Inspection on 01/09/05 for St Catherines Care Home

This inspection was carried out on 1st September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

St Catherines Care Home 13/04/07

St Catherines Care Home 29/04/05

St Catherines Care Home 07/01/05

St Catherines Care Home 16/07/04

St Catherines Care Home 15/09/03

St Catherines Care Home 04/11/02

St Catherines Care Home 26/02/02

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE St Catherines Care Home Barony Road Nantwich Cheshire CW5 5QZ Lead Inspector Anthony Cliffe 1 st Announced September 2005 09:00 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. St Catherines Care Home F51 F01 S18740 St Catherines V238161 010905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service St Catherines Care Home Address Barony Road Nantwich Cheshire CW6 5QU 01270 610 881 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Community Integrated Care Carolyn Penfold Care Home 40 Category(ies) of OP - Old Age (20) registration, with number DE(E) - Dementia over 65 (20) of places DE - Dementia (2) MD(E) - Mental Disorder (1) St Catherines Care Home F51 F01 S18740 St Catherines V238161 010905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 The home is registered for a maximum of 40 service users to include: * Up to 20 service users in the category of OP (old age not falling within any other category). * Up to 20 service users in the category of DE(E) (Dementia over the age of 65) * Two named service users in the category of may be DE (dementia under 65) * One named service user in the category of MD(E) (mental disorder over the age of 65) 2 Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidelines which may be issued through the Commission for Social Care Inspection. The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with Commission for Social Care Inspection. 3 Date of last inspection 29th April 2005 Brief Description of the Service: St. Catherine’s care home is a single storey building situated on the outskirts of Nantwich. The home provides nursing care for 20 older people diagnosed with dementia and 20 older people whose needs are due to physical frailty. The home is operated by Community Integrated Care, a not for profit organisation. Bedroom acccomodation consists of 38 single and one double bedroom. There are no en-suite facilities. There are day facilities including a lounge, dining room, and conservatory on each unit. There is a large foyer entrance with seated area and separate shared activities room situated off this area. Externally the gardens have been landscaped to provide a sensory garden with raised flowerbeds.The home is situated on a bus route and is close to the town centre and local shopping facilities. It also has its own transport. St Catherines Care Home F51 F01 S18740 St Catherines V238161 010905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was undertaken by a regulatory inspector. The inspection took place over six hours and feedback was given to the manager at the end of the inspection. It included inspection of records, observation of staff practice and discussion with residents and visitors. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. St Catherines Care Home F51 F01 S18740 St Catherines V238161 010905 Stage 4.doc Version 1.40 Page 6 DETAILS OF INSPECTOR 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) Scoring of Standards Statutory Requirements Identified During the Inspection St Catherines Care Home F51 F01 S18740 St Catherines V238161 010905 Stage 4.doc Version 1.40 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 Residents are fully assessed before moving into the home to ensure the home can meet their identified needs. EVIDENCE: Care plan of residents who had recently moved into the home were examined. They contained pre-admission assessment documentation completed by the manager or deputy. For the two recent admissions, assessments were available from the services where they had been accommodated prior to moving into the home. One resident was self-funded and the local authority funded one. Pre admission assessment had been completed with relatives present. Relatives contributed information to a detailed life history. The pre admission assessments were very detailed and recorded all the relevant information. Copies of the assessments from the local NHS professionals involved in the residents care were obtained. St Catherines Care Home F51 F01 S18740 St Catherines V238161 010905 Stage 4.doc Version 1.40 Page 8 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10 Residents’ plans ensure that health and social care needs are identified and met. The procedures for managing medication has improved and ensures residents receive their prescribed medication. Residents are treated with dignity and respect. EVIDENCE: A number of care plans were examined. Care plans had a comprehensive range of assessment documents completed in full with care plans to address the identified needs of residents. The home uses a person centred approach and plan in caring for people. It was evident in care plans that people’s routines and wishes were recorded. An example of this was that a resident liked to choose her own clothes and to use cleansing cream on her skin. The resident was able to attend to her personal needs independently and could wash and dress herself. The outcome for the resident was that she liked to look clean and presentable with the minimum of assistance and remained motivated to maintain her independence. A Relative visiting the home said that she had been involved in the care planning process and contributed toward the life history of her relative. Evidence from care plans, and from conversations with residents and a relative, indicated that the health needs of residents were met. Care plans recorded when residents had been registered with a general practitioner. St Catherines Care Home F51 F01 S18740 St Catherines V238161 010905 Stage 4.doc Version 1.40 Page 9 A resident had a high waterlow score and an air-replacing mattress was in use to prevent pressure ulcers. The review of a residents’ care plan identified that since moving into the home the resident was gaining weight, assisting staff with her mobility and increased her mobility. A general practitioner comment card stated ‘this is a very caring environment and I would be happy for a relative of mine to stay here if necessary’. A care manager/placement officer comment card stated ‘ I have always found staff to be extremely helpful at St Catherine’s. Residents are well cared for and the ambience is welcoming, clean and bright. Relatives have always been pleased with the care their loved ones are receiving’. Medication administration and recording has improved, with the introduction of an audit system, which identified the errors on the medicine administration record sheets. The audit system identified that some signatures had not been recorded for the administration of medicines in the previous month and the audit had picked up these errors with action taken to address them. The audit system was completed at the end of each week. No errors were found during the inspection visit. People spoken with expressed their satisfaction with the care being provided at the home. A residents said ‘I am still settling in and I am getting used to the different people and their names. I don’t want to make any friendships yet it’s too early. All I can say is that the staff have helped me settle in and they are very kind’. Another resident talked about her experience of living at St Catherine’s. The resident said she had lived at two previous care homes. The residents said she had become dissatisfied with the care at another home ‘ the staff were very cheeky, they answered you back. After I had a stroke they sent me a soft diet, as I cannot swallow. After three weeks they started to send me a normal diet, which I could not eat. A friend visited St Catherine’s for me and said I would love it, it’s clean and bright and of a high standard. I liked it instantly. Even though I am registered blind I can make out colours and shapes. The place is clean and spacious. I have some of my own furniture. I get what food I order. There is a good choice and I am a fussy eater. They asked me what I liked to eat when I just arrived. The big difference is the staff. They are mature, helpful and respectful. The place is everything my friend said it was. I have lived in care homes for nine years and this is the best. Staff are so helpful. I cannot walk and they come to help me when I call them with the call bell. They speak to you with respect. The biggest difference I can see between here and the other homes is that it is well managed and the staff are mature and friendly’. Relative/visitor comment cards stated ‘ The love and care given to patients by all the staff at St Catherine’s is excellent, helping them to end their days with dignity and in comfort. They also give help to relatives and friends when needed’. ‘I particularly like the way staff take time to speak with residents personally and in such a positive way. Even when staff are very busy’. St Catherines Care Home F51 F01 S18740 St Catherines V238161 010905 Stage 4.doc Version 1.40 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 and 14 Residents are supported to exercise choice in their lifestyle and to meet their social needs. Families and friends are welcomed into the home at any reasonable time and kept informed about their needs. EVIDENCE: Residents were seen to be free to move around within the home. A variety of sitting areas were available. Staff were observed spending social time with residents and several residents were dressed and waiting to go into the activities lounge. During breakfast residents were given the choice to eat in the dining room, lounge or their bedroom. A resident shared her experience of living at St Catherine’s and said ‘I have been out twice since I moved here, the first time in seven years. We went to the Blue Planet at Ellesmere Port for a day out and thoroughly enjoyed it. The activities lady has asked me what I like to do. She arranged for one of the carers to help me into Nantwich to buy a pair of shoes. I spend a lot of time in my bedroom, but staff take me into the lounge and the garden. The activities lady is arranging for me to have talking books. I have my own routine following my stroke. I like to go to bed at 7.30 pm after having a drink and something to eat. I have kept up that routine here. When I want to get up in the morning, I ring for staff and they come and help me. I have no grumbles or complaints, I am not square between the ears and will tell the staff if I am unhappy with anything.’ A visitor was visiting a relative and celebrating her birthday. St Catherines Care Home F51 F01 S18740 St Catherines V238161 010905 Stage 4.doc Version 1.40 Page 11 She said she visited her relative weekly. She said ‘I always feel welcomed, and staff are always available even when they are busy I can still get information about mum. Some days if she doesn’t look well and I am worried staff reassure me she is not on a downward slide. They keep me and my sisters informed. I find it calm here and the home is well maintained. Whenever I talk to family, friends or relatives and mention St Catherine’s, they say what an excellent place, what a good reputation it has, it’s recognised by the whole community’. St Catherines Care Home F51 F01 S18740 St Catherines V238161 010905 Stage 4.doc Version 1.40 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 Residents and relatives are aware of the complaints procedure. The homes adult abuse training and procedures protect residents. EVIDENCE: A resident stated her awareness of the complaints procedure and said ‘I have no grumbles or complaints, I am not square between the ears and will tell the staff if I am unhappy with anything’. A relative said she was aware of the complaints procedure and could talk to staff if she was not happy. She said ‘the management of the home is very important to me, the staff are courteous and respectful and well informed about mum. Freda is wonderful I cannot praise her enough. Three relatives/visitors comment cards stated they were aware of the complaints procedure and had not made a complaint. Two care manage/placement officer comment cards stated they had not received any complaints about the home. A general practitioner comment card stated he had not received any complaints about the home. The registered providers’ corporate induction programme includes adult abuse awareness training. All new staff will undertake training as part of induction. The manager is to arrange for existing staff to have training on the registered providers’ adult abuse awareness training. The home has the revised copy of Cheshire County ‘There can be no secrets’ adult protection policy. The manager said that training from Cheshire County Council should take place after September 2005. Information leaflets on Cheshire County Council adult protection procedures were available in the home to residents, relatives, visitors and staff. St Catherines Care Home F51 F01 S18740 St Catherines V238161 010905 Stage 4.doc Version 1.40 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 The environment promotes the health and safety of residents. EVIDENCE: On Meadow and Weaver units linen cupboards have been converted to provide storage for portable hoists as recommended at the last inspection visit. Additional storage for linen has also been created. All bedroom doors have been fitted with free-swinging self-closure devices. An electric profiling bed was purchased for a resident who needed one. St Catherines Care Home F51 F01 S18740 St Catherines V238161 010905 Stage 4.doc Version 1.40 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29 and 30 The home’s recruitment procedures ensure residents are protected. The home promotes staff training to provide a skilled workforce. EVIDENCE: Recruitment procedures for staff by the registered provider ensured that Protection of Vulnerable Adult and Criminal Records Bureau checks were completed prior to staff commencing employment. Applications for employment contained a chronology of the applicant’s previous employment details. Qualified staff completed a certificate in infection control In February 2005, risk assessment in March 2005 and moving and handling training in July 2005. Care staff attended training on customer care in May 2005, first aid in July and August and food hygiene in April and July 2005. Three staff are due to attend the registered providers’ foundation training In September 2005. Care staff have also attended the primary care Trust training programme on communication and dementia. The activities organiser has attended training from Age Concern on creative activities and therapeutic activities in dementia, adult abuse awareness and depression in older people. St Catherines Care Home F51 F01 S18740 St Catherines V238161 010905 Stage 4.doc Version 1.40 Page 15 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 and 35 There is leadership guidance and direction in the home to ensure residents receive consistent quality care. EVIDENCE: The manager undertakes quality assurance. The manager completes a weekly health and safety audit of the building. The handyman tests the water outlet temperatures over a period of a month as part of the health and safety audit. The registered providers’ representative recorded regulation 26 visits as taking place monthly. Audits on policies and procedures used in the home are completed monthly. The manager completes a monthly management report on clinical information, care plans, pressure ulcers and treatment, health and safety, accidents to residents and staff. The home completes a weekly audit of medicines. Satisfaction surveys were last completed from September to November 2004 and the results published in the spring of 2005 in the registered providers ‘you and me’ publication. St Catherines Care Home F51 F01 S18740 St Catherines V238161 010905 Stage 4.doc Version 1.40 Page 16 On the 11th July the Central Cheshire Patient and Public Involvement Forum (CCPCT) visited St Catherine’s and were complimentary in their report on the standards of care and facilities offered at the home. The home does not deal with any residents’ finances except for personal spending money. Otherwise residents control their own money or have relatives who assist them. Residents have personal money in safekeeping. Receipts are given to relatives for money paid in. Residents’ money is kept in separate envelopes; all transactions are recorded and double signed; receipts for all expenditure made on behalf of residents are filed. St Catherines Care Home F51 F01 S18740 St Catherines V238161 010905 Stage 4.doc Version 1.40 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION x x x 3 x x x x STAFFING Standard No Score 27 x 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x 3 x x x St Catherines Care Home F51 F01 S18740 St Catherines V238161 010905 Stage 4.doc Version 1.40 Page 18 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations St Catherines Care Home F51 F01 S18740 St Catherines V238161 010905 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Unit D, off Rudheath Way Gadbrook Way Northwich Cheshire CW9 7LT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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