Inspection on 19/03/10 for Cloisters

This is the latest available inspection report for this service, carried out on 19th March 2010.

CQC found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Cloisters 20/07/06

Cloisters 10/01/06

Cloisters 18/07/05

Cloisters 31/01/05

Cloisters 27/07/04

Similar services:

Chirnside House

Emmaus House

East Croft Grange

Craignair

Croston Park Nursing Home

Conifers Nursing Home

Elmsdene Care Home

Crawfords Walk Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 03/06/2010.

Key inspection report Care homes for older people Name: Address: Cloisters 5 Abbotsford Road Blundellsands Liverpool Merseyside L23 6UX     The quality rating for this care home is:   three star excellent 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: Patricia Thomas     Date: 1 9 0 3 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 25 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Cloisters 5 Abbotsford Road Blundellsands Liverpool Merseyside L23 6UX 01519243434 01519243434 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Bernadette Neale,Mr Stephen John Neale Name of registered manager (if applicable) Mrs Hazel Welsh Type of registration: Number of places registered: care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The registered person may provide the following category/ies 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: Dementia Code DE The maximum number of service users who can be accommodated is: 20 Date of last inspection Brief description of the care home Cloisters is a permanent care home, registered in the category of dementia for twenty elderly people. The registered providers are Mr. S. and Mrs. B. Neale, and the registered manager is Mrs. Hazel Welsh. Cloisters is a detached Victorian house with a car park at the front and an enclosed and well-maintained garden at the rear. Cloisters is close to a train station and bus routes and is situated in a quiet residential area. Cloisters has a passenger lift to all levels and there are sixteen single and two double rooms, all with call bells. Bedrooms are located on the ground floor and upper Care Homes for Older People Page 4 of 25 20 Over 65 0 Brief description of the care home floors. There are two large lounges and a dining room, which seats twenty people and is also used for activities sessions. The home is staffed throughout the day and night and care staff have NVQ qualifications. Care Homes for Older People Page 5 of 25 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: three star excellent 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 three stars (***). This means that people who use this service experience excellent quality outcomes. The visit to Cloisters was carried out by one inspector over a five hour period. The visit was just one part of the inspection. We also looked at other information we had about the home. Before the visit, the home manager was asked to fill in a questionnaire called the annual quality assurance assessment (AQAA). This gave us up to date information about Cloisters. We sent our questionnaires out to people who live in the home and staff who work there. Other information we had received since our last major inspection at the home was also reviewed. During our visit, we looked at various records and walked round the home. We spoke with a number of people who live and work there and they gave us their views about Cloisters. Care Homes for Older People Page 6 of 25 We used a system called case tracking. This is a way of inspecting that helps us to look at services from the point of view of some of the people who use them. We track peoples care to see whether the service meets their individual needs. We received ten surveys from people who live in Cloisters and ten from people who work there. The responses are included in the report. The fees for this service range between £525.00 and £540.00 per week. Care Homes for Older People Page 7 of 25 What the care home does well: What has improved since the last inspection? What they could do better: Care Homes for Older People Page 8 of 25 We have not given any requirements or recommendations during this visit. We found there is a continued commitment by staff to personal development. The culture in the home is one which appreciates opportunities to constantly develop their skills and in this way, improve outcomes to the people who live in the home. 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 order line 0870 240 7535. Care Homes for Older People Page 9 of 25 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 10 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are admission and assessment procedures in place to ensure the care needs of people will be met when they move in to Cloisters. Evidence: We read information about when people move in to Cloisters and found there are good systems for introducing them to this home. They receive information about the home and have their mental and physical health care needs and preferences assessed. This means they have the have details about the home to inform their decision about moving in. Also, the home is able to demonstrate that the service has the skills and facilities to meet their needs after they move in. All admissions are firstly on a four week trial basis to ensure the home is suitable for the person. People who live in the home have a contract of residence which sets out the fees and outlines their rights and responsibilities as residents. We received positive comments from people in surveys about their experience on moving in to Cloisters. Care Homes for Older People Page 11 of 25 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 are treated with dignity and respect in Cloisters. Their health and personal care needs are taken seriously. Evidence: We case tracked the care records of two people who live in the home. We found that there are good systems in place for recording and reviewing peoples care needs and identifying risks to their safety. This is to give staff the guidance they need to support people properly and safely. This will also ensure they will receive the level of care they need and stay as independent as possible. Records showed us there is good consultation with people about their care needs and the way they like things to be done. For those who are not able to express their opinions, their families and representatives are asked. This means people will receive support in the way they need and prefer. All people who live in Cloisters are registered with local G.P.s and have access to community health and paramedical services with clear records are kept of contacts with them and the outcomes. There is a system in place for managing peoples prescribed medication and staff who Care Homes for Older People Page 12 of 25 Evidence: give out medication have received training and have written guidance to follow. We tracked medication for two people. Their prescribed drugs were in stock and the medication administration records were up to date. To help ensure all drugs accepted into the home will be accounted for, there is a system for auditing medication during provider visits and for returning unwanted drugs to the pharmacy. It was evident during the visit that a lot of attention had been paid by staff to peoples personal grooming and clothing when supporting them. Staff were respectful toward people who live in the home and were offering choices about how and where to spend their time and their meals and drinks. Three people spoken with said they have their hair done and staff treat them well. We received ten surveys from people who live in the home. They told us they always receive the care and support they needs and staff are available when needed and act upon what they say. We received ten staff surveys which said they are always given up to date information about people they support in their care plans. They said there is always enough staff on duty in Cloisters to support the needs of the people who live there. Care Homes for Older People Page 13 of 25 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. Social activities and meals are both well managed and provide daily variation and interest for people living in Cloisters. Evidence: We looked at care plans and activities summaries to check the lifestyle and choices on offer in Cloisters. We found that peoples social preferences and interests are assessed when they move in and their ability to participate is assessed and desired outcomes stated. We looked at the activities programme which offers a range of craft and therapeutic sessions. There was a summary of each persons participation in their care records and this is updated each month. People were enjoying time in the lounges and garden at the time of the visit. Records showed us there are no undue restrictions on visiting times and visitors to the home at the time of our inspection, were given privacy and offered a drink. Peoples religious needs and preferences are recorded when they move in and arrangements are made for them to have the support they need from local ministers. Care records show us that there is good communication with peoples families about each persons progress and condition while they are living in Cloisters. There were records of named advocates for people who have no family and may need independent representation. We spoke with the cook, read catering records and care plans. Peoples dietary needs Care Homes for Older People Page 14 of 25 Evidence: are recorded in their care plans and their meal and drink preferences are catered for. The menus were read and showed a good variety for meals with choices and alternatives offered. People are asked what they would like before meal times and for those unable to communicate well, their food intake is monitored (regarding what they eat and what they refuse), to ensure they are getting food that is to their liking. People are weighed each month and any sustained weight loss would be referred to the persons G.P. There is a pleasant dining room which has enough seating and place settings for the people in residence. Meals are served in one sitting. We spent some time in the dining room during the meal and saw that there was a relaxed atmosphere. Some people were able to eat independently, others were getting the help they needed from the manager and care staff. Meals are served directly from the kitchen which is next to the dining room. We found that the kitchen is well equipped and catering records up to date. There were good stocks of fresh, frozen and chilled foods in store, and evidence of choices for breakfast cereals and hot and cold drinks. In surveys we received ten people told us the home arranges activities which they can take part in if they choose. They told us they were satisfied with their meals. Care Homes for Older People Page 15 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service were protected by the complaints and safeguarding procedures, which were understood by staff. Evidence: The complaints procedure is displayed in the home so that people have regular access to it if needed. This is also given out with the statement of purpose and is available in large print. Staff who were spoken with during the visit understood the complaints procedure and in the surveys we received people told us they had received a copy of the complaints procedure and knew who to speak with informally if they had any concerns. Cloisters has safeguarding and whistle-blowing procedures and staff have received the relevant training and updates. Staff spoken with showed an in depth knowledge of the procedures and the indicators of abuse. This will help to ensure that suspected abuse of any person living in the home will be reported and investigated. We have not received any complaints or safeguarding referrals about Cloisters since our last visit. The providers carry out monthly monitoring visits and with the manager, review procedures to ensure that they are up to date and in line with current best practice guidance. Work is currently taking place to ensure that deprivation of liberty safeguarding material will be updated for staff. In this way the rights of those who do not have capacity to make decisions will be further protected in their home. Care Homes for Older People Page 16 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. In Cloisters, people enjoy a suitably adapted, clean and very pleasant home. Evidence: Cloisters is a detached Victorian dwelling house which has been extended. The home furnished and decorated in domestic style, providing a comfortable environment for the people who live there. Personal accommodation consists of sixteen single rooms and two shared rooms with screens provided for privacy. Some of the bedrooms have en suites and each bedroom has a nurse call bell, electric sockets, bed lights and television points. There are bathrooms and showers located on each floor and separate toilets. The home has a bath hoist, ramp and passenger lift to all floors. There are high level toilets seats, grab rails to assist people who may be physically frail. There are two lounges at the front of the building, one with television. People were moving freely between lounges during our visit. One person was doing word puzzles, she said she prefers this to watching television and it is good to have a quiet place. There is a pleasant dining room on lower floor level, which can be reached by the lift or stairs. The home was clean and free of odours during our visit and domestic staff are employed. Staff receive training in control of substances hazardous to health and infection control to keep the premises safe and hygienic. There is a car park and gardens at the front of the house and a secure garden at the back. The garden has recently been landscaped providing a purgola, pond and patio Care Homes for Older People Page 17 of 25 Evidence: area for people to enjoy in fine weather. There is also a well tended lawn and planted areas. A number of people were enjoying the garden during the visit when showers permitted. Three people we asked, told us their home is comfortable and they have brought pictures and ornaments to personalize their bedrooms. In surveys received people told us their home is always fresh and clean. Care Homes for Older People Page 18 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive care and support from suitably vetted staff who have the skills to support them correctly. Evidence: We looked at the staff rosters, which gave a true record of the staff who were on shift. The manager is supernumerary to care staff levels and a cook and housekeeper were on duty. A handy person is employed part time. We spoke with three members of staff who are employed as care assistants and we looked at their training records. They said their mandatory training is up to date and they have received dementia training. Records and certificates gave evidence of the training they have received. They said the training is relevant to their roles. They said the care plans are easy to follow and they give them the guidance they need and are regularly reviewed so people will receive the level of support they need. Over fifty percent of staff employed have National Vocational Qualifications. In staff surveys they told us, Training courses for staff are always available. Training is on offer and regularly updated. All staff work well together as a team. The residents are well looked after. To check that only suitable staff will be employed we looked at recruitment procedures. To give evidence that these are being followed, we looked at three personnel files for those most recently employed in the home. These gave clear evidence of the vetting that takes place before staff are in post. We saw evidence of Care Homes for Older People Page 19 of 25 Evidence: satisfactory criminal records bureau clearances, employers references and employment histories. There were copies of interview notes, employment certificates and job descriptions on file. Before people work unsupervised in the home, they receive induction training. In surveys received from staff they told us their induction training covered everything they needed to know to do the job as a new employee. Staff on duty during the visit confirmed this to be the case. Care Homes for Older People Page 20 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Cloisters is well run and a high level of consultation with people who live there (and their representatives) means they they can contribute to the homes development. Evidence: The manager of Cloisters has many years experience in her role and holds a management qualification. There are clear arrangements in place for senior staff to deputies in the managers absence to give continuity. The manager was able to express good knowledge of the needs of people supported in the home and there was good access to all the information we requested during the visit. In staff surveys they told us the manager supports them well and ensures they have the training they need. We looked at quality monitoring systems in the home and found this is done through audits in consultation with people who use the service and their families. The questionnaires for 2010 were available for inspection. The responses were positive and had been reviewed and summarised in February 2010. The manager said the service will be developed according to the responses received in questionnaires. The owners of the home carry out monthly monitoring visits and audit aspects service such as Care Homes for Older People Page 21 of 25 Evidence: medication, accident records and care plans. The manager reviews care plans at least once a month or more regularly in response to any change in the persons condition. This is to ensure that the care people are receiving and their risk assessments are up to date and relevant to their needs. There was evidence also of placement reviews with social services. The manager confirmed that the home does not become involved with personal finances and does not hold personal allowance monies on behalf of residents. We looked at health and safety records, risk assessments and accident records. We found there are good systems for identifying and as far as possible, elimating risks to peoples safety. Reviews showed us that none of those in residence had complex moving and handling needs at the time of our visit. In speaking with staff and looking at training records, we found their health and safety training is up to date and they have procedural guidance in safe working practice. The building is well maintained and all safety certificates such as for gas, electricity and fire safety, were up to date. We found there are good systems for infection control and the laundry was well organised and suitably equipped. Food storage systems were satisfactory and a supply of protective clothing is available for staff as they need it. Care Homes for Older People Page 22 of 25 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 23 of 25 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 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 24 of 25 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. 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