Inspection on 14/10/09 for St Catherines

This is the latest available inspection report for this service, carried out on 14th October 2009.

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

St Catherines 15/02/06

St Catherines 19/09/05

St Catherines 17/01/05

St Catherines 23/06/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Aston Court Nursing Home

Polesworth Group 70 Long Street

Breme

Ravenhurst

Polesworth Group 64 Long Street

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Key inspection report Care homes for adults (18-65 years) Name: Address: St Catherines Coventry Road Coleshill Birmingham West Midlands B46 3EA 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: Julie McGarry Date: 1 4 1 0 2 0 0 9 This report is a review of the 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 stars – excellent  2 stars – good  1 star – adequate  0 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. They reflect the things that people have said are important to them: 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 Adults (18-65 years) Page 2 of 35 Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) 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 Adults (18-65 years) Page 3 of 35 Information about the care home Name of care home: Address: St Catherines Coventry Road Coleshill Birmingham West Midlands B46 3EA 01675434050 F/P01675434050 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Father Hudson`s Society care home 16 Number of places (if applicable): Under 65 Over 65 16 16 16 0 0 0 learning disability physical disability sensory impairment Additional conditions: The maximum number of service users who can be accommodated is: 16 The registered person may provide the following category 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 (LD) 16 Physical disability (PD) 16 Sensory Impairment (SI) 16 Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 35 A bit about the care home St Catherines is a registered care home for 16 younger adults with learning and physical disabilities. The care home consists of 3 interlinking purpose-built bungalows and the provision of management facilities. The Father Hudson’s Society provides 24 hour care and support for the people living in the home. The home is situated within the Father Hudson’s Society main complex, which is situated in the small town of Coleshill, North Warwickshire and close to all local amenities and services the town, has to offer. The current weekly charge ranges from £781 to £1309, with additional charges made for hairdressing, chiropody, toiletries, magazines, aromatherapy, activities and holidays. The fee information given applied at the time of the inspection; persons may wish to obtain more up to date information from the service. Care Homes for Adults (18-65 years) Page 5 of 35 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 35 How we did our inspection: This is what the inspector did when they were at the care home The quality rating for this service is a three star this means that people using the service receive excellent outcomes. This was a key unannounced inspection visit. This is the most thorough type of inspection when we look at key aspects of the service. One Regulation Inspector carried out this unannounced key inspection on one day between 08:00 and 17:00 hours. Three people using the service were identified for case tracking. This is a way of inspecting that helps us to look at services from the point of view some of the people who use them. Our assessment of the quality of the service is based on all this information plus our own observations during our visit. Throughout this report the Care Quality Commission will be referred to as us or we. What the care home does well People who are considering moving into the home benefit from having their care needs Care Homes for Adults (18-65 years) Page 7 of 35 assessed so they can be sure the home can meet their needs. People are supported in a respectful manner and their personal care needs are met. Staff are knowledgeable about the people who use this service. They have a good understanding of their roles and responsibilities. People are supported to gain access to advice from health professionals where they need it so their health needs can be met. The service provides daily in-house and external day care services activities. This Care Homes for Adults (18-65 years) Page 8 of 35 provides people who live there the opportunity to participate in their interests and preferences both within and outside of the service. Visitors are made welcome which supports people to maintain enduring relationships. What has got better from the last inspection The home is now has a manager who is registered with us. Staff are receiving training in the protection of vulnerable adults. Work has been undertaken to redecorate areas of the home. Care Homes for Adults (18-65 years) Page 9 of 35 Care plans and risk assessment have been reviewed to provide up to date information on the needs of the people who live there. What the care home could do better The home should ensure all aspects of risk are identified and actions taken to ensure risks are minimised. The home should ensure that medicines are stored in compliance with their product licence to maintain their stability. Regulation 26 visits should be carried out every month by the registered provider or other suitable person. Care Homes for Adults (18-65 years) Page 10 of 35 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Julie McGarry 77 Paradise Circus Queensway Birmingham W Midlands B1 2DT 01216005300 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 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 Adults (18-65 years) Page 11 of 35 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 12 of 35 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information is provided for prospective users of the service and their families to help them to decide if the agency can meet their needs. People can be confident that their individual needs will be fully assessed prior to being offered a service. Evidence: In the AQAA the manager stated a home visit was made to the service user and information about the service was offered. An initial assessment was completed to ensure we were able to meet the service users needs we worked with the service users current staff team to support the service user to get to know St. Catherines by developing a time table of visits and over night stays. All our service users have a statement of purpose a service users guide and a written contract of residency. This informs all service users and relatives carers what we aim to provide and what is included in the service provided by St. Catherines as well as terms and conditions of residence. To find out whether this was the case, one resident who moved to live at the home since the last inspection was case tracked during this inspection. This involved looking at their Care Homes for Adults (18-65 years) Page 13 of 35 Evidence: care files and talking to the staff that care for them. Their living accommodation and the facilities available to them were also looked at. The file of one resident admitted since the last inspection was examined to assess the pre-admission assessment process. Their records show a person centered plan complied of information received prior to each person moving in, both had been updated as the staff learn more about each persons individual needs and preferences. Records on file show that this person was able to visit the home and stay over night before moving there. Information from the previous care provider was also on file to identify this persons needs to enable St Catherines to determine if they can fully meet this persons needs. The homes Statement of Purpose was looked at as part of the inspection. This document clearly identified the levels of service that could be offered to specific user groups. It was detailed, informative and reflective of the actual service being provided. Contracts were also looked at on two peoples files. Contracts contain the current fees and extra charges that are levied by the home and which are referred to in the service user guide. Care Homes for Adults (18-65 years) Page 14 of 35 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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 are actively supported to make decisions and choices about their own lives. People who use the service find the lifestyle experience matches their expectations and preferences, they are helped to make choices and have control over their lives. Evidence: In the AQAA, the manager stated We work with our service users to put together an agreed care plan to meet their needs in their choosen way, all staff are required to become familiar with each persons care plan within their induction period. Service users are invited to their reviews any changes are agreed and implemented in the service users care plan. To find out whether this was the case, the care files of the three people being case tracked were reviewed to see whether the Home are work with residents to develop a plan of care in a way that promotes peoples rights and choices. Conversations were held with two of the three people case tracked plus two other people to identify whether their needs are being met in a way in which they prefer. Care Homes for Adults (18-65 years) Page 15 of 35 Evidence: Conversations were also held with the manager, assistant managers, and staff to identify their knowledge of the needs of people under their care. Each person living at the home has a care file. Care files were looked at to case track peoples experience of the service. Care records include important background information about them and identify their care needs with any support needed to meet them. The homes approach to care planning is appropriately person centred (PC) in that the plans focus on the preferences skills and goals of each person. Particular care staff are allocated to every resident as their key worker and they take specific responsibility for aspects of their care. They can provide some one to one support and have a role in drawing up and reviewing their plans. This offers residents some individual attention and means key workers get to know them their needs likes and dislikes and so can advocate for them better. Relevant risk assessments are carried out to promote each residents safety. Risk assessments seen in care records sampled are recorded in a format that is personalised and comprehensive. When necessary specific plans had also been put in place to manage particular behaviours in the best way and to keep residents and other people as safe as possible whilst promoting their independence. Residents are encouraged to make daily life decisions although for some this can be limited due to their disabilities. Staff were seen to show a high level of understanding and to try to offer them choices. Some people that live in the home have communication difficulties, which make it hard for them to make their needs and wishes known in a verbal manner. It was apparent from watching them with the staff members on duty that they are competent at making their wishes known in a non verbal manner and that the staff are able to interpret these as appropriate. The home has a high staffing ratio to ensure that each individual is able to do what they choose when they choose as one of the methods of promoting independence and providing person centered care. Residents are encouraged to make daily life decisions although for some this can be limited due to their disabilities. Staff were seen to show a high level of understanding and to try to offer them choices. We saw and heard staff seeking permission to enter residents bedrooms before entering, talking to individuals in a friendly and respectful manner, and offering assistance with personal care discreetly. Sampled records showed that care is provided in the ways indicated in the plans. All the staff spoken with were enthusiastic and had a positive attitude on promoting peoples independence. Staff receive training that covers respect privacy dignity equality and diversity. People met at the inspection were well dressed in appropriate clothing suited to the Care Homes for Adults (18-65 years) Page 16 of 35 Evidence: weather. One person spoken to told us I like it here, and agreed that all the staff were nice. For the people who live here who have communication difficulties staff were observed communicating effectively and respectfully. Care Homes for Adults (18-65 years) Page 17 of 35 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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. The people living in this home are supported to make choices about their lifestyle and to develop life skills. Daily activities promote independence and opportunity for people to live ordinary and meaningful lives in the community where they are living. Evidence: In the AQAA we are told Our service users are supported to pursue activities of their choice within the local and wider community extra staffing is arranged around different events giving service users more opportunities. We at St. Catherines consider family and friends to be of value and encourage where the service user wishes involvement. We have open visiting throughout St. Catherines and support where necessary service users to visit family and friends. Activity planners were seen in individual care plans and showed that people do different things each day including going to day services. From looking at the information in the care plans of the three people case tracked, it was evident that the activity planners reflected individual preferences. Daily records looked at showed that during the week Care Homes for Adults (18-65 years) Page 18 of 35 Evidence: activities to meet identified needs are regular and support ordinary and meaningful lifestyles. There is evidence on care plans and in photographs that activities are wide and varied. We saw records which are used to monitor when people take part in a variety of activities based on their individual needs and capabilities. These include picnic at a local water park, trips to the train station, aromatherapy support, and going to the cinema. The home has purchased a Wii and karaoke system. People are also supported to go on holidays to such place as Euro Disney in Paris, Blackpool and Spain. One person who has an interest in computers showed us the computer that they have in their room which also supports them with their sensory needs. When we looked at this persons care plan it also informed us x goes into the managers office most afternoons in the week after they finish at the day centre or when they are off, as x likes to answer phones, empty bins, and help with computer work. The range and diversity of activities enable residents to develop their interests, hobbies and life experiences. Some of the people maintain links with their family. There was evidence in daily records that peoples needs with regard to keeping in touch with friends and relatives had been recorded. Families are invited to attend peoples reviews and their views on the service have been sought through questionnaires in a recent quality audit. Comments given from the audit include: We are very happy with Xs care everyone in bungalow three are very friendly and helpful. Staff should always be told what a wonderful job they are doing caring for the residents. We are very happy with the recent changes for X at St. Catherines, and happy with the staffing. Menus were sampled to establish that a balanced and varied diet is provided that meets peoples needs and preferences. A range of food had been offered including Sunday roasts and other traditional English dishes that reflect the cultural needs of people living in the home. All food being stored in the kitchen looked fresh and was well within the use by date. Care Homes for Adults (18-65 years) Page 19 of 35 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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 benefit from the consistency of care delivered by staff. Person centered care plans are in place to guide staff, this helps ensure care is provided in the way that meets with each persons own needs and preferences. Not all residnets benefit from their privacy and dignity being upheld. Evidence: In the AQAA we were told Service users care plans detail the support the service user requires for each aspect of their care. All care plans include risk assessments required for the care for our service users, regular entries are made by staff monitoring personal and health care support. Service users attend their local G.P surgery when they are feeling unwell and other clinics to help monitor health physical diagnosis. There is a full procedure for the receipt recording, storage, handling, administration and disposal of medicines. To find out whether this was the case the care files of the three people being case tracked were reviewed to see whether the Home are recording reviewing and acting upon identified care needs, and a safe system of managing medication is in place. Conversations were held with two of the three people case tracked plus three other people to identify whether their needs are being met in a way in which they prefer. Care Homes for Adults (18-65 years) Page 20 of 35 Evidence: Conversations were also held with the manager, assistant managers, and staff to identify their knowledge of the needs of people under their care. Care plans show that the personal and health care needs of the residents are identified and care is offered in a person centered way. That is each individual resident is offered support in a way that they personally prefer, and meets their individual needs in regard to the time that go to bed, support for their personal hygiene, and their preferred routines. Records are kept of all the support people receive from staff. Residents were seen to be well presented and appropriately clothed in relation to their age disability and the weather. Residents receive personal support in the way they prefer and require as evidenced through observations during the inspection, discussions with staff and examination of records. For example, on the morning of the inspection not all residents were up and dressed. Residents arose at varying times and made choices about where to have breakfast and what they wished to eat. Care records provide information about residents medical history conditions and any current health issues showing how they should be monitored and dealt with and by whom. Staff receive moving and handling training and plans with risk assessments regarding residents mobility are in place as well as a range of aids, hoists, and equipment provided. Physical care checks are also carried out to promote good health e.g. weight records are maintained kept and records of seizures. There was evidence that care plans are reviewed at least monthly, but are not always updated when there is a change in care needs. For example daily records show that staff recognised a change in one persons skin integrity. Records show that a senior member of staff advised on how to manage their personal care and staff spoken to were clear about the care practices require to minimse risk of further skin breakdown. However the care plan for skin integrity or personal care has not been updated to reflect a change in need and care practices. Records for another person shows that staff have contacted a speech and language therapist when they become concerned about this individuals swallowing needs. The therapists visited and records show they found them to be at moderate risk of aspiration. When we reviewed this persons file we found no plan in place for this risk. Staff spoken to were able to discuss this persons nutritional needs and the importance of offering food in small pieces, soft and moist to reduce the risk of them aspirating. When we discussed this with the manager immediate action was taken to asses the risk and put a plan in place. When we visited one persons room, we observed that one bed rail was being used to enable one person to move in the bed. The home did not have a risk assessment plan in place for the use of one bed rail. We discussed this with the manager who took immediate action to ensure a risk assessment was recorded in the their file, and the Care Homes for Adults (18-65 years) Page 21 of 35 Evidence: manager gave us assurances that other professionals would be contacted to review the best practice for supporting this person to move safely whilst in their bed. We found evidence of good care planning for those identified as being at risk of epileptic seizures, including a care plan in place to advice staff of appropriate actions to take should this peron have a seizure, the plan also included guidelines on the use of emergency medical intervention. Staff spoken to were able to inform us of actions they would take should this person have a seizure, and this information was consistent with their care plan. This should promote the health and well being of this person. One person whose health needs have recently changed, has been able to participate in best interests meetings to ensured they are supported to be involved with any decision making regarding their future care and treatment. Staff provide personal care in private and were sensitive and discreet when supporting people with any aspect of their personal care and support. Records show that people who live here are having access to annual reviews of their care by social services. During the inspection we found evidence in health records and care plans to show that people who live at this home have access to good quality physical and mental health care support. We read records that show that as part of promoting peoples health staff support individuals to access regular visits from the dentist, optician, specific health consultants, behavioural nurses, their GP, and a chiropodist when needed. Preventative measures such as pressure relieving mattresses and cushions were seen to be in use for residents. The systems for the management of medicines in the home were examined. No one living at the home is able to self administer their medication, and so staff take full responsibility. Good arrangements continue to be in place for the safe storage of medication. Staff are trained in the safe handling and administering of medication and manage medication well on behalf of all people currently living at the home. The pharmacist delivers medication in blister packs. The medication sheets show that the number of tablets received into the home so that they can be accounted for and that staff are signing for the medication given out. A suitable lockable cabinet is in place for the safe storage of medication in each bungalow at the home. The cabinets were well ordered. The temperature of the medicine cabinet / rooms are being not maintained to ensure medications are stored below the required 25 degrees. Care Homes for Adults (18-65 years) Page 22 of 35 Evidence: The home currently carries no controlled drugs that would necessitate any special storage and recording arrangements. There are a range of policies and procedures in place relating to administration, covert practices, training and disposal of medication. Care Homes for Adults (18-65 years) Page 23 of 35 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. 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. The agency has relevant policies and procedures in place to ensure health, safety and welfare is maintained for the people who use the service and for the staff who work in the service. Evidence: The AQAA tells us We have a copy of the complaints procedure on display in all of the bungalows allowing access to the service users their friends and families and to visitors. The complaints procedure is also included in the service users guide. All staff received awareness training on protection from abuse and what to do if abuse is suspected. From our observations and discussions with staff we found that the complaints procedure is not displayed in every bungalow as stated in the AQAA and the homes statement of purpose. The AQAA and records seen during this inspection showed that there had been no complaints made about the home since the last inspection. We have not received any complaints or concerns about this service since the last key inspection. Staff spoken to were aware of the complaints procedure. Staff were seen to be attentive to the needs of the individuals, using knowledge gained from other professionals, the homes care plans, and their own experience of working with each person. We observed staff taking time to listen and observe signs and cues to ensure they understood peoples views. Individuals who live at the home appeared Care Homes for Adults (18-65 years) Page 24 of 35 Evidence: relaxed with staff which may indicate that they feel safe. There have been three referrals made to the local authority since the last inspection under safeguarding protocols. Required policies and procedures are provided to promote residents welfare and protect them which include multi agency procedures for the protection of vulnerable adults (POVA) recognising abuse and whistle blowing. Staff are expected to read all these documents. The manager, team leader, and the staff team have received training on POVA procedures, and those spoken with are clear about their role and responsibility for safeguarding the vulnerable adults who live at the home. Relevant instruction is also part of the homes induction programme and the accredited training course for staff working with people who have learning disabilities (LDAF). It was evident through discussions with the manager that she is aware of local Social Services and Police procedures and her responsibilities for responding to allegations of abuse. Staff were able to confirm that they had attended training related to the protection of vulnerable adults. Two members of staff were able to explain the action they would take if they saw abuse. Both answered appropriately. Clear audit trails and financial management guidelines were in place for individual personal spending monies. Each persons money is checked on a daily basis and two members of staff are required to sign for each transaction undertaken. Monies checked during the inspection tallied with balances recorded and receipts available. Care Homes for Adults (18-65 years) Page 25 of 35 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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 who live here benefit from a home that is well maintained and furnished so that people live in a clean, comfortable environment. Evidence: The AQAA states St Catherines consists of 3 different bungalows offering accessible accommodation to 16 service users. Each bungalow provides a homely and relaxed atmosphere and comprises of a spacious open plan lounge and kitchen with a multi level preparation area. A sensory room to aid relaxation and quiet time away from others. A garden with high and low beds, tubs and containers that are accessible. To find out whether this was the case, the living accommodation and the facilities available to people who live at the home were looked at, and residents and staff were spoken with. A tour of the building was undertaken at the start of the inspection. There is a warm and welcoming atmosphere in the home at the time of the visit. The accommodation comprises of three self-contained bungalows next to each other. The impression obtained of them is homely and comfortable and that they are maintained, furnished and decorated to a good standard. Care Homes for Adults (18-65 years) Page 26 of 35 Evidence: Residents bedrooms are well personalised to reflect their individual interests and needs including such as specialist beds, a computer, sensory lights and music systems. All three bungalows were found to be clean, tidy, warm, fresh and airy. Whilst most residents are not able to take an active part in household tasks staff clearly make sure that cleanliness and good hygiene are promoted and take pride in the bungalows. Improvements have been made to the rear gardens since the last inspection. This includes new fencing, and the development of two raised flower bed, for people to grow plants and flowers. We are told that two residents in particular have taken an interest in the garden since this has been developed. The home has relevant policies and procedures in relation to infection control and health and safety. The laundry area has good systems of infection control. The laundry room is equipped with sufficient commercial equipment to manage the soiled laundry for the home and is satisfactory for the control of infection. The home also provides staff with disposable gloves and aprons and paper towels. Staff were observed to wears aprons and gloves when providing support with personal care. One of the three kitchens seen was clean and well organised. Records were kept of the fridge and freezer temperatures showing appropriate temperatures to maintain good food safety. Care Homes for Adults (18-65 years) Page 27 of 35 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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 who use this service are protected by robust recruitment procedures that have been consistently followed to ensure staff are suitable to work with vulnerable adults. Evidence: The AQAA states We ensure there is a sufficient number of staff with the correct skill mix on duty at all times, we have a high percentage of staff with NVQ 2 or above in care. All staff have to complete mandatory training and updates. All staff receive supervision, and are supported by their assistant manager who works on shift alongside the staff team. The number of staff on duty was discussed with the manager a copy of the duty rota was seen. The number of staff on duty on the day of inspection was as recorded on the duty rota and this appeared to be sufficient to meet the needs of those that live at the Home. The total number of staff within the home is 36; this includes the post of a full time manager who hours are supernumerary. The manager states that 30 members of care staff are qualified to National Vocational Qualification in Care Level 2 (NVQ level 2). This is above the national Minimum Standard for 50 of staff to be qualified. This should mean that residents benefit from having their needs met by staff that are appropriately experienced and qualified. Pre-inspection information and the training chart in the home shows that staff have completed training in the full range of mandatory, health and safety related training, (e.g. medication, first aid, adult protection, food hygiene and fire Care Homes for Adults (18-65 years) Page 28 of 35 Evidence: safety) as well as specialist care courses, such as bereavement, epilepsy, and communication. All staff receive regular individual supervision. Staff spoken to feel well supported by senior staff and management, although we were informed by one member of staff they felt too much red tape was in place at the home. It is also confirmed that staff meetings are held regularly. Records are kept of issues discussed in supervisions and meetings, with agendas and minutes taken. Staff clearly work together well as a team and there are good and open communication channels within the home. The majority of staff work with specific individuals in each bungalow, this is to ensure staff are knowledgeable about the people that they regularly support. The manager has recently started to implement new introduction programs for all staff to each bungalow. This is to ensure all staff are able to work confidentially at each bungalow, should the need a rise. Two staff files were seen, they included all of the necessary documentation to demonstrate that the staff are suitable to work with people living at the home. They included CRB (Criminal Records Bureau) checks and two references. Staff present during this inspection were able to answer our questions about meeting the needs of people who live in the home, and have clearly got to know them well. Staff interacted with people in a positive, relaxed and calm manner, being attentive to needs, no matter how expressed, and responding in ways that upheld their dignity and wellbeing. Staff spoken to were clear about their lines of accountability and were able to tell us who they would speak to if they had any queries. Care Homes for Adults (18-65 years) Page 29 of 35 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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 benefit from being supported by a service that is consistent, well planned and managed. Evidence: The AQAA stated Each bungalow has an assistant manager who is responsible for the day to day operations of the bungalow; they are supported and supervised by a deputy manager and the manager. Each bungalow holds regular team meetings to allow clear communication and feedback relating to changes, polices and new procedures. Polices and procedures are in place to ensure service users finances are handled appropriately. Since the last inspection, the home has appointed a new manager who has registered with us. This meets the requirement made at the last inspection and complies with Section 11 of the Care Standards Act 2000. The manager is well qualified to manage this service, and discussions with her show an open, positive and inclusive approach to management. The service has access to equipment and resources to ensure the service runs efficiently for the benefit of the people of use this service. There is good and safe storage for records, and sufficient Care Homes for Adults (18-65 years) Page 30 of 35 Evidence: space and equipment such as telephones and computers to enable the manager and staff to conduct their duties efficiently. There is evidence of evaluation systems that provide an opportunity to improve the service by consultation with people who use the service, their families, professionals, and staff. A questionnaire was sent to relatives, professionals and staff recently. Each completed questionnaire was seen and the majority of responses were positive. The Annual Quality Assurance Assessment (AQAA) completed by the manager was completed to a good standard. Information provided could be better supported by a greater range of evidence. The Annual Quality Assurance Assessment (AQAA) informed us about the development of the service and future plans for improvement. During the visit staff appeared confident in their roles, the home was relaxed and the people who live here appeared at ease and comfortable. Information provided by the manager in the pre-inspection questionnaire indicates that relevant Health and Safety checks and maintenance are being carried out at the home. A number of Health and Safety records were checked, including the fire safety log. These records showed that health and safety matters are well managed. The fire alarms are tested on a weekly basis and a fire risk assessment is in place. Regulation 26 visits are not being carried monthly by the registered provider or other suitable person. Registered providers are required to carry out such visits at least once a month and reports made available for inspection. As previously noted, further work must be carried out to ensure all identified risks are assessed and appropriately recorded to ensure staff have the guidance to respond consistently. As previously mentioned, the personal monies of the three people were audited. The home was able to demonstrate good and safe practices in the management of peoples monies. Care Homes for Adults (18-65 years) Page 31 of 35 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 32 of 35 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 Description 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 Description 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 1 20 The purchase of a maximum, minimum thermometer is advised to accurately read the maximum, minimum and current temperatures on a daily basis to ensure that the medicines are stored in compliance with their product licence to maintain their stability. A copy of the complaints procedure should be made available in the home at all times and should be clearly displayed throughout the service. This will help to ensure that people who use the service, staff and visitors have a clear understanding of how to make a complaint. Regulation 26 visits should be carried out at least once a month by a registered provider. The manager must ensure that all areas of risk are identified,and apppropriate plans in place to minimise any risk. This relates to use of bed rails, aspiration and skin integrity. 2 22 3 4 39 42 Care Homes for Adults (18-65 years) Page 33 of 35 Care Homes for Adults (18-65 years) Page 34 of 35 Helpline: Telephone: 03000 616161 or 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). 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