Inspection on 21/11/06 for St Cecilia`s

This inspection was carried out on 21st November 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 Cecilia`s 02/03/06

St Cecilia`s 23/11/05

St Cecilia`s 06/01/05

St Cecilia`s 29/07/04

St Cecilia`s 22/03/04

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Snydale Care Home

Hawkhills

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The Grove Waltham

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Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE St Cecilia`s Glendale House 19 - 21 Stepney Road Scarborough North Yorkshire YO12 5BN Lead Inspector Karen Ritson Key Unannounced Inspection 21st November 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 Cecilia`s DS0000007735.V320705.R01.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 Cecilia`s DS0000007735.V320705.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Cecilia`s Address Glendale House 19 - 21 Stepney Road Scarborough North Yorkshire YO12 5BN 01723 503111 01723 501080 m.padgham@stcecilias.co.uk 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) St Cecilias Care Services Limited Mr Michael Andrew Padgham Mrs Josephine Edmond Care Home 21 Category(ies) of Dementia (5), Dementia - over 65 years of age registration, with number (21), Old age, not falling within any other of places category (21) St Cecilia`s DS0000007735.V320705.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service Users in category (DE) must be aged 50 years and over. Date of last inspection 2nd March 2006 Brief Description of the Service: St Cecilia’s is a large adapted property. The home is located on a main road giving direct access to the town centre. Public transport passes the door. It was originally two separate houses but these have been converted to provide accommodation for service users in single and shared bedrooms. Some bedrooms have an en-suite provision. There are a number of communal areas throughout the home. The home does not have a passenger lift and consequently service users occupying the first floor must be reasonably ambulant. The secluded and private rear garden is provided with outdoor seating and specifically designed for the category of service user accommodated. The home has a statement of purpose and service user guide, which provide information about the scope and nature of the care and facilities on offer. These, with CSCI reports, are available on request at the home. The home charges between £346 and £471 each week. Chiropody, hairdressing and newspapers are not included in this fee and these are charged at cost. This information was provided to CSCI on 21/11/06. Jo Edmond manages St Cecilia’s on a day-to-day basis; she works closely with Michael Padgham who oversees the home and both are registered managers of the home. St Cecilia`s DS0000007735.V320705.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection for this service took 12 hours. This includes time spent gathering information and examining documentation before and after a site visit and in writing the report. The site visit took place on 21st November 2006 between 9:30am and 13:45pm. Information for this inspection was gathered from the following: • A tour of the premises • Observations of care throughout the day of the site visit. • Speaking with service users. • Speaking with staff. • Case tracking four service users on the day of the site visit. • Reading comments from service users and relatives. • Looking at information provided by the manager in a pre inspection questionnaire. • Notifications sent to the commission from the home since the last inspection. • Examining selected policies, procedures and records kept at the home. • Examining information regarding the home on the file kept by CSCI. All key standards were looked at during this inspection. The manager was available throughout the day of the site visit. What the service does well: This home provides a good level of care for the service users living here, many of whom have a dementia. The care needed is written down in detail for staff to follow. Each service user has a particular worker called a key worker who specifically helps them. The files are well organised and it is easy to follow what each person needs and which other health care professionals are involved. The home has a safe method of looking after medication. Each service user is at the centre of planning for their care and their particular interests are written down. The home works hard to make the lives of those living there as interesting as possible and uses various activities to help them make the most of their abilities and enjoy their life in the home. The meals are very good. Service users are helped to complain if there is a problem, and all complaints are taken seriously. Staff are well trained and in sufficient numbers to make sure service users receive friendly unhurried care. The manager is well qualified and approachable. Staff said they could go to either Mrs Edmond or Mr Pagham if there were any difficulties. Visitors to the home were very complimentary in general. One said the home was: ‘First class in all respects.’ Another said: St Cecilia`s DS0000007735.V320705.R01.S.doc Version 5.2 Page 6 ‘I am particularly impressed by your staff who are cheerful and friendly.’ Another said: ‘I am totally satisfied with the way my mother is being looked after.’ 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. The summary of this inspection report can be made available in other formats on request. St Cecilia`s DS0000007735.V320705.R01.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 Cecilia`s DS0000007735.V320705.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Standard 6 is not applicable. Quality in this outcome area is good. Prospective residents and their representatives have the information needed to choose a home. Service users needs are assessed in detail ensuring their needs are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each service user receives an assessment of care prior to admission. A more detailed assessment is then carried out during the first few weeks following admission and a personal profile and care plan are drawn up using this information. Most service users were unable to comment due to their capacity, however, comments from relatives suggested that great care was taken to understand the care needs of each individual. Observations of care also showed that all staff had a good understanding of each individual’s care needs. Details submitted on the pre inspection questionnaire and the homes’ brochure showed that service users have the opportunity to visit and familiarise themselves with the home. St Cecilia`s DS0000007735.V320705.R01.S.doc Version 5.2 Page 9 The assessment process forms a good foundation for providing appropriate responsive care. St Cecilia`s DS0000007735.V320705.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is good. The health and personal care a resident receives is based on individual needs. Service users and relatives are consulted during the care planning process and this informs good care practice. The principles of respect, dignity and privacy are put into practice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A detailed care plan is drawn up from the assessment and other information received. These are regularly reviewed so that the changing needs of service users may be met. Information is drawn from health care professionals and others in order to build a detailed picture of each persons care needs. All healthcare visits and comments are recorded separately to ensure that the care offered is consistent and all staff are made aware of any necessary changes. A health care professional said: ‘They act on my advice.’ St Cecilia`s DS0000007735.V320705.R01.S.doc Version 5.2 Page 11 A visitor had written: ‘The standard of care offered …is of the highest order and I have no worries or concerns when leaving (my relative) in such capable hands.’ Risk assessments are carried out in all relevant areas of care. Visitors indicated that care plans were discussed with them in reviews. Medication is well kept, recorded and administered, according to policy; ensuring service users are kept safe. Observations during the day of the site visit confirmed that service users were treated with regard to their privacy and that dignity was protected. When asked if she was satisfied with the way they were cared for, one service user said of the carers: ‘They’re nice.’ Another said: ‘They smile.’ The caring and thorough approach of the home ensures that service users care needs are met. St Cecilia`s DS0000007735.V320705.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is good. Residents are assisted to choose their social activity and keep in contact with family and friends. Social, cultural and recreational activities meet resident’s needs. Residents receive a healthy, varied diet, which they enjoy. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Social and activity preferences are recorded on each service users file. Key workers regularly review these and any required changes are made. The home keeps a separate activities record. Staff said that they made an effort to offer activities which appeal to each individual. Due to the capacity of most of the service users one to one activities often worked best. Staff spoke of having the time to sit and chat with service users. One of the lounges is used as a sensory area where service users can enjoy fibre optic lights, listen to soothing music, enjoy textured materials and have their hands massaged. The home has a people carrier which will seat eight and service users have enjoyed many outings during this year. Places visited have included Oliver’s Mount and Cloughton tearooms. Some service users enjoy helping with domestic chores such as folding sheets, others are happier playing dominoes or doing jigsaws. The home uses memory cards to encourage discussion of past events in history or film stars for example. A dining area is decorated with memorabilia from the ‘30s ‘40s and ‘50s. St Cecilia`s DS0000007735.V320705.R01.S.doc Version 5.2 Page 13 This also is designed to promote discussion and reminiscence. The home employs an activities coordinator who visits twice a week; this person used to work as a carer at the home and knows the service users well. The home also has visits from outside entertainers. One member of staff described how they were planning a pantomime for Christmas. These arrangements ensure that service users are offered the opportunity to become involved in activities they prefer. Visitors are welcome at all reasonable times. One wrote that the home had: ‘A nice atmosphere, everything seems to run smoothly when we visit.’ Sample menus were submitted during the site visit and these showed a good choice on offer. One visitor said: ‘The food served is a well balanced diet.’ Any dietary needs are recorded and taken into consideration when planning meals. A nutritional assessment is carried out whenever necessary with the results incorporated into the care plan. The chef has been recently appointed, but was not available on the day of the site visit. The manager said that the meals had improved, with fresh meat and vegetables now being used to replace any frozen foods. This ensures that service users receive a good diet, which they enjoy. St Cecilia`s DS0000007735.V320705.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. Residents have access to an effective complaints procedure; their complaints are listened to and acted on. Service users are protected from abuse, through updated staff training and abuse procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints policy and procedure. Staff said the service users and relatives could speak with staff or the managers if there was a problem and that they were confident complaints would be listened to and any concerns acted upon. All complaints are recorded with outcomes; however, there have been no complaints since the last inspection. Staff have received abuse awareness training. The home has an equal opportunities policy and procedure. This approach ensures that complaints are treated appropriately and service users are protected from abuse. St Cecilia`s DS0000007735.V320705.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. Service users live in a safe, well-maintained and comfortable environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is well decorated and furnished and provides a safe environment for service users. There is an attractive garden, which benefits from the recent addition of a pond. A summer house is provided for service users sit outside in the warmer months. There is a paved area outside the day room. The walls of this are decorated with metal advertising boards from the past and form part of a reminiscence theme within the home. The home has three lounges, and two dining areas. Sufficient bathing and showering facilities are provided. Most room are single and screening is provided in the three double rooms for privacy. The home is kept clean by the housekeeper, who works hard to eradicate odour. St Cecilia`s DS0000007735.V320705.R01.S.doc Version 5.2 Page 16 Compliance with the fire authority and the environmental health department has been achieved. Service users said they liked the internal décor of the home. There are no recorded problems with the laundry service. St Cecilia`s DS0000007735.V320705.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27 to 30. Quality in this outcome area is excellent. Staff in the home are well recruited, trained and in sufficient numbers to fulfil the aims of the home and meet the changing needs of residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home employs sufficient staff at each shift to care for the service users. Staff spoke of having time to talk with service users and to engage them in activities, and whilst some said they would like still more time, the staffing ratio is favourable, exceeding the recommendation by the residential forum. The housekeeper is awaiting the appointment of a new assistant. A high proportion of staff have achieved or are working towards NVQ level two. Staff are appropriately recruited and files are well organised, containing all required information from application to appointment. Care staff are interviewed with the specific needs of service users with a dementia in mind. There is a robust staff structure with all staff being clear about their role and that of others working at the home. All staff have received POVA first and CRB checks and all have been employed following the receipt of two references. The home has worked in accordance with its equal opportunities policy with regard to the employment of overseas staff and those with a disability. Staff training is very thorough and records showed that staff have received induction, foundation, and other relevant training for this client group, with in house training complementing external training. Staff spoke enthusiastically about their St Cecilia`s DS0000007735.V320705.R01.S.doc Version 5.2 Page 18 training and one said that it motivated her to find out yet more about how to care for service users with a dementia. The training focuses upon person centred care. There is emphasis upon how staff may communicate with and discover the wishes of those service users who may appear to have limited capacity. All staff spoken to showed a firm grasp of this person centred approach and spoke of the service users with respect and care. Visitors to the home commented very favourably upon the attitude of staff. One said: ‘’The staff are very caring at all times (even when) they are really busy.’ A health care professional said: ‘The staff come to the door quickly, they are always polite and accompany me to the patient.’ This approach ensures that service users received informed care based on best practice. St Cecilia`s DS0000007735.V320705.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area is good. Service users benefit from an open style of management based on respect. Service user and other views inform practice. Service users welfare is protected by good health and safety systems. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager is suitably qualified. All staff said they could approach her or Mr Padgham for support if there was a problem. Staff felt there was a homely and positive atmosphere most of the time. All said they enjoyed working at the home. A visitor had written: ‘St Cecilias is an excellent home, very well run by caring management and staff.’ St Cecilia`s DS0000007735.V320705.R01.S.doc Version 5.2 Page 20 The home has developed a quality assurance system. The views of service users and relatives are taken into consideration and incorporated into care plans. The manager has sent out survey forms to health care staff and is awaiting their return. Staff meetings provide a place where any problems or suggestions can be discussed. A recent difficulty with communication between staff which had been raised in staff surveys had been resolved in this way. The results of all surveys are discussed in staff meetings so that service users and relatives opinions may affect the development of the service. The manager is developing a way in which the results of these surveys may be made public and was considering the St Cecilias website and the regular newsletter as vehicles for communicating an annual plan of improvement. The home has comprehensive health and safety policies and procedures with environmental risk assessments, which ensure the safety of service users. St Cecilia`s DS0000007735.V320705.R01.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 4 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 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 4 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 3 St Cecilia`s DS0000007735.V320705.R01.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. 1 OP33 Refer to Standard Good Practice Recommendations Recommend that the manager continue with the arrangements to make the results of quality assurance surveys public and to incorporate results into an annual plan. St Cecilia`s DS0000007735.V320705.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: 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 © 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 Cecilia`s DS0000007735.V320705.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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