeable about the residents needs and choices in their everyday lives and support them to meet these as required. The residents feel that they are well supported and very much feel involved in the running of the home. The manager and staff ensure that in consultation with the residents`, families and friends are encouraged to keep in contact and he ensures they are kept updated with any plans that are being proposed within the home. What has improved since the last inspection? The manager has ensured that the requirements made at the last inspection have been met to ensure the residents safety at all times. A dor guard system has been installed that allows the fire doors to be held open but will close automatically if the fire alarm sounds. Risk assessment have been written and reviewed to ensure they are person centred and support the individuals to take risks in their everyday lives. Medication procedures are now being followed correctly to ensure an audit trial is in place, which protects the residents from incorrect doses of medicines. What the care home could do better: Whilst no requirements and recommendations have been made following this inspection the manager and his team should continue to provide support to the residents in making choices about their lives and revisit the investors in people programme. CARE HOME ADULTS 18-65 St Peter`s Home 13 Louvain Way Garston Watford Hertfordshire WD25 7EH Lead Inspector Mrs Alison Butler Unannounced Inspection 7th August 2008 09:30 DS0000071630.V369849.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address DS0000071630.V369849.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. DS0000071630.V369849.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Peter`s Home Address 13 Louvain Way Garston Watford Hertfordshire WD25 7EH 01923 894781 01923681564 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) Amity Residential Care Ltd Mr P Arokiasamy Care Home 8 Category(ies) of Learning disability (8), Mental disorder, registration, with number excluding learning disability or dementia (8) of places DS0000071630.V369849.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning Disability - Code LD Mental Disorder, excluding learning disability or dementia - Code MD The maximum number of service users who can be accommodated is 8 2. Date of last inspection Not applicable Brief Description of the Service: St Peters Home is situated in the residential area of Garston, North Watford. The home is a large style chalet bungalow. The home can provide for up to eight residents who have a learning disability and who may have associated mental health diagnosis. The accommodation consists of a kitchen, dining room, separate lounge, laundry room, separate bathroom and WC, together with a staff office. There are three bedrooms on the first floor with combined shower and WC. The home does not have a have a passenger or stair lift and as such those accommodated upstairs must be fully ambulant. The home is close to the leisure facilities at Woodside and a multi screen cinema complex. Local buses run close by and there is easy access to other Hertfordshire towns. There are two small shopping parades within walking distance of the home. Watford town centre is accessible by car and bus and has a full range of community facilities and main line station. For up to date fees, a copy of the Statement of Purpose and Service User Guide contact should be made with the manager. There are additional charges made for newspapers, chiropody, toiletries etc. DS0000071630.V369849.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This service has recently had been purchased by Amity Residential Care Ltd, however, the management and staff team have remain unchanged. We (The Commission for Social Care Inspection) carried out this key unannounced inspection between 09:30 and 14:15 and it took just under 5 hours to complete. We looked at documentation in the home, observed what was going on the home, spoke with the people who live at the home and staff on duty and had a look round the home. Our records show that we sent out an Annual Quality Assurance Assessment (AQAA) form and this was returned as requested. This is a self-assessment document that looks at outcomes for service users. It also provides us with some numerical information. There are no outstanding requirements or recommendations from the previous inspection and no requirements were made following this visit. What the service does well: The home provides a clean, well-maintained and homely environment for the residents to live in which meets the needs of the people who live in St Peters. The manager and the staff provide the residents with good quality personal and health care, which is well documented within the individual plans. The staff are knowledgeable about the residents needs and choices in their everyday lives and support them to meet these as required. The residents feel that they are well supported and very much feel involved in the running of the home. The manager and staff ensure that in consultation with the residents’, families and friends are encouraged to keep in contact and he ensures they are kept updated with any plans that are being proposed within the home. DS0000071630.V369849.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. DS0000071630.V369849.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000071630.V369849.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can be confident that an assessment will be competed to ensure the home can meet people’s individual needs. EVIDENCE: No new residents have been admitted since our last inspection in May 2007. There are admission procedures in place to ensure a detailed assessment takes place, which also involves other health care professionals to ensure that the placement is suitable and the home is able to meet individual needs. DS0000071630.V369849.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live at St Peters home have detailed care plans in place, which reflect their needs and goals, so that they are supported in making decisions about their lives. EVIDENCE: The residents we spoke with at St Peters were happy that their needs were being met and that they felt supported by the staff. Interaction we saw between the staff and the residents showed that they are able to make choices. We saw that the care plans are detailed and give staff the action that is required to support individual care needs. Care plans are person centred and are regularly reviewed these care plans are linked to risk assessments were applicable to ensure the residents are supported to take risk as part of an independent lifestyle. People have an allocated keyworker who supports him or her in their decision making where appropriate. DS0000071630.V369849.R01.S.doc Version 5.2 Page 10 All the residents are able to express their wishes and staff appeared to be knowledgeable about peoples’ needs, likes and dislikes. Four of the residents attend the Watford Advocacy project on a monthly basis, which ensures that they have an independent voice to look over their best interests. Residents have 1-1 time with their key worker and these sessions are documented, they allow the residents to discuss any issues they may have and any changes they wish to make with the care plans. Everyone we met appeared relaxed and comfortable and appeared happy to speak to us during the inspection. DS0000071630.V369849.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live in the home are supported to live full and active lives that meet their expectations. Residents are provided with freshly cooked nutritionally balanced meals which support their health needs and what they like. EVIDENCE: The staff support everyone to take part in their own activities, either individually or in groups. We saw that each person has their own daily programme and these are recorded in their individual plans. Some of the residents attend various day care activities, transport is provided by the day care facility and if this is not available the home have the use of two vehicles to support people to get them to their relevant day service of their choice. DS0000071630.V369849.R01.S.doc Version 5.2 Page 12 A wipe board provides information of weekly and monthly activities, who is responsible for assisting with the evening meal and it provides information to the residents which staff are working and who will be covering the sleep-in. Three of the residents were supported on a holiday to Euro Disney Paris and they told us that they had a really good time, what rides they had been on and which characters they had met. Four of the residents had chosen to go to Butlins at Bognor Regis and had very much enjoyed their time there especially the nightlife. One resident chooses to holiday with their family and this is usually to go abroad. DS0000071630.V369849.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live in the home can be confident they will receive support to ensure that they receive a good quality of personal and health care. EVIDENCE: We saw that the care plans provide the staff with clear guidance to ensure the residents personal and health care needs are met. One resident was being supported by staff from the home to attend a review meeting with other care professionals and discuss what is working and if there is other support needs they require. Detailed notes are made when residents attend appointments with health care professionals such as neurologist, psychologist and psychiatrist professionals. There is good information on specific health needs and detailed information on what support is needed and what information staff need to record to best support them when attending appointments. The care records show that a resident’s behaviour has improved with the consistent support that staff have provided to them. DS0000071630.V369849.R01.S.doc Version 5.2 Page 14 Medication procedures are followed and an examination of the records showed them to be accurate. They now use a monitored dosage system, which provides a more robust system to prevent errors in administration. The home has no controlled drugs. DS0000071630.V369849.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live at St Peters can be confident that their concerns are listened to and that they are safeguarded from abuse. EVIDENCE: The manager reported that there has been one complaint received which is still waiting an outcome, this has been reported appropriately and a record of the outcome would be made once available. There has been one safeguarding referral made and the resident concerned is no longer at risk and a full investigation is under way. The manager assured us that we will be informed of the outcome. All staff receive training in safeguarding as part of their induction, and regular updates take place to ensure staff are clear of the procedure to follow should a allegation be made to them. Staff are aware of whistle blowing and a policy is available in the home. These procedures ensure that the people who live in the home are protected from abuse by well informed staff who know what to do if they have any concerns. DS0000071630.V369849.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live at St Peters can be confident that the home is clean and well maintained and provides an environment, which meets people’s needs. EVIDENCE: A tour of the home showed it was clean and well maintained. It is furnished and decorated in a domestic style that produces a homely and comfortable environment. All residents have their own room and are able to personalise them in a style and colour of their choice. The kitchen is well equipped in a domestic style and meets the needs of the home. DS0000071630.V369849.R01.S.doc Version 5.2 Page 17 There is a large garden to the rear of the home, which the residents take pride in this and have each purchased flowers of their choice to bring colour to the garden. It is hoped during the next year a conservatory will be built providing additional space for the residents to choose where they would like to spend time when at home. To ensure both residents and staff safety policies and procedures are in place for the prevention of the spread of infection and training has also been provided. DS0000071630.V369849.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are supported and protected through the homes recruitment polices and procedures. EVIDENCE: The rotas showed that adequate staff are provided on each shift to support the residents needs, and that these staffing numbers are flexible to meet changes to routine and support to attend appointments etc. Examination of newly recruited staff files showed that all the relevant information had been obtained prior to their commencement, these checks ensure that they are fit to work with vulnerable people. Staff have or are working towards an NVQ award in Care. A training programme is in place and staff receive regular up date to ensure they have the skills and updated in best practice. DS0000071630.V369849.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service benefit from a well run home. Health safety and welfare is promoted and protected through a series of checks and monitoring. EVIDENCE: The residents told us that they feel that they are supported and have a good relationship with the manager and staff. The manager has ensured that the residents and their families have been fully informed about the recent purchase of the home and that there would be no changes in the staffing and the management. A BBQ has been arranged and all the families have been invited to it, the occasion is to be used to give them the opportunity to ask questions and be given information of any plans for the coming year. The residents are very much looking forward to this event and have been able to invite friends and families of their choice. DS0000071630.V369849.R01.S.doc Version 5.2 Page 20 There have been a number of inspections taken place due the sale of the home covering gas, fire, electric and building, there are certificates available to evidence this. A quality assurance tool is in place to ensure that a review of the quality of care is carried out. Regulation 26 reports were available for examination to ensure that the proprietor has a clear understanding of the quality of the care provided at the home. A dorguard has been fitted to the kitchen door; this allows the door to be left open providing residents with free access but also to protect them should a fire occur. The fire risk assessment requires up dating and the manager assures us that this will be done as soon as possible to ensure that it reflects the safety of all who live, work and visit the home. DS0000071630.V369849.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X DS0000071630.V369849.R01.S.doc Version 5.2 Page 22 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. Refer to Standard Good Practice Recommendations DS0000071630.V369849.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 DS0000071630.V369849.R01.S.doc Version 5.2 Page 24 - 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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