Inspection on 11/11/08 for Holy Cross Priory

This inspection was carried out on 11th November 2008.

CSCI found this care home to be providing an Good 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

Holy Cross Priory 21/11/06

Holy Cross Priory 01/02/06

Holy Cross Priory 22/08/05

Holy Cross Priory 07/01/05

Holy Cross Priory 27/09/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Holy Cross Priory Lewes Road Cross In Hand Heathfield East Sussex TN21 0TS     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Rebecca Shewan     Date: 1 1 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. the things that people have said are important to them: They reflect 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Holy Cross Priory Lewes Road Cross In Hand Heathfield East Sussex TN21 0TS 01435863298 01435867843 HCPriory@tiscalli.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: The Grace and Compassion Benedictines care home 24 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Service users must be older people aged sixty-five (65) years or over on admission. The maximum number of service users to be accommodated is twenty-four (24). Date of last inspection Brief description of the care home Holy Cross Priory is a residential home registered to provide care and accommodation for up to twenty-four older people. The home has been owned and run by the Benedictine Sisters of our lady of Grace and Compassion, a registered charity since 1964. The Charity is the registered owner of a further six residential/nursing homes and several sheltered housing schemes nationally. The home is a large detached Victorian manor house comprising of two detached properties, with part of the home registered as a nursing home. Within the grounds of the home are also sheltered accommodation units. The building has had many uses in its history including a hotel in the 1930s and as a monastery during the 1950s. It is set within extensive grounds in a rural location, between the villages of Cross-in-Hand and Blackboys. The home is presented across three floors with a shaft lift providing level access to all floors. Care Homes for Older People Page 4 of 25 0 Over 65 24 Brief description of the care home Residents accommodation consists of twenty four single rooms with the majority being en-suite. Shared facilities include a large lounge, dining room, entrance hall and chapel. Care staff and residents are principally from the religious community. The home provides care and support to residents who are both privately funded and those who are funded by Social Services. The home?s fees as from 01 October 2006 are #300 per person per week. Additional costs are charged for chiropody (approx #9) hairdressing(#6.50-#25), newspapers, magazines and toiletries. The homes literature states that one of its main aims is to provide the highest standard of care for every person living here at the home, their family and carers. 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: two star good 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: This unannounced inspection took place during the morning and afternoon of the 12th November 2008. The Annual Quality assurance assessment (AQAA), incident reports and previous inspection reports, held by the Commission for Social Care Inspection, were read before the inspection. The inspection of the home took six and a quarter hours. Records such as care plans, staff files and medication records were also viewed. Seventeen service users (known as residents) were accommodated at the home at the time of the inspection. A tour of the whole home was undertaken and the Registered Manager, the Deputy Manager, the Cook and two residents were spoken with. The CSCI also conducted Service User and Staff surveys. The responses from the surveys received were positive Care Homes for Older People Page 6 of 25 in all areas relating to the home and the care provided. The range of fees charged (at the time of this report) are 350 GBP to 400 GBP per week. Additional charges are made for dry cleaning, hairdressing, toiletries and chiropody. Potential new residents can obtain information relating to the home via CSCI Inspection Reports, Care Managers, Placing Authorities, by word of mouth and by contacting the home direct. What the care home does well: What has improved since the last inspection? What they could do better: It is recommended good practice that the complaints procedure is updated to reflect Care Homes for Older People Page 8 of 25 that CSCI can be contacted at any stage during the event of a complaint. Once this document has been amended it is recommended that both the Service User Guide and Statement of Purpose are updated to include the revised document. It would be considered good practice that all credits and debits made to residents personal allowance accounts are signed for by two staff and that all daily care record entries should be signed and dated. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.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. Potential new residents are provided with appropriate pre admission information, in order to allow them to make an informed choice about the home being able to meet their needs. There are good processes in place for assessing potential new residents with services being offered to only those residents whose needs can be met. Evidence: The Statement of Purpose and Service user Guide were viewed. These were found to be appropriate in content. A minor amendment to both documents is required, in order to reflect the amended Complaints procedure (See Complaints and Protection section). Therefore recommendation has been made. Following the inspection of November 2006 improvements have been made to ensure that the previous inspection requirement that accommodation is not provided to residents until the home is satisfied that they can meet their care needs and that this Care Homes for Older People Page 11 of 25 Evidence: is confirmed in writing to them has been met. Documentation relating to the most recent admissions to home were viewed and found to have been completed fully and conducted with the involvement of the resident and/or their representatives (where applicable). The homes Deputy Manager carries out pre- admission assessments. The homes Registered Manager also conducts pre assessments, when the need arises. Copies of care management assessments from the placing authority are obtained, where these exist. The Registered and Deputy Manager address any issues, which are highlighted within this assessment. Documented records are maintained of all correspondence with the placing authority. Letters of admission acceptance are sent to the potential new resident, this was confirmed by the Registered Manager. Intermediate care is not provided by this home. Care Homes for Older People Page 12 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. Residents are offered a good provision of health care and personal support. All care is administered in way that protects residents privacy and dignity. Medication procedures ensure that all necessary precautions are taken to ensure that errors do not occur. Evidence: Care plans set out in detail the action which needs to be taken by care staff, to ensure that all individual health, personal and social care needs are met in a structured and consistent manner. Care plans were sampled and it was evidenced that they were comprehensive, detailed in content and covered all aspects of residents needs. Care plans are written to allow the assessor to gain a good overview of individuals medical, mental health, social and personal care needs and provide the assessor with a clear overview of the Residents current needs, limitations and required assistance. Residents involvement in the care plan review process was also evident. Risk assessments for falls/tissue viability/nutrition were viewed and found to be comprehensive in detail. Daily care entries were also viewed and it was evidenced that day time entries were Care Homes for Older People Page 13 of 25 Evidence: dated and night time entries were recorded as N. Therefore a Recommendation has been made. Residents are registered with a GP from one of two local GP surgeries. District Nurses, Speech and Language Therapy, Occupational Therapy, Audiology, Physiotherapy and the Dietitian are available to the home and attend to residents as needed, these services are accessed via the GP. Residents can attend the local Opticians or visiting Opticians are also available. Dental treatment is arranged via private and/or NHS surgeries. There are both types of surgeries available locally. The home has a Chiropodist who attends the home every six to eight weeks and as required. The home has access to pressure relieving equipment, as required. The home has good procedures in place for the monitoring and recording of all drugs administered, disposed of and those entering and leaving the home. The stores for medication were viewed and these were found to be maintained in a clean and orderly manner. Medication administration records were viewed and these were found to be maintained appropriately. Controlled Drugs are maintained on the premises and were found to be recorded appropriately. The home has appropriate self medicating risk assessments in place. A homely remedies policy signed by a GP is in operation. Following the inspection of November 2006 improvements have been made to ensure that the previous inspection recommendation that further consideration is given to promoting residents privacy with regard to the sharing of communal bathrooms and toilets has been actioned. Communal bathrooms and toilets were all noted to have lockable doors and clear vacant/engaged signage in place. Staff were observed providing personal support to residents in such a way that promoted and protected their privacy and dignity. Care Homes for Older People Page 14 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. The home provides a wide range of social, cultural and recreational facilities. Menus and meals including specialist diets are designed to meet residents dietary needs. Residents choice and wishes are respected in all activities and mealtimes. Evidence: Following the inspection of November 2006 improvements have been made to ensure that the previous inspection Requirement that the home provides the necessary facilities to promote residents opportunity for activities and recreation has been met. Daily activities are provided by the Holy Cross Priory Nursing Unit, which is part of the Holy Cross Priory. Every Wednesday afternoon there are sessions for bingo, boardgames, crosswords and quizzes. Activities can be changed according to residents choice. Records are maintained of all activities conducted and those attended. Residents birthdays and seasonal events are celebrated. Residents spoken with said that they liked the activities being arranged as they are, as they allow for prayer times/mass to be the main focus of their day and that they could pick and choose those attended, whilst residents commented in CSCI surveys that activities are available but dont like to attend and go only to those I like. A hairdresser attends the home twice a week. Care Homes for Older People Page 15 of 25 Evidence: Residents religious wishes are observed and arrangements are in place for residents to receive Mass and Prayer on a daily basis. The home has an on site chapel. Other denominational Holy Communion is also available. The management of the home believes in promoting an equal and diverse culture among staff and residents. External activities are arranged three to four times a year. Such outings are trips to places of local interest. There are currently no day centre attendees at present. Residents have close links with the Linked Hands organisation, who arrange shopping trips to Eastbourne. Weekly trips into the local village of Heathfield are also available via Age Concern. Contact with family and friends is positively encouraged with visitors being able to attend the home at any time and in accordance with the residents wishes. The homes menus are devised on a four week rolling programme. All meals are home cooked with an alternative option available for each mealtime. Mealtimes can be varied upon request and residents guests are also welcome to have meals at the home. Meals can be taken in the residents bedroom or in the communal dining room. Medical, therapeutic or religious diets are provided as needed. The meal served during the inspection was ample in quantity and attractively presented. The lunchtime meal was observed to be unhurried. Care Homes for Older People Page 16 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from a robust and efficient complaints procedure, whilst the homes procedures, processes and staff training should protect residents in the event of an allegation of abuse. Evidence: There is an established complaints procedure in place, which is in need of amending. The current Complaints Procedure states that the CSCI can be contacted after all internal processes have been exhausted, as opposed to at any stage during the process. Neither the management of the home or CSCI have received any complaints within the past twelve months. Criminal Record Bureau (CRB) checks have been carried out on all existing staff. Nursing and Midwifery Council (NMC) PIN checks are conducted for Registered Nurses. Both CRB and Protection of Vulnerable Adult (POVA) checks are carried out on all new staff. Staff have attended training in the Protection of Vulnerable adults within the last twelve months. This was evident from the staff files were viewed. A copy of the East Sussex County Councils Safeguarding Adults procedures is readily accessible to staff. There have been no Safeguarding Alerts raised by the home in last twelve months. Care Homes for Older People Page 17 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The accommodation provided for residents is well maintained, safe, hygienic and odour free. Infection control policies are in place and procedures are adhered to by staff at all times. Evidence: The location and layout of the home are suitable for its stated purpose. The home is well maintained and all areas of the home, including the garden, are accessible to residents. The home has an ongoing plan of refurbishment in place, four bedrooms have recently been refurbished and the roof is currently being cleaned. The large garden/grounds are well maintained. The home has an infection control policy in place and staff are trained in infection control procedures, staff training records viewed confirmed this. Staff were observed adhering to infection control procedures. An environmental infection control audit is also conducted annually by the Registered Manager and her Deputy. Records viewed confirmed this. The home was clean and odour free throughout. There is a daily cleaning schedule in place. 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. The health needs of residents are well met by a staff team that have the necessary skills and experience to the meet the needs of current residents. There is good maintenance of all staff recruitment files. Staff receive training that is both current and appropriate to the needs of residents. Evidence: A competent staff team, sufficient in number, meets the residents needs. There is a staff rota in place, which details staff designations and hours of working. The home has a permanent staff team of the Registered Manager, Deputy Manager (an RN), fifteen Carers, one Cook, one Housekeeper, one gardener and one Maintenance person. The care staff team consist of Nuns and Lay persons. Six carers are National Vocational Qualification (NVQ) level 3 trained and eight are NVQ level 2 trained. One Carer is currently completing the NVQ level 3, in care training. Following the inspection of November 2006 improvements have been made to ensure that the previous inspection Requirement that a thorough recruitment procedure is operated that includes securing two authentic/appropriate references and the retention of documentation as identified in schedule 2 including recent photographs of employees has been met. Staff recruitment files were viewed and it was evidenced Care Homes for Older People Page 19 of 25 Evidence: that these files contain all items required under the Care Homes Regulations 2001. The home has an Equal Opportunities policy in place and is an equal opportunities employer. A number of staff are recruited from overseas and all relevant visa, health and passport checks were noted to have been obtained. Staff induction training is conducted in line with Common Induction Standards guidance. Mandatory training consists of Infection Control, Moving and Handling, Health & Safety, Protection of Vulnerable Adults, Induction, basic First Aid and Fire Safety. Additional training is conducted in NVQ, medication, Diabetes, tissue viability, Dementia, care planning, respect and autonomy and basic food hygiene. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents experience the benefits of a home that is well managed and administrated. Consideration is given to residents choice and opinion in all aspects of provisions provided. The health, safety and welfare of residents and staff is protected at all times. Evidence: The Registered Manager has managed the home for a number of years. She is an RN level 1 and has achieved the Registered Managers Award (RMA). There is a formal quality monitoring and quality assurance system in place. Yearly audits are conducted. The results of audits are correlated and the published results are made available to residents in a file which is located in the main hall. The Statement of Purpose and Service User guide is also audited and updated as required. Residents meetings are held every quarter, these meetings are minuted. Monthly staff meetings are also held, the minutes of which were viewed. Care Homes for Older People Page 21 of 25 Evidence: Following the inspection of November 2006 improvements have been made to ensure that the previous inspection Requirement that the systems for dealing with residents monies is reviewed and improved to include the use of receipts and a procedure that reflects the practice in the home has been met. Personal allowance accounts are maintained for three residents. The accounts for these were viewed and it was evidenced that audited accounts and receipts are maintained for all monies credited and debited from these allowances. The accounts are currently signed by the Registered Manager, good practice would be that all credits and debits are signed for by two persons. Therefore a Recommendation has been made. The home does not take any responsibility for any other residents finances and most residents have family, friends or representatives who protect their financial affairs. Following the inspection of November 2006 improvements have been made to ensure that the previous inspection Recommendation that staff supervision is further developed along with individual training and development assessment and profile has been met. Staff supervision records viewed confirmed this. Following the inspection of November 2006 improvements have been made to ensure that the previous inspection Recommendation that an external environmental risk assessment is completed along with individual risk assessments for the use of the passenger lift has been actioned. Records viewed confirmed this. The homes maintenance files were viewed and it was evident that fire drills, fire alarm testing and fire equipment checks, health & safety checks and water checks had been carried out. There were no health & safety issues noted at the time of this inspection. 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 1 5 The Statement of Purpose and Service Users Guide will need updating to include an amended Complaints Procedure. That all daily care entries are dated and timed. That the Complaints Procedure is amended to reflect that the CSCI can be contacted at any stage during a complaint. That all credits and debits made to residents personal allowance accounts are signed for by two staff. 2 3 4 7 16 35 Care Homes for Older People Page 24 of 25 Helpline: 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 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 © (2008) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!