Inspection on 25/09/06 for St Catherines Residential Care Home

This inspection was carried out on 25th September 2006.

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 Residential Care... 17/09/07

St Catherines Residential Care... 06/01/06

St Catherines Residential Care... 28/06/05

St Catherines Residential Care... 29/09/04

St Catherines Residential Care... 05/05/04

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Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE St Catherines Residential Care Home 61 St Catherines Lincoln Lincs LN5 8LR Lead Inspector Elisabeth Pinder Unannounced Inspection 25th September 2006 09:30 X10015.doc Version 1.40 Page 1 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 St Catherines Residential Care Home DS0000002420.V312921.R02.S.doc Version 5.2 Page 2 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 Residential Care Home DS0000002420.V312921.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Catherines Residential Care Home Address 61 St Catherines Lincoln Lincs LN5 8LR Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01522 520643 mark@stcatherines92.freeserve.co.uk St Catherine`s Care Homes Limited Mr Mark James Browne Care Home 14 Category(ies) of Dementia - over 65 years of age (5), Old age, registration, with number not falling within any other category (14) of places St Catherines Residential Care Home DS0000002420.V312921.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Home is registered to provide personal care for service users of both sexes whose primary needs fall within the following categories: Old Age, not falling within any other category (OP) - 14 Dementia - Over 65 years of age DE (E) - 5 The maximum number of beds registered is 14 2. Date of last inspection 06 January 2006 Brief Description of the Service: St Catherines cares for older people in a non-smoking environment in two detached properties situated on the main Lincoln to Newark road, the town centre of Lincoln is a short bus ride away. The main house provides accommodation for ten residents; the smaller property provides accommodation for four. There is a third property within the grounds, this is not registered with the Commission and is only used for private meetings, staff training and hairdressing. There are two small gardens and a car parking area. Both houses have two floors and there is a stair lift to the bedrooms on the first floor in the main house. There are a variety of aids and adaptations in the main building to allow residents to move around the home more independently. Eight of the bedrooms are single; one double room has en-suite facilities. There are five communal toilets, four communal bathrooms and three shower rooms. Mr Mark Browne is the Company Director of St Catherine’s and also the Registered Manager. Since the previous inspection the home has varied its registration to include up to five beds for dementia care. The current weekly fee range is £335.00 - £415.00. Additional costs are made for hairdressing, personal toiletries, newspapers, holidays and chiropody, these are all private arrangements and costs are met by individual residents. St Catherines Residential Care Home DS0000002420.V312921.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit to the home was undertaken by one inspector and formed part of a key inspection. The visit lasted four and a half hours and took into account any previous information held by the Commission for Social Care Inspection (CSCI) including the homes pre-inspection questionnaire, previous inspection reports, their service history, records of any incidents that had been notified to the CSCI since the last inspection. Prior to the visit nine resident ‘Have your say about’ questionnaires were received and comments from these will be mentioned throughout this report. The site inspection consisted of case tracking a sample of three residents’ records, talking to them and assessing their care. Some policies and procedures were seen together with some records concerning the safety of the home. A general conversation was held with the four residents who live in the smaller house while they were clearing up from their lunch. Two care staff were spoken to, one who had just commenced working in the home and one who was the key-worker of one resident traced. The site visit focussed on key standards and checking whether issues raised at the previous inspection had been addressed. What the service does well: What has improved since the last inspection? Action has been taken to address the requirements and recommendations made during the previous visit. A new kitchen has been fitted and the outside of the building has been repainted. Signs and pictures have been put up to help residents with dementia care needs. St Catherines Residential Care Home DS0000002420.V312921.R02.S.doc Version 5.2 Page 6 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 Residential Care Home DS0000002420.V312921.R02.S.doc Version 5.2 Page 7 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 Outcomes Statutory Requirements Identified During the Inspection St Catherines Residential Care Home DS0000002420.V312921.R02.S.doc Version 5.2 Page 8 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 the following standard(s): 3, standard 6 is not applicable Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. This home clearly sets out what it intends to do for residents and this information is freely available to residents and their relatives. Prospective residents are encouraged to take time before making the decision to move into the home on a permanent basis. EVIDENCE: The statement of purpose and service user guide have been amended to include what the service offers for people with dementia care needs. It is clearly written in an easy to read format and available to residents and their relatives/representatives prior to admission and in the home. Three residents have been admitted since the previous visit and care records examined showed that a full needs assessment was carried out prior to admission and, where social workers had been involved, a copy of their care plan was available. The provider said that prospective residents or their representatives are contacted, usually by telephone, to confirm that after St Catherines Residential Care Home DS0000002420.V312921.R02.S.doc Version 5.2 Page 9 assessment the home can, or cannot, meet their care needs. The provider was asked to formalise this by writing to residents and this was agreed. Comments from resident questionnaires identified that one resident felt that they had not been given enough information before moving in, but had not regretted the move. Another comment identified that one resident did not have time to view the home before moving in but was satisfied with it since. One resident spoken to had been admitted for a period of respite care and wants to stay permanently saying “it’s lovely here, everyone is so kind”. St Catherines Residential Care Home DS0000002420.V312921.R02.S.doc Version 5.2 Page 10 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 the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. Care plans contain sufficient information to ensure residents’ health and care needs are met but there is still a lack of detail in the recording of evaluations of both care plans and risk assessments. Medication is administered and stored using safe procedures. Residents’ privacy and dignity is respected. EVIDENCE: Care plans set out clear information on how residents’ needs should be met. These are signed and dated by care staff and residents showing their involvement in this process. However, evaluations of both care plans and risk assessments must be improved to include details of any changes required to the current care given. This was raised during the previous inspection and discussed again with the provider who agreed to address this issue. Residents spoken to all said that they felt their current needs were being met, however, a resident questionnaire identified that one resident felt they were St Catherines Residential Care Home DS0000002420.V312921.R02.S.doc Version 5.2 Page 11 not always able to go to bed as early as they would like. This was discussed with the provider who said he would speak with staff about this and ensure this was resolved. There is a detailed medication policy and medication was being stored, administered and recorded correctly. An immediate requirement was given during the previous visit regarding secondary dispensing and this has now stopped. Staff members spoken to had a good knowledge of residents needs and the action required to meet these. Staff were observed carrying out their duties with kindness and sensitivity towards the residents, especially when attending to their personal needs. St Catherines Residential Care Home DS0000002420.V312921.R02.S.doc Version 5.2 Page 12 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 the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. Residents are able to express choices in their daily lives and receive a nutritious, varied diet meeting individual preferences and health requirements. EVIDENCE: Individual social preferences are recorded within care plans and records are kept of activities and trips out. Recent events have included entertainers, a fish and chip supper and a ‘war time sing-a-long’. One resident said how much he loved being able to go to fetch a daily newspaper from the local shop and another resident spoke about going to church on Sundays and fellowship meetings during the week. Other comments from residents were: ‘I can entertain visitors if I wish’; ‘I can come and go as I please as long as I let staff know when I can be expected back’. Care records identify residents’ likes and dislikes and any health requirements. Menus supplied prior to the visit showed that a varied, well balanced diet is offered and the midday meal was observed to be nutritious. Meals are cooked by staff who had a good knowledge of nutrition and were observed to give assistance to residents when needed. Residents said how much they enjoyed the meals and confirmed that they have a good choice. Tables were nicely laid with tablecloths/napkins and condiments. Residents said that they are St Catherines Residential Care Home DS0000002420.V312921.R02.S.doc Version 5.2 Page 13 frequently asked for their choices and suggestions of meals and resident meeting minutes confirmed this. Residents living in the small house are quite independent and are able to make their own drinks and they have the facilities to cook if required. The main meal of the day is prepared and cooked in the main house and residents said that they are always hot when they receive them. St Catherines Residential Care Home DS0000002420.V312921.R02.S.doc Version 5.2 Page 14 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 the following standard(s): 16 & 18 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to the service. The home’s complaints procedure is not up to date and new staff have not received training in the protection of vulnerable adults. EVIDENCE: Staff spoken to said they were aware of the policies and procedures relating to safeguarding adults but had not yet undertaken specific training. The provider explained that the training organisation had cancelled training booked in June and this has now been re-booked for November. On exanimation of the complaints procedure it was found to refer to the National Care Standards Commission instead of the Commission for Social Care Inspection and when this was brought to the attention of the provider he agreed to amend it immediately. Information was given to the provider about the Commission’s procedures for reporting complaints and the address and telephone number was given for the Central Registration and Compliance team (CRCT). Since the previous inspection there has been no complaints and no adult protection referrals. Resident questionnaires identified that all residents know how to make a complaint and those spoken to during the visit said that they felt confident to raise any concerns with either the provider or care manager. St Catherines Residential Care Home DS0000002420.V312921.R02.S.doc Version 5.2 Page 15 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 the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. Residents living in this home live in a well-maintained, pleasant and clean environment. Screening facilities could improve in shared rooms. EVIDENCE: Two requirements set during the previous inspection have been addressed and residents questionnaires identified that the home is always fresh and clean. Both the interior and exterior decoration is well maintained and recent improvements to the home include a new kitchen, repainting the outside of the building and the redecoration of one bedroom. During the visit the home was clean, tidy with no odious smell. Colours, pictures and signs are being used to help residents with dementia to find their way around the home. During a tour of the building a large window in the lounge was open wide and the safety catch was unattached. This could present a risk to residents with St Catherines Residential Care Home DS0000002420.V312921.R02.S.doc Version 5.2 Page 16 dementia and when brought to the attention of the provider he said he would action this immediately. The grounds are very small but well kept and seating is available. One resident who smokes said he likes to sit outside after his meals to have a smoke. Two bedrooms were viewed and these were well personalised. One resident showed me his room which was a shared room and the only screening available was a portable screen which required staff to put up when needed. A discussion was held with the provider with regards to using screening that could be used by residents independently and he agreed to look into this. Another resident who shares a room said that she feels safer with someone else in the room at night. St Catherines Residential Care Home DS0000002420.V312921.R02.S.doc Version 5.2 Page 17 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. Staff numbers are in sufficient quantity for them to be able to care for the residents. Staff training is on-going and residents are supported by competent staff. EVIDENCE: Since the previous inspection a system has been put in place to monitor dependency levels of residents living in the home and the staff rota showed that there were enough staff on duty to meet the current needs of residents and staff and residents spoken to confirmed this. However, one comment taken from residents questionnaires read ‘staff busy sometimes and do not always help straight away’. This was discussed with the resident who was happy for it to be shared with the provider and he agreed to look into this immediately. Other specific comments were; “we are all so well looked after” and “I love living here, the staff are brilliant”. Records of staff recently employed showed that they had been recruited using robust procedures based on equal opportunities. Satisfactory criminal record checks had been received prior to their employment and one member of staff confirmed that she had undertaken induction training before commencing work. St Catherines Residential Care Home DS0000002420.V312921.R02.S.doc Version 5.2 Page 18 Information supplied in the pre-inspection questionnaire showed that only 20 of care staff have achieved the National Vocational Qualification (NVQ) at Level 2. It is recommended that 50 of staff achieve NVQ training and the provider said that plans are in place for more staff to commence this training. Five staff hold a current first-aid certificate. The pre-inspection questionnaire also identified that all statutory training has been undertaken i.e. moving and handling, food hygiene, health and safety, fire training and first aid at work. Other courses held within the last twelve months have included dementia awareness, infection control and employment law. No specific training has been undertaken regarding equality and diversity and this was discussed with the provider. Staff spoken to said that although equal opportunities are covered in their induction they have not had any specific training and had limited knowledge of this subject. All new staff are given a copy of The General Social Care Council (GSCC) code of conduct. Future training is to include basic food hygiene. St Catherines Residential Care Home DS0000002420.V312921.R02.S.doc Version 5.2 Page 19 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. The home is managed competently and the staff are supported and supervised in carrying out their respective roles. There are insufficient systems in place to measure quality assurance. EVIDENCE: The provider is also the registered manager, he is supported by a care manager and both have completed the Registered Managers Award and NVQ level 4 in Management. Residents said that they felt the home is run very well, a number of residents have lived in the home for many years and have an excellent relationship with the provider. Staff spoken to said that they feel supported by management and confirmed that supervision and appraisal take place. They confirmed that St Catherines Residential Care Home DS0000002420.V312921.R02.S.doc Version 5.2 Page 20 either the provider or care manager are always on call should they need any advice when they off not on the premises. Residents meetings are held and residents spoken to said they feel comfortable to raise matters at them. Residents’ finances held by the home were checked and found to be in order. Six requirements were set against these standards during the previous visit and these have all been addressed. Records pertaining to residents and staff are held in a number of places, for example, residents pre-admission assessment is not held on the main file and staff references are not all held in their file. A discussion was held with the provider regarding records being kept altogether and he agreed with this. Information received prior to the visit identified that all policies and procedures have been reviewed this year and a sample viewed confirmed this. Risk assessments have been carried out relating to uncovered radiators and a sample of maintenance records were viewed and these were all in order. No system is in place at the moment to assess and review the quality of care provided at the home. This was discussed with the provider who said he has sent away for information and plans to implement systems as soon as possible. This should include seeking the views of all people involved in the service, for example; residents, relatives/representatives, General Practitioners (GP’s), district nurses and social workers. St Catherines Residential Care Home DS0000002420.V312921.R02.S.doc Version 5.2 Page 21 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 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 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 St Catherines Residential Care Home DS0000002420.V312921.R02.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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. 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. Refer to Standard Good Practice Recommendations St Catherines Residential Care Home DS0000002420.V312921.R02.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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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