Inspecting for better lives Key inspection report
Care homes for older people
Name: Address: St Catherine`s Care Home St Catherine`s Care Home West Road Newcastle Upon Tyne NE15 7PY 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: Janet Thompson
Date: 1 9 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 27 Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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 27 Information about the care home
Name of care home: Address: St Catherine`s Care Home St Catherine`s Care Home West Road Newcastle Upon Tyne NE15 7PY 01912452400 Telephone number: Fax number: Email address: Provider web address: june.spoors@stcuthbertscare.org.uk Name of registered provider(s): Name of registered manager (if applicable) Ms June Spoors Type of registration: Number of places registered: St Cuthberts Care care home 45 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home St Catherines Care Home is purpose built and provides nursing, personal and social care. It also provides 11 Dementia care beds for older people. The home is situated on the West Road in Newcastle upon Tyne and is part of St Cuthberts Care. The home is accessible to all local amenities and public transport. All the accommodation is at ground level and there are extensive gardens and ample car parking. There are 45 single en-suite bedrooms, six of which could be used as companion rooms. Several of the bedrooms have patio doors, which lead into the internal secure garden. There are several communal lounges and two dining rooms. There is a conservatory, Chapel and quiet room. There are bathrooms, a shower room and toilets close to all resident areas. The fees for the home vary and are available on request from the home. The statement of purpose is available to residents, families and visitors. Care Homes for Older People
Page 4 of 27 Over 65 0 34 11 0 Care Homes for Older People Page 5 of 27 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: The quality rating for this service is 2 stars. This means the people who use the service experience good quality outcomes. We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations. This will only happen when it is considered that people who use the service are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. This was an unannounced inspection. It took place over two days. Before the visit we Care Homes for Older People
Page 6 of 27 looked at: Information we have received since the last inspection visit. How the service dealt with any complaints or concerns since the last visit. Any changes to how the home is run. The manager’s views of how well they care for people. We always seek the views of people who use the service, their relatives, staff and other users of the service. This is usually given to us in the form of questionnaires. At the time of writing this report we had received twelve responses from questionnaires. During the unannounced visit we: Talked with people who use the service and some of the staff. Looked at the information about people who use the service and how well their needs are met. Looked at other records the home is required to keep. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the building to make sure it was clean, comfortable and safe. Checked what improvements had been made since the last inspection visit. The manager was at the inspection. Feedback was given to her at the end of the second visit. What the care home does well: What has improved since the last inspection? Staff have recieved training in protection of vulnerable adults. This helps them to recognise and prevent potential abuse. The complaints book has been pre-headed to guide staff in those areas to be recorded in the event of a complaint. Care Homes for Older People Page 8 of 27 The courtyard has recently been landscaped. It now has a number of even pathways that residents can access. This was a very attractive feature and many residents were looking forward to using it in the better weather. What they could do better: 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 27 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 27 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. People are properly assessed, taking account of their needs and wishes, so that they can be assured this is a suitable home and receive an individual care service. Evidence: Four pre-admission assessments were seen. They contained enough information to enable staff to assess if they could meet the individual needs before admission. Information from other health professionals was included in the assessments where needed. We spoke to residents about the admissions procedure but they could not remember the details. In surveys most residents said they had enough information about the home before they came in. Care Homes for Older People Page 11 of 27 Care Homes for Older People Page 12 of 27 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 receive personal care that takes account of their diverse needs. Evidence: Four care plans were examined and two were case tracked. This means that we spoke to the individual residents or observed their care then matched our observations to what was written in the care plan. Both case tracked care plans did reflect the actual care needed by the residents. Care plans took account of peoples diverse and differing needs. People were supported to achieve independence and meet individual goals. The plans for residents requiring nursing care contained a tissue viability assessment. The ones for those requiring residential care did not. One of the case tracked residents did not have a tissue viability assessment but he was sitting on a pressure relieving cushion. Records showed that he had, in the past ,had a tissue viability problem resulting in a wound that required dressing by the community nurses. This persons assessments showed that he was at low risk for falls. However a care plan was in place for medium risk of falls. A care plan earlier in the year stated that he should be weighed weekly but this did not happen and was discontinued a month later. The
Care Homes for Older People Page 13 of 27 Evidence: deputy manager had started to audit care plans but had not yet got a lot of them done. The actual care of residents appeared to be good. Residents looked clean and tidy. The male residents were cleanly shaved. Several female residents were having a manicure on the day of inspection. Residents said they were well looked after. In questionnaires residents said they could have a bath when they like, staff were attentive to their needs and they were happy with the care provided. Medication ordering, administration, storage and disposal were examined. All medicines were accounted for and all those administered were signed for. There was only one amount of controlled drug. This was checked and was correct. The medications fridge was broken but by the second visit this had been replaced. Staff were seen to treat residents politely and respectfully. In questionnaires residents said that staff treated them respectfully. Staff were seen to knock on doors and respect residents right to privacy. Care Homes for Older People Page 14 of 27 Daily life and social activities
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to lead a healthy and fulfilling personal lifestyle. This takes account of their wishes and diverse abilities. Evidence: The home has been without an activities organiser. A new person started just before the second inspection date. Staff have been maintaining a basic level of occupation for residents. The new activities organiser had good ideas for improving the social life of residents and recording their differing needs. Staff support residents to use a range of services within the local community. Residents are encouraged to be in control of their own lives and enjoy their own interests and hobbies. There is a chapel within the home where services are regularly held. The manager reported that residents are not restricted to one faith and are supported to attend their own church where needed. Residents said they liked the food. They said they could have a choice and that the food was well cooked. We ate the food at the home. It was well presented. The food was hot enough and very tasty. The standard of the cooking was good. The cook showed us the menu and said that twice per week the main meal was with chips, the rest of the time residents had a roast dinner or something with vegetables.
Care Homes for Older People Page 15 of 27 Evidence: Residents told us that they did feel as though they could make choices in their lives. They said that any limitations were down to their own physical abilities. Residents said staff helped them to stay independent as much as possible. Care Homes for Older People Page 16 of 27 Complaints and protection
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are protected from harm through thorough policies, procedures and staff training. Evidence: Staff follow the home’s policies and procedures relating to the management of complaints and allegations of abuse. Staff are kept up to date with information and training in the protection of vulnerable adults. Residents are told how to complain through the complaints procedure. This was clearly visible within the home. Residents spoken to said they would complain if they needed to but none of them had any current complaints. The complaints book showed that there had not been any complaints since the last inspection. CSCI have not been involved in any complaints in the past year. Care Homes for Older People Page 17 of 27 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. Residents live in a safe comfortable home that is generally pleasant and clean. Evidence: The home was generally clean and free from odours. Some areas such as the legs and top of a residents walking aid did have stains but on the whole resident areas were well kept. The furniture and general décor provides residents with a comfortable homely environment. They said the home was warm enough and they felt happy with their rooms. Outside areas were neat and tidy. The courtyard has recently been landscaped to enable residents to walk around it and sit under a gazebo. Some ancillary areas were untidy. The laundry and linen store were not tidy and could not have been easy to keep clean. The cleaners cupboard, where hazardous substances are stored was the same. One of the fridges in the kitchen was dirty on top and around the door handle. There was a collection of leaves between the kitchen fly screens and the window. The fly screens themselves were greasy. These matters had been attended to by the second visit. Bathrooms in the home were clean and tidy. Baths are fitted with a swing over seat to
Care Homes for Older People Page 18 of 27 Evidence: assist residents into the water. The staff reported that some of the more dependant residents found these difficult or uncomfortable. The dining room carpet, though not old, was stained and staff reported that it was difficult to keep clean. There appeared to be enough bedding and towels in the home. Staff reported that it is easy to get replacements and that they had enough equipment to carry out their job. Staff told us that they needed new kylies for the beds. The manager was unaware of this and agreed to order some immediately. Care Homes for Older People Page 19 of 27 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 using the service are supported and protected through staff numbers, skill and ability. Evidence: The current staffing levels are: Daytime. 8am-8pm. One qualified nurse, one senior carer and eight carers. This sometimes drops to six carers in the afternoon. Night time. Four care staff and one qualified nurse. Records showed there were sufficient numbers of cleaning and catering staff on duty each day. Training records showed and staff confirmed that 31 out of 38 care staff had achieved NVQ level 2. This is well above the 50 target. Other statutory training appeared to be up to date but there was no training overview chart to confirm this. Each staff member has an individual training record and training is organised by the Providers training department. Four staff recruitment files were examined. These were for two new carers, one nurse and one long term employed carer. All contained good information. Thorough
Care Homes for Older People Page 20 of 27 Evidence: background checks had been carried out before employment. Residents were protected through checking of criminal records information for all employees. Interviews were conducted against a person specification list to ensure fair and equal employment. Staff work a probationary period and there was evidence that this is extended in cases of less than satisfactory performance. Care Homes for Older People Page 21 of 27 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. People using this service are protected through reflective management taking account of the diverse needs of the service. Evidence: The home has an experienced registered manager. She has been assessed as having the competency and skills to run the home. The manager is supported by a deputy manager who has responsibility for some of the auditing in the home. The home does operate a quality assurance system. Residents and their relatives are consulted about the service provided. Residents questionnaires are sent out by the home manager but have not been done this year as yet. Some audits of care plans and medications are carried out but so far these are not done often enough or robustly enough. The manager reports to the organisation on performance outcomes but these are mostly related to numbers of visitors, activities and appearance. Care Homes for Older People Page 22 of 27 Evidence: Servicing and maintenance agreements are in place for facilities and equipment. These were up to date apart from the gas safety certificate which could not be found. All fire safety checks; tests and instructions to staff are conducted at the required frequency and recorded. There were no obvious trip hazards in the home. Fire exits were clear of obstruction and all hazardous fluids locked away. Residents personal monies were well accounted for. Records were examined and showed that two signatures were obtained for most transactions. Three amounts of money were counted and were correct. Care Homes for Older People Page 23 of 27 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 24 of 27 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 7 13 All residents should have a tissue viability assessment carried out monthly. This helps to prevent the occurrence of pressure sores. 27/12/2008 2 26 13 All ancillary areas of the home must be kept clean and tidy at all times. This is to enable those areas to be easily cleaned to minimise spread of infections. 27/12/2088 3 38 13 Provide evidence of a gas safety certificate. This proves that the provider has taken steps to maintain the safety of the gas system 27/12/2008 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 25 of 27 1 7 Care plans should be reviewed to ensure that there is a seamless flow from assessment to plan and evaluation. Care plans should be standardised throughout the home. 2 3 22 26 Review the bathing facilities for highly dependant residents. When the dining room carpet is replaced consider washable flooring. Ensure that walking aids belonging to residents are regularly cleaned. 4 30 There is an overall training plan that enables the manager to monitor staff development and demonstrate the training accomplished. Carry out regular and comprehensive auditing of all systems and clinical areas. 5 33 Care Homes for Older People Page 26 of 27 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 © (2009) 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 27 of 27 - 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!
