Inspection on 29/09/08 for St Cuthberts House Residential Care Home

This inspection was carried out on 29th September 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

Ashlea Mews Residential Home

Eastwood

West Lodge

Arran House

Avenue Community Nursing Home

Cosin Lodge

Farmborough Court

Cragston Court

Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: St Cuthberts House Residential Care Home Sidmouth Road Low Fell Gateshead Tyne & Wear NE9 6US     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Lee Bennett     Date: 0 2 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: St Cuthberts House Residential Care Home Sidmouth Road Low Fell Gateshead Tyne & Wear NE9 6US 01914823167 01914926839 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): St Cuthberts House Limited Name of registered manager (if applicable) David James French Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 28 The registered person may provide the following category of service only: Care Home only Code PC To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following categories: Dementia - Code DE, maximum number of places 28 Mental Disorder, excluding learning disability or dementia, Code MD maximum number of places 28 Date of last inspection Brief description of the care home St Cuthberts House is an adapted care home, set within its own grounds. Accommodation is provided over two floors, with lift access available for some bedrooms on the first floor. The ground floor and gardens have ramped access, making Care Homes for Adults (18-65 years) Page 4 of 29 care home 28 Over 65 0 0 28 28 Brief description of the care home them suitable for people who are physically disabled or frail. All bedrooms are single. The needs of people who have mental health needs or dementia can be catered for here. The home accommodates people over and under 65 years of age (please ignore the categories section above). Nursing care cannot be provided here, but District Nurse, or other specialist nursing help can be arranged. The home is in the Low Fell area of Gateshead, close to a wide range of shops, pubs, places of worship and a library. A large leisure centre and swimming pool is just over a mile away. For up to date information on fees and charges, please contact the home directly. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: Before the visit we looked at; Information we have received since the last visit in January 2008. How the service dealt with any complaints and concerns since the last visit. Any changes to how the service is run. The care providers view of how well they care for people. The views of people who use the service and their relatives, staff and other professionals. The visit; An unanounced visit was made on 29th September 2008. This lasted about 5 hours. A further follow-up visit was made on 2nd October. This lasted about 4 hours. Care Homes for Adults (18-65 years) Page 6 of 29 During the visits we; Talked with people who live here, some of the staff and the manager. Observed life in the home. Looked at information about the people who use the service and how well their needs are met. Looked at other records, which must be kept here. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around parts of the building to make sure it was clean, safe and comfortable. Checked what improvements had been made since the last visit. We told the registered manager what we had found. What the care home does well: What has improved since the last inspection? What they could do better: Overall this home operates at a high standard, and its pervious excellent rating would have been maintained had it not been for some shortfalls in the staffing standards. In the past staff have recevied a range of training relevant to the needs of the people living here, and the health and safety obligations of the staff. However, over the past year or so this has declined, and some important ares, such as manual handling have been ommitted. Also staff are not receiving formal, structured supervision time on a consistent and frequent basis. Care Homes for Adults (18-65 years) Page 8 of 29 Health and safety is generally well managed here, but the fire risks posed by people smoking in their own rooms, although identified, were not being managed in the way that the homes manager had stipulated in a risk assessment, increasing the potental fire risk from a cigarrette being placed into a plastic bi rather than a metal one. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Before coming here people have their individual needs and aspirations assessed. This is so the manager can be confident that each persons particular needs and wishes can be met here. Evidence: Before receiving a care service, each person is entitled to have their needs looked at by a social worker or health worker. This is called an assessment. For every person who has moved here the registered manager has obtained a care managers (social workers) assessment prior to their admission. She will also obtain information from health care workers, such as Psychiatric Nurses, and Psychiatrists. Before coming here people can also make a visit, meet the manager, staff and other people living here and take a look around the home. From the care assessment an interim care plan is developed, and later a more comprehensive plan of care written up. At regular intervals people have their care reassessed to make sure the home and its staff can still meet their needs. The evidence Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: outlined within service users care plans and their progress notes, along with the Inspectors observations, indicated that the service is able to meet the needs of those currently living here. Overall, those service users present, including those whose needs were case tracked, appeared content with the service being provided, and made positive comments about the care and support they receive here. Care Homes for Adults (18-65 years) Page 12 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. All of the people living here have clear, concise and accurate care plans and risk assessments in place. Effective care planning can offer guidance to care staff about care practice and ensure consistency where necessary. Good risk assessment can help promote independence, whilst maintaining safety. Evidence: Each person living here has their own personalised care plan file. This is developed by their key worker (a member of staff who helps a person plan their care) and covers a broad range of need areas. These are linked to regular monitoring of their identified needs and are then periodically reviewed and subsequently updated. Summary information, in the form of an assessment, has been developed, to offer an overview of each persons needs. Individual care plans are then developed to guide the practice of staff. This documentation highlights each service users abilities, strengths, and preferences, as Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: well as areas of need. Care plans, which are revised after periodic reviews are one way in which the people living here can influence the care they receive. The people living here are also encouraged to make decisions regarding their care, and the running of the home, though the care planning process and periodic regular house meetings. Closely linked to care planning arrangements are risk assessments. Again, these have been developed by key workers. Areas of risk such as those relating to the self harm, medication, fire risk and so on, are documented within the service users’care files. A risk assessment for a service user smoking in his room could not be located, but written by the time of our second visit (see management section below). Each identified risk area has an assessment that records who or what may be harmed, current and additional control measures, and periodic reviews. Risk assessments relate to activities and risks that may occur both outside and within the home, and relate to the activities undertaken by service users and the equipment available in the home. The aim of the risk assessment process is to promote the independence of the people living here, and to allow them to maintain or develop their skills. Care Homes for Adults (18-65 years) Page 14 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living here are encouraged by the staff to lead active and fulfilling lifestyles by having a regular community presence, by accessing a range of community facilities and by keeping in touch with family and friends. This will assist in them leading a full and enjoyable life. Evidence: The staff team know the people who live here well, and have a good understanding of their life histories, interests and backgrounds. The way the home itself has been furbished reflects the interests of many who live here, and parts [such as the smoking room and games area] retain the appearance of a social club or attractive boarding house / hotel. Activities take place within the home, and people will access local community facilities Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: independently and also with staff support where needed. A lot of work has been carried out to the garden areas. This has made them an attractive and safe place for people to spend their time. Throughout the inspection we saw that visitors came and went freely, and people told us that they were made welcome. Relatives and friends told us theres no set visiting times, its excellent here, theyre doing things all the time. Theyve got a greenhouse and they take them on trips out. Meal times are an important element of the daily routine, and where people have particular dietary needs and preferences these are outlined within their care plans. The cook has a good knowledge of people individual food choices and particular needs, such as diabetes. Where people have particular dietary needs these are clearly documented within care plans, and monitored if necessary. The cook prepares an excellent range of fresh meals, which are well presented, use fresh and wholesome ingredients. A choice menu is operated and a record kept of the meals planned and provided. Meals are normally taken within the dining room, but people can eat their meals elsewhere in the home if they wish. Some of the people living here also help in meal preparation and related tasks, but staff will provide more specific help with eating where this is necessary. The staff here were observed to be courteous and attentive during meal times. All of the people we spoke with were complimentary about the food provided. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples’ personal and healthcare needs are well supported. Their choices, privacy and dignity is respected. This means that their health and welfare is maintained. Evidence: The people living at St Cuthberts have their personal care needs outlined within their care plans. Their needs are supported and met, where appropriate, in private, and they are encouraged to cater for their own needs where possible. Specialist support and the input of other care professionals is sought where necessary, and care staff are able to demonstrate a good understanding of service users’ needs. Staff working in the home are able to provide personal support for the people living here in a flexible and responsive manner and will assist them to access health care in a prompt way, particularly if there are any concerns about a person’s health. Each person’s health needs are regularly identified through assessments and these are monitored where appropriate. Furthermore, a record of contact with healthcare professionals is maintained within each persons care plan file, which helps to make sure each person has received the health care they need. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: Linked to these health and personal care arrangements, is the support given with medication. Locked, secure storage has been installed for medications. Printed administration records are kept, and a sample signature list is maintained to identify which staff members were responsible for each medication administration. Staff at the home have undergone training in relation to medication administration (the safer handling of medicines course) and seek additional advice from a pharmacist when needed. A brief audit of loose medicine stocks was concluded successfully. Where service users take possession of their own medication, this is undertaken in reference to a risk assessment and helps promote their independence. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living here are supported to express their views, and they are listened to and acted upon. Staff help ensure that service users are protected from abuse, neglect and self-harm. Evidence: A complaints procedure is available within the home, and informs the people living here, their friends and family that they can contact the Commission if they wish regarding complaints. A record of complaints and suggestions is maintained, although none have been received. Staff have not all received training from the local Adult Protection Co-ordinator. Such training is to help explain the role of adult protection, and to offer guidance to staff. The care provider has adult protection procedures, which are available in the home, should staff need guidance in this area. The local authority’s procedures are also available. Care Homes for Adults (18-65 years) Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living here benefit from well maintained, homely, clean, and generally safe accommodation. This can help promote a positive image for service users, and ensure they remain comfortable. Evidence: St Cuthberts House is an adapted building, that has been more recently extended. Everyone has their own bedroom, and these are generally clean, tidy and personalised to suit each persons taste. Bathrooms and toilets are located throughout the building for ease of access. There is one large dining room, a designated smokers room, in the style of a bar, a games room, that has a range of free arcade games, and a quieter lounge area. There are large gardens, that offer an alternative space for people to spend their time, should they wish. The home was found to be clean throughout. Care Homes for Adults (18-65 years) Page 20 of 29 Care Homes for Adults (18-65 years) Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Suitably qualified staff are employed here in sufficient numbers, and are safely recruited, however, they do not receive sufficient training or regular supervision. This can mean that the people living here are safeguarded from unsuitable staff being employed here, but that staff are not kept up to date, or have regular, formal, planned opportunities to discuss their work. Evidence: Staffing levels are maintained to a level where there is never less than three care staff [increasing to five at busier times] working at any one time during the day [8:00am to 10:00pm]. There are two waking night staff. The examination of a sample of staff records, and confirmation by the manager, indicated that staff are only employed in the home after the receipt of sufficient background checks having been carried out, which help determine their suitability to carry out their role. These checks include the receipt of a Criminal Records Bureau ‘disclosure’ and two written references. Once recruited to the home, staff need to receive a range of training, relevant to the needs of service users, health and safety, and to care in general. For the staff whose Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: records we looked at it was clear that there had been little in the way of training offered and arranged over the past twelve months. What training has been received is in the form of videos, and does not include topics such as moving and handling or general health and safety. In terms of best practice, video based training is useful in complimenting the training offered to staff, but ideally should form part of the training programme, rather than being its dominant element. Staff will receive basic health and safety related instruction as part of their induction, but this has not been refrehed recently. 10 out of the 15 care staff working here have undertaken and achieved an NVQ in care, at level 2 or higher. Two more are working to achieve this award. Training and attaining qualifications in care are one of the issues that can be discussed at staff supervision and appraisal sessions. However, these are infrequently arranged or carried out. For the three staff whose records we looked at, although some one to one sessions were held, these were not being carried out on a regular or consistent basis. Care Homes for Adults (18-65 years) Page 23 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This home benefits from the leadership and direction of an experienced and qualified manager, where quality and safety is, on the whole, well managed. This can contribute to the health, welfare and security of service users. Evidence: There is a clear management structure within the home, which is family run. There is a manager and a deputy manager, supported by a team of senior carers and care workers. The manager seeks the views of the people living here regularly, which includes an annual questionnaire survey. There are also periodic residents meetings where peoples views are sought and they are asked to be involved in the running of the home. There are regular checks of the building to ensure an acceptable standard is maintained, although quality checks have not ensured that levels of staff training and supervision are kept up to date and at recommended standards. Just as the quality of the care provided is checked, so are matters affecting health and safety. Therefore regular checks on the building are carried out, water and fridge / Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: freezer temperatures are monitored, and working practices that could present a risk are looked at. Information on the chemical products used here is kept, so that if an accident or spillage occurs, staff have the information at hand to know what to do. During the inspection the following health and safety matters were identified: Metal bin missing from bedroom where service user smokes [on both inspection visits]. There were no other hazards observed. Care Homes for Adults (18-65 years) Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 23 13 All staff must receive 27/04/2009 training on abuse awareness and local safeguarding adults procedures. This is so they are aware of how to identify and respond to suspicions on abuse. 2 35 18 Staff must receive regular 27/04/2009 paid training, including training on health and safety related topics (such as moving and assisting) and adult protection. This is so staffs knowledge and skills remain up to date with current good practice. 3 36 18 Staff must receive regular, structured supervision. This is so they have formal opportunities for their work to be discussed. 27/04/2009 4 42 13 The actions noted in the homes own risk assessments [fire safety] must be implemented. 27/04/2009 Care Homes for Adults (18-65 years) Page 27 of 29 This is so the risks presented by fire hazards are minimised, and service users and staff are kept safe. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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