Inspection on 14/10/08 for St Catherine`s Home

This inspection was carried out on 14th October 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

St Catherine`s Home 21/06/07

St Catherine`s Home 19/06/06

St Catherine`s Home 03/10/05

St Catherine`s Home 04/04/05

St Catherine`s Home 08/11/04

St Catherine`s Home 13/05/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth 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: St Catherine`s Home 35 Derby Road Enfield Middlesex EN3 4AJ     The quality rating for this care home is:   one star adequate 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: Jacqueline Izzard     Date: 1 4 1 0 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 28 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 28 Information about the care home Name of care home: Address: St Catherine`s Home 35 Derby Road Enfield Middlesex EN3 4AJ 02088041136 02088041136 emilyrose1st@yahoo.co.uk(personalmanagerem ail) Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) ADR Care Homes Ltd Type of registration: Number of places registered: care home 16 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The four service user places for those with dementia are restricted to the ground floor accommodation only. Date of last inspection Brief description of the care home St Catherines Home is a care home for sixteen older people of either gender who are in need of personal care only. The home is a large detached house in Enfield, which was extended and opened in 1986. There are shops and bus and rail routes a short distance away. The home has twelve single bedrooms and two double bedrooms on the ground and first floor. A lift is available to access both floors. On the ground floor there is a good size kitchen, a large through lounge and a dining room. At the front of the home, there is off street parking for several vehicles and to the rear, there is a large 0 0 Over 65 4 16 Care Homes for Older People Page 4 of 28 Brief description of the care home well-kept garden with two large sheds. The fee range for residents living in the home is #398 - #420 per week depending on their needs. Care Homes for Older People Page 5 of 28 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: one star adequate 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 1 star. This means the people who use this service experience adequate quality outcomes. This inspection took place on 14 October 2008 and lasted one day. The inspection was unannounced. During the inspection we met with the manager and five residents individually. We also met three staff members and all the residents in the home whom we were able to speak with during the course of the day. We were also able to meet with a resident and his relative to ask their views on the service provided by this home. We looked around the home and inspected records. We looked at a selection of staff files to see if they had been properly recruited, trained and supervised. We looked at a selection of residents files to see if their care needs had been assessed and met. Care Homes for Older People Page 6 of 28 Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? 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 8 of 28 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 9 of 28 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. Residents can be assured that their needs have been assessed before the home offered them a place. Evidence: We looked at the assessments carried out on three of the residents. It was evident that the manager had assessed these people before offering them a place at the home to ensure their needs were known and could be met. The home is not equipped to provide intermediate care but does offer respite care. Care Homes for Older People Page 10 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are at risk of their personal care needs not being met as some are not receiving enough support with personal care. Residents will benefit from a new care plan format to address their holistic needs more fully. Evidence: We looked at the care of five residents in detail. This involved reading their care plans, risk assessments, personal care records, medication records and any other records relating to their care. We then spoke privately to these residents or observed them and their interaction with staff. Three of the five had a completed care plan and one other still needed to be completed as it was partly completed. Care plans focused mainly on on health and personal care issues and did not fully address peoples social, cultural and religious needs. One person who was in the home for a period of respite care did not have a care plan Care Homes for Older People Page 11 of 28 Evidence: devised by the home, but the home were using a care plan written by social services. This persons cultural needs in respect of certain cultural foods and gender of care staff were not being fully met. However, we discussed this with the resident in private and s/he said s/he was satisfied with the care being provided and had understood that the home could not always provide the gender of staff s/he preferred to provide help with personal care. The manager said that new care plans were in the process of being introduced and showed a copy which was an improved format as it addressed more areas of need than the current plans. We looked at records of personal care provided as four women were observed to have not had support with their hair. The manager said that the hairdresser visits weekly and that she was due on the day of the inspection but not able to attend. We discussed this with the provider who said that all four women refused to allow staff to wash their hair. There was no mention of this in the care records. Personal care was an area which needed improvement. Residents had been asked how often they would like a shower or bath and their wishes recorded. However, when we checked the records it was evident that their requests were not being met. We looked in detail at records for three residents. One said s/he wanted a bath three times a week. We compared this with records for the last seven weeks and saw this was not taking place. Another had no bath or shower recorded as taking place in the last seven weeks. The third was reported as being unwilling to cooperate with staff trying to support her with personal care. This persons records stated that she had only received personal care once in the last week and was refusing to allow staff to help her to wash. This person had been referred to the GP but there was no clear reason why the other two had not received the support needed for their personal care. One resident was observed to wearing mismatched slippers. We advised staff to ensure this person was immediately provided with a matching pair for health and safety reasons to prevent a fall but they failed to locate a matching pair of slippers. We observed three slippers under a chair, all unfit to wear. This indicated a lack of attention to personal care and to minimising the risk of falls. Staff on duty on the day of inspection were seen to have certificated training in medication. Some staff do not have accredited training in medication but the manager said that a new medication system is being introduced later this month and all staff will be provided with training. We asked two residents whether they were satisfied with their care and they said they were happy. The other three whose care plans were inspected were not able to give Care Homes for Older People Page 12 of 28 Evidence: their views verbally but were interacting with staff and there were no concerns noted about their wellbeing. Records were being kept of health appointments for residents and there was no evidence that their heath needs are not being adequately met. Care Homes for Older People Page 13 of 28 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. Residents are satisfied with their lifestyle in the home. They are generally happy with the food. Evidence: To assess these standards we observed an afternoon in the main lounge and a mealtime and afternoon tea, plus discussion with the manager and five residents about food and activities. We also looked at records of activities, menus and records of food actually eaten. No outings are provided for residents. We asked four people if they would like to go out. All said they would not. Those care plans seen had limited information about peoples social, cultural and religious needs and a requirement is made about this in a previous section of this report. Some activities in the lounge are provided. These were ball games, skittles, colouring books and Bingo. Two of the five residents we spoke with said they did not like this kind of activity and preferred to stay in their room reading and watching television or listening to music. We observed four residents playing skittles and saw that they did enjoy this activity. Two residents told us that their friends and family are made welcome when they visit. We had the opportunity to Care Homes for Older People Page 14 of 28 Evidence: meet a relative who said s/he was satisfied with the care and attention provided by the home and that staff responded to any suggestions made or requests for support. Some residents stay in their bedrooms but are visited regularly by staff. Four of the five residents we spoke to were positive about the food. Comments were, lovely, very nice food, I enjoy my dinners, and Its alright, Im eating it arent I? The other person said she did not like the food but was seen to be provided with with extra snacks such as biscuits. Seven residents were asked about their daily life in the home. One was not able to give an informed view due to mental health issues. The others all said they were satisfied with their lives in this home. One said, I am very lucky to be here.. Another said s/he was very happy and that staff provided birthday cards and presents to residents which was appreciated. One said the manager was approachable and kind and s/he had no wish for any activities as s/he preferred to be alone. Care Homes for Older People Page 15 of 28 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 are provided with information on how to make a complaint and their concerns are listened to . They are protected by people trained in safeguarding their wellbeing. Evidence: The homes complaints procedure was seen to be displayed on the wall in the home. This procedure was also seen to be in the service user guide document, which the manager said was in every bedroom. We asked two of the more able residents if they knew how to make a complaint and both said they did. They also said they were happy in the home and had nothing to complain about. A relative said that the manager and staff listened whenever s/he raised any concerns and acted on his/her requests and suggestions. The manager was able to show us evidence that when residents had not been happy about the food, she had listened to them and changed the menu. We selected three staff files to see if they had been trained in safeguarding procedures and saw certificates showing that they had attended this training so that they knew what to do in the event of a suspicion of a resident being abused. The manager showed a good understanding of safeguarding when we discussed Care Homes for Older People Page 16 of 28 Evidence: relevant issues with her and knew that she had to report any safeguarding concerns to the local authority. She demonstrated that she had experience of using these procedures. Care Homes for Older People Page 17 of 28 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 adequate 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 and homely environment. They would benefit from a greater level of privacy by putting locks on bathroom doors and from improved kitchen facilities. Evidence: Since the last inspection, a new wet room has been provided to make showers easier for residents. New chairs for the lounge have been purchased. The manager said that a redecoration programme was in progress. The kitchen was in need of cleaning. Floors and cupboards were sticky and work surfaces were stained and scored from use of knives. Some pans were not safe to use as they had no handles. The fridge freezer as working, though its shelves and drawers were damaged. A requirement is made to clean the kitchen and a recommendation made to inform us of when the kitchen is planned to be refurbished. Most residents eat meals in the lounge or their bedroom, while a smaller group eat in the dining room. Residents said they can choose to sit in the lounge or spend time Care Homes for Older People Page 18 of 28 Evidence: alone. Three residents told us they preferred to stay in their room and were happy with the comfort of their bedrooms. All bedrooms seen were clean and had suitable furniture. Residents can bring their personal belongings to make the room more homely. We also saw that one resident had some personal belongings around her chair in the lounge to make her feel comfortable. There were no locks on bathroom doors to protect residents privacy and dignity. One toilet was out of use as it was blocked. We were told that this happens regularly but that a plumber would be addressing the problem shortly. Care Homes for Older People Page 19 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents of this home are supported by a staff team who are being provided with appropriate training. A lack of attention to thorough recruitment practices means residents could be put at risk. Evidence: At the time of this inspection, the home provided two staff plus the manager on duty during the day. We asked four residents if they felt this was enough staff to meet their needs and all four felt it was. One said, I never have to wait for anything, another said, They seem to manage well. There have been four new staff appointed in 2008 and we looked at their training records. We also looked at three staffs recruitment records to see if they had been properly checked for suitability before starting work in the home. This included two of the four new staff and one who started in 2007. All three had been allowed to start work before all the required checks on their suitability had been received. All started before their Criminal Records Bureau disclosure and check with list of people unsuitable to work with vulnerable adults had been carried out. Their Criminal Records Checks were in place and inspected at the time of this inspection. One had a last employer reference which had not been verified to ensure it was from the persons manager and one had no reference from her last employer. This is of concern as Care Homes for Older People Page 20 of 28 Evidence: inadequate checks on staffs suitability to work in a care home could place residents at risk. Following the inspection the provider suppplied the managers file and we were able to confirm that appropriate checks had been taken out before the manager was employed. Requirements are made to improve recruitment practice. Staff training records showed staff had been provided with induction training and training in relevant topics such as medication and dementia. The manager advised that one staff has completed NVQ 3 training and another is currently doing so. She said that five staff are enrolled on NVQ level 2 training due to start shortly after this inspection. Staff were receiving supervision from the manager on a regular basis. At night there is one staff awake and one sleeping in. The manager and four residents said that night time staffing levels meet residents needs at this time. Care Homes for Older People Page 21 of 28 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 benefit from a home where their best interests are considered and their views listened to. Their health and safety is protected. Evidence: A self assessment of the home (called an AQAA) was completed by the manager an provided us with up to date information about the home and its plans for improvement. The manager informed us that she has completed the Registered Managers Award training. A relative praised her management style. She informed us that she is supported by the providers and spends part of each day working alongside care staff with residents to ensure she knows all their needs well. There have been changes in the management arrangements for the home since the last inspection, which we have not been informed about. This is of concern as the provider has a responsibility to inform us of any change of management arrangements for the home. We have not Care Homes for Older People Page 22 of 28 Evidence: received an application for registration for this manager yet. We saw that the current manager had completed a quality assurance audit in March 2008. We saw from this that residents views had been listened to and acted upon. Some residents had expressed dissatisfaction with the food at the home and as a result, surveys detailing individual likes and dislikes had been completed and a new menu developed. This is an example of good practice as it indicates that residents views are listened to. A further quality assurance audit had recently been undertaken and action highlighted from the results to improve the service offered at the home. A sample of health and safety records were selected for inspection. These were all up to date, indicating that the home ensures equipment is maintained safely. The electrical installation inspection certificates showed a number of remedial works which needed to be addressed. This work had been completed by the time of this inspection. Staff have been trained in health and safety topics. Care Homes for Older People Page 23 of 28 Are there any outstanding requirements from the last inspection? Yes R 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 1 31 8 The registered person must 31/07/2007 make application to the CSCI for the registration of a manager to manage the care home Care Homes for Older People Page 24 of 28 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 15 The registered persons must 30/11/2008 ensure each resident has c care plan which addresses their holistic needs, including social and cultural needs, which is reviewed every month. This to ensure that staff know residents holistic needs and to ensure the plan reflects their up to date needs at all times. 2 8 13 The registered persons must 30/11/2008 ensure that all residents are supported to wear suitable footwear to prevent the risk of falls. This is to ensure residents are provided with shoes/slippers that fir them and which match to prevent them from falling over due to ill fitting footwear. Care Homes for Older People Page 25 of 28 3 8 12 The registered persons must 02/12/2008 ensure that residents are provied with the personal care they need in the way they have requested it. This is to ensure that residents are supported to have baths and showers as often as they wish in accordance with their recorded preferences. 4 19 23 The registered persons must 02/12/2008 ensure that the kitchen is kept clean at all times. This is to ensure that residents food is prepared in a hygienic environment at all times. 5 21 12 The registered persons must 02/12/2008 provide suitable locks for all bathroom doors. This is to provide better privacy and dignity for residents. 6 29 19 The registered persons must 30/11/2008 ensure that all future staff employed have all the required checks in place before they start work in the home. This is to ensure residents are not put at risk. 7 29 19 The registered persons must 30/11/2008 obtain outstanding references for those staff who do not have two verified references on their file. Care Homes for Older People Page 26 of 28 This is to ensure that staff have been checked thoroughly for suitability nd residents are not put at risk of being cared for by an unsuitable person. 8 31 8 The registered persons must 30/11/2008 inform the Commission of any change of manager for this home. This is required by The Care Homes Regulations to ensure we know who is managing the home. 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 27 of 28 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. 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