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Inspection on 28/06/05 for St Catherines Residential Care Home

Also see our care home review for St Catherines Residential Care Home for more information

This inspection was carried out on 28th June 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

This home provides a comfortable, clean and homely environment for residents living here. The staff group know the residents well and residents said they like the staff and felt they are listened to. Staff were seen to be kind and polite when speaking to residents. Care records are detailed and give a clear picture of the needs of residents. Residents are free to choose whether they participate in the activities provided. Meals are varied, well balanced and nicely presented offering choice and variety.

What has improved since the last inspection?

The home has taken action to address the requirement and recommendations raised at the last inspection. The registered owner/manager has completed a National Vocational Qualification (NVQ) level 4 in management and training has been undertaken regarding dementia care and adult abuse. Quality assurance questionnaires for residents were completed in April and issues highlighted are being addressed.

What the care home could do better:

The management should carry out risk assessments with regards to staffing levels and staff deployment to ensure residents needs are met. A risk assessment should also be written regarding two unguarded radiators and if any risk identified action must be taken to minimise this.

CARE HOMES FOR OLDER PEOPLE St Catherines Residential Care Home 61 St Catherines Lincoln LN5 8LR Lead Inspector Elisabeth Pinder Unannounced 28 June 2005 @ 09:30 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 Residential Care Home C53 C04 S2420 St Catherines V233938 280605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service St Catherines Residential Care Home Address 61 St Catherines Lincoln LN5 8LR 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) 01522 520643 01522 575714 Mr M J Browne Mr M J Browne Care Home Only (PC) 14 Category(ies) of Old Age, not falling within any other category registration, with number (OP) - 14 of places Dementia - Over 65 years of age (DE(E)) - 1 (Female) St Catherines Residential Care Home C53 C04 S2420 St Catherines V233938 280605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 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) - 1 The category DE(E) applies to one named person aged 65 years of age who is named in the Notice of Proposal to register dated 29 November 2004. The maximum number of beds registered is 14 Date of last inspection 29.09.04 Brief Description of the Service: St Catherine’s 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 is 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 ensuite facilities. There are five communal toilets, four communal bathrooms and three shower rooms. St Catherine’s is owned and managed by Mr Mark Browne of St Catherine’s Care Home Ltd St Catherines Residential Care Home C53 C04 S2420 St Catherines V233938 280605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 5 hours and was carried out by one inspector as the first of two statutory inspections for 2005/6. Before the visit information was gathered from the pre-inspection questionnaire and six relative/visitor comment cards. The main method of inspection used was “case tracking”. This involved selecting three residents and tracking the care they receive through the checking of their records, discussion with them, the care staff and observation of care practices. It also included a general discussion with four other residents. Three bedrooms were viewed and a selection of care records inspected. The registered owner/manager is available daily for advice and support but the day to day responsibilities are carried out by the deputy manager. What the service does well: What has improved since the last inspection? The home has taken action to address the requirement and recommendations raised at the last inspection. The registered owner/manager has completed a National Vocational Qualification (NVQ) level 4 in management and training has been undertaken regarding dementia care and adult abuse. Quality assurance questionnaires for residents were completed in April and issues highlighted are being addressed. St Catherines Residential Care Home C53 C04 S2420 St Catherines V233938 280605 Stage 4.doc Version 1.30 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 C53 C04 S2420 St Catherines V233938 280605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection St Catherines Residential Care Home C53 C04 S2420 St Catherines V233938 280605 Stage 4.doc Version 1.30 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 standard(s) 3 Residents are admitted into the home only after a full care needs assessment has been carried out and written confirmation has been sent assuring them that their needs will be met. EVIDENCE: Care records examined of two residents admitted since the National Minimum Standards were written showed that a pre-admission assessment had been carried out and these formed the basis of their care plan. Although residents spoken to could not remember the arrangements for coming into the home their records showed that these had been carried out. Both staff spoken to knew about the care needs of residents and were aware of the homes preadmission assessment procedure. They also confirmed that the owner/manager and deputy always discuss the needs of prospective residents prior to admission. St Catherines Residential Care Home C53 C04 S2420 St Catherines V233938 280605 Stage 4.doc Version 1.30 Page 9 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, 10 There is good care planning in this home. This ensures that the health and social care needs of the people living in this home are identified. Individual risk assessments are of a good quality, stating who is at risk and the action needed to minimise the risk. EVIDENCE: Individual care plans contain sufficient information to ensure that all aspects of health, personal and social care needs are identified and planned for. Those examined were generally up to date and showed that residents and/or their representatives have been involved, however, one resident has moved from the smaller house into the main house and the care plan did not reflect the reason why and the change in need. This resident was spoken to and was able to clearly describe her care needs and how these had changed recently. Individual risk assessments regarding falls, continence and other physical difficulties, for example swollen knees have been drawn up and give clear instruction as to the action needed to minimise these risks. Both staff spoken to were aware of residents needs and said that they are kept informed of all changes by the owner/manager and deputy. Residents also said that staff treat them well and that their privacy is respected. One resident said that “my personal care is done how I ask”. St Catherines Residential Care Home C53 C04 S2420 St Catherines V233938 280605 Stage 4.doc Version 1.30 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 & 15 Social activities and meals are arranged after discussions with residents. Meals are well managed and reflect resident’s likes and dislikes. EVIDENCE: A number of people living in the home were spoken to and everyone who commented on the food said how good it is and that they were happy with the food provided. Menus were inspected and found to be balanced and interesting. Care plans showed residents likes and dislikes and dietary requirements. Tables were laid with clean tablecloths and the lunchtime meal was homemade chicken pie, mashed potatoes and fresh vegetables, this was nicely presented, with fruit and ice-cream for dessert. Two visitors in the home declined to speak with the inspector, however, all five relative/visitors comment cards received identified that staff/owners welcome them in the home at any time. Residents also said that they are able to see their visitors when they want and in private. The home provides a small range of activities which are carried out mainly by care staff in the afternoons. These include cards, dominoes, manicures, videos, shopping trips and walks. One resident regularly attends a day centre and two others go to a church fellowship meeting. One resident said how St Catherines Residential Care Home C53 C04 S2420 St Catherines V233938 280605 Stage 4.doc Version 1.30 Page 11 much she had enjoyed an entertainer the previous evening who had come in to sing and play music. Minutes of a meeting held with residents in April stated that some people would like to go to a local garden centre and one resident requested to go to watch Lincoln City play football. Activity records showed a visit to the football match had taken place and the manager said that he is arranging the outing to the garden centre. Some people spoken to said “there’s not much to do” and comments taken from the home’s quality assurance questionnaires were “would like to go out to the pub again as I really enjoyed it” and “would like to go out more”. When this was discussed with the manager he said that residents often change their minds or chose not to join in with activities arranged. St Catherines Residential Care Home C53 C04 S2420 St Catherines V233938 280605 Stage 4.doc Version 1.30 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 The home takes the issue of addressing complaints very seriously and residents are confident that their concerns will be listened to and acted upon. There is a complaints procedure for residents and/or their relatives to follow. EVIDENCE: The home has a detailed complaints procedure and this is given to all prospective residents and their relatives/representatives. No complaints have been received by the CSCI since the last inspection, one complaint had been received internally and had been dealt with correctly. One resident spoken to said that she felt able to raise any issues herself, others said they would speak to their families. Staff spoken to knew the complaints procedure well and said that they felt confident to make a complaint if necessary. St Catherines Residential Care Home C53 C04 S2420 St Catherines V233938 280605 Stage 4.doc Version 1.30 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) 19 Residents living in this home live in a safe and comfortable environment. The standard of the environment is good with the home continuously improving the decor on a planned basis. EVIDENCE: The home is clean and well decorated. All furnishings are of a domestic nature and residents said they like the home, and are happy with their bedrooms and felt that they were kept clean. The three bedrooms viewed were individually decorated and furnished and contained personal items reflecting individual interests and tastes. There is an on-going programme of redecoration and refurbishment and one bedroom has been decorated since the last inspection. Twenty-two radiators have recently been fitted with guards and there are now only two unguarded radiators in the home, these are both situated in bathrooms. The manager should carry out risk assessments and if any risk is identified action must be taken to minimise this. Bathrooms and toilets were clean and are lockable. There are hoists available and handrails to assist residents. St Catherines Residential Care Home C53 C04 S2420 St Catherines V233938 280605 Stage 4.doc Version 1.30 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) 27 The staff group are an established team and know the needs of residents and the action needed to meet their needs. However, the deployment and numbers of staff available in the mornings should be reviewed to ensure sufficient staff are available to meet these needs. EVIDENCE: There is a low staff turnover in this home. Records show that there are two care staff on duty during the day and one wakeful night staff who is assisted by a sleeping night staff member who is on call from 11pm – 6.30am. There is a third member of staff on duty from 9.30am – 3pm two days per week to enable the deputy manager time in the office. The home does not employ separate cleaning/laundry and catering staff therefore the care staff are responsible for these tasks. Residents spoken to said that staff in the home are kind and caring but that they are always busy, especially in the mornings. During the visit residents were seen to be sitting in the lounge for long periods without a member of staff being present as staff were busy cooking lunch and cleaning rooms. However, all five comment cards received from relatives/visitors identified that in their opinion there is always enough staff on duty. St Catherines Residential Care Home C53 C04 S2420 St Catherines V233938 280605 Stage 4.doc Version 1.30 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) 31 & 32 There is clear leadership in this home. Management offer guidance and direction to staff to ensure residents receive consistent quality care. EVIDENCE: The registered manager has recently completed a National Vocational Qualification (NVQ) level 4 in management. The deputy manager also has this qualification and has nearly completed level 4 in care. Systems are in place where residents and staff can air their views to the manager such as staff and residents meetings and quality assurance questionnaires. However, management are asked to document the action taken to address any issues raised at these meetings. Residents and staff made positive comments about the management of the home and said that they feel they can approach either the owner/manager or deputy at anytime if they have any concerns. St Catherines Residential Care Home C53 C04 S2420 St Catherines V233938 280605 Stage 4.doc Version 1.30 Page 16 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 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x x STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 3 x x x x x x St Catherines Residential Care Home C53 C04 S2420 St Catherines V233938 280605 Stage 4.doc Version 1.30 Page 17 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. 2. 3. 4. Refer to Standard 7 19 27 32 Good Practice Recommendations Care plans should reflect all changes in residents needs. Risk assessments should be carried out regarding two unguarded radiators and if risks are identified action must be taken to minimise the risk. Staffing levels and deployment should be reviewed regularly to ensure sufficient staff are available to meet residents needs. It is recommended that management document action taken to address issues raised during residents meetings or from quality assurance questionnaires. St Catherines Residential Care Home C53 C04 S2420 St Catherines V233938 280605 Stage 4.doc Version 1.30 Page 18 Commission for Social Care Inspection Unity House 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. Extracts may not be used or reproduced without the express permission of CSCI St Catherines Residential Care Home C53 C04 S2420 St Catherines V233938 280605 Stage 4.doc Version 1.30 Page 19 - 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. 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