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Inspection on 19/11/08 for St Judes Residential Home

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

This inspection was carried out on 19th November 2008.

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

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

An excellent standard of care is provided for the people who live at the home. People said they enjoyed living there, and that the staff were kind and helpful. Comments received were very positive about the care. One person who lives at the home wrote on a survey, `All residents are encouraged to make this place their home. Personal needs are identified and endeavoured to be met. There is a great philosophy of care and respect among the staff and the residents allowing us to live in a comfortable, relaxing, warm homely environment`. There were written care plans in place for each person. This helps staff make sure that each person gets the support and assistance that is needed for them to live safely and comfortably. The environment was nicely decorated and well maintained. Staff were motivated and enthusiastic about their work. One member of staff wrote on a survey, `The service we provide is to take care of the people in our care, to look after them to a high standard in all areas considering their needs relating to disability, age, gender, race, ethnicity, sexual orientation and faith. We try to keep the people happy and to help them cope with everyday life. I believe our service does this to a high standard. The management expect us to do a good job to a high standard and this is what I hope I and other staff have achieved`.

What has improved since the last inspection?

The last inspection report contained four recommendations which have all been addressed. Contracts are now renewed each time the fees are changed to make sure people know the amount they are being charged. All non monitored dosage medicines now have the date of opening identified on the packet to create a clear audit trail. The complaints policy has been updated so that people know who to complain to if they are unhappy. The quality assurance system has been developed and results of surveys are now published.

What the care home could do better:

It is commendable that there are no requirements or recommendations following this inspection. The manager strives to continually provide an excellent service and is always looking to improve the service in whatever way she can.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: St Judes Residential Home 22 Breckon Hill Road Middlesbrough TS4 2DR     The quality rating for this care home is:   three star excellent 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: Susan Lowther     Date: 1 9 1 1 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. the things that people have said are important to them: They reflect 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 26 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 26 Information about the care home Name of care home: Address: St Judes Residential Home 22 Breckon Hill Road Middlesbrough TS4 2DR 01642868914 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Elaine Stephens Type of registration: Number of places registered: Miss Elaine Stephens care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home St. Judes is a large Victorian terraced house in a residential area on the outskirts of Middlesbrough, opposite to a primary school, close to shops and local amenities, within walking distance of the town and adjacent to bus routes. The home provides accommodation for eight people, in single rooms, all with en-suite facilities. Five with a shower, wash hand basin and w.c. and one of these rooms also has a bath. The other three rooms have a wash hand basin and w.c. In addition, there is a bathroom containing bath, wash hand basin and w.c. The home is non-smoking and residents and staff have agreed to only smoke outside where there is a rear garden patio area. There is a large comfortable lounge, a breakfast/dining room and a kitchen, which is domestic in nature. There is a lawned garden to the front of the property. 8 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 26 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: three star excellent 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: The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. This unannounced inspection took place on 19th November 2008. a tour of the building took place and the inspector spoke to four people who use the service, three staff and the manager. The inspector viewed some of the service’s records. Surveys were also returned from people who use the service and from staff. Information from these is included throughout the report. The manager supplied some information prior to the inspection on a form called an AQAA. This is an annual quality assurance assessment for the home to provide Care Homes for Adults (18-65 years) Page 5 of 26 information about their service. The inspection focused on key standard outcomes for people using the service and to check whether the recommendations from the previous report had been addressed. The fees charged at the time of this inspection were between 370 pounds and 385 pounds per week. The fees to not include charges made by the chiropodist or the optician. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the care home does well: What has improved since the last inspection? What they could do better: 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. Care Homes for Adults (18-65 years) Page 7 of 26 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 8 of 26 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 9 of 26 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. People are appropriately assessed before they are admitted to the home. Their individual needs and aspirations are considered. Evidence: Although there have been no admissions to the home since the last inspection, two sets of documentation were examined and they showed that a full assessment had been carried out prior to the person moving into the home. The assessment documentation covered areas such as preferred recreational activities, personal care, nutrition, dress management, emotional status, medication and health, independence/leisure, culture/religion and finance. People who live in the home confirmed that they had been assessed before they moved into the home. One person who lives in the home said, All parties were included in the decision, myself, members of the multi disciplinary team and the staff of the home. In fact even before visiting the home the manager came to see me to tell me about the home and to find out whether I would be interested in moving into the home. The manager confirmed that people are invited to visit the home on several occasions before the final decision is Care Homes for Adults (18-65 years) Page 10 of 26 Evidence: made about whether they go to live there. This is to make sure this is the correct decision not only for that person but also for the other people who live in the home. The last inspection report contained a recommendation that contracts be renewed each time that fees are changed. The manager confirmed that this is now being done. Care Homes for Adults (18-65 years) Page 11 of 26 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 who live in the home have care plans. These contain risk assessments and show how risks are managed. The files also include information about how people are supported and assisted with making decisions and living their lives as independently as possible, within their capabilities. Evidence: Each person who uses the service has an individual care plan, which showed involvement from the person and the multi agency professionals and staff. People spoken with confirmed that they attend reviews and are given a copy of the document. Two sets of documentation were examined, which showed the information was detailed. Within the plans there was also a personal profile of the person. Individual programmes were in place for each person covering areas such as attendance at work, training and education and social and leisure activities. One person who lives in the home said, I have had many opportunities to pursue my Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: interests and hobbies. As long as I inform people what I am doing each day there are no problems. Another said, It is my choice. I spend my time going to town and i do voluntary work. Relevant and detailed risk assessments were in place for each person covering issues such as absences, mood change and offending behaviours. Care Homes for Adults (18-65 years) Page 13 of 26 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. People are offered their choice of daily activities and can live their lives as they wish. Staff care for people in the way they want. People are encouraged to have a healthy and varied diet. Evidence: All of the people have an agreed weekly programme ranging from attending day centres to taking part in employment, work experience, training and education. Social activities are also programmed to individual choice including visits to a sports centre or the pub and shopping trips into town. Holidays are arranged on a regular basis. One person confirmed that people are given a choice. When asked if people were allowed to do what they wanted to do at the weekend the response was, Absolutely if there are any specific nights out for example or events you may wish to attend it would be facilitated. Also you are free to choose whatever you wish to do at any time. Another Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: response was, Yes I can visit my family. One member of staff said, We take most of the people out on social nights to the pub, although not all of them like to come. Carers are invited to go on holiday with the people who live in the home and we also take them to the seaside on days out. Family and friends are welcome to visit at any time. The menus are varied and people confirmed that they have a choice. The home have recently gained a Five Star Award for food hygiene. Care Homes for Adults (18-65 years) Page 15 of 26 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. The health and personal care needs of people are met. There are suitable arrangements in place for dealing with medication. Evidence: Two care plans were examined which detailed the personal support given to the people who use the service. Each person has their own General Practitioner and a care coordinator appointed by the multi disciplinary team. The care plans identify all physical, emotional and mental health needs and are evaluated on a minimum of a six monthly basis or when a need changes. Policies and procedures are in place for the ordering, receipt, storage, disposal and administration of medication. All non monitored dosage medicines now have the start date written on the package to make sure there is a clear audit trail. This was a recommendation in the last inspection report. All staff who give medication have received appropriate training. There is a procedure in place for people who wish to administer their own medication. Staff would assess them first to make sure that this is safe. Care Homes for Adults (18-65 years) Page 16 of 26 Care Homes for Adults (18-65 years) Page 17 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that their concerns and complaints are dealt with appropriately and that safeguards are in place to protect them from abuse. Evidence: The home has a complaints policy and procedure in place. This has been updated as recommended in the last report so that people know the process to follow. There had been no complaints made to the home since the previous inspection. Staff are always available for people who use the service to go to if they have any concerns or are unhappy. One person said, We speak to the staff or manager. You are made aware of the complaints procedure if you are unhappy with anything. We are all given the name and address to whom you can formal complaints if they cannot be resolved internally. The home has a safeguarding policy and procedure in place. There was evidence in staff training files to show that training in the protection of vulnerable adults had been carried out. Staff confirmed that they know the procedure to follow and would have no hesitation in whistle blowing if they suspected an incident of abuse had occurred. The home have recently won the Safeguarding Adults Award presented by Middlesbrough Dignity and Respect Awards in Adult Social Care. Care Homes for Adults (18-65 years) Page 18 of 26 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 home is clean and well maintained. It is decorated and furnished to a good standard and provides a homely environment for the people who live there. Evidence: A tour of the home was carried out. All areas were very clean, tidy and well decorated. People who use the service are involved in choosing the decor and furnishings in their own rooms and also in the communal areas. Bedrooms were very individual containing personal possessions. One of the people who lives in the home said, The home is beautifully decorated and maintained to a high standard. All residents are encouraged to make this place their home. Everyone is encouraged to personalise their own living area and wishes are met as far as possible with regard to the communal areas. Care Homes for Adults (18-65 years) Page 19 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are appropriately recruited, trained and in sufficient numbers to meet the needs of the people who live in the home. Evidence: The home has a rota in place, which is flexible for the needs of the people who use the service. There is a policy and procedure in place for the recruitment of staff. Staff records showed that the required information, references and CRB checks were in place prior to staff commencing work in the home. On commencement of employment each member of staff has an induction programme.Staff receive appropriate training, which helps them with their work. There is very little turnover of staff in the home, they know the people well and positive comments in the surveys reflected this. Staff training files were examined which showed training had been carried out in Safeguarding People, Health and Safety Management, Food Safety, First Aid, Fire Safety, Medication and Mental Health training. At the time of the inspection all of the staff had either achieved NVQ level 2 or above or were working towards it. The home has a formal supervision system in place. One member of staff said, We have regular supervision meetings to see if there are any ways we need help or advice to do our job better. If I am not sure of Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: something I would ask management for advice or help. The home have recently achieved the Investors in People award. Care Homes for Adults (18-65 years) Page 21 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be assured that the home is well managed and they are given the opportunity to comment on how the home is run. Policies and procedures are in place to safeguard their health, safety and wellbeing. Evidence: The manager is qualified and competent to run the home. The home has an annual service plan in place and a quality assurance system. People who use the service are given a survey annually to complete to seek their views about life in the home and the service provided and staff give support to complete these. An action plan is then formulated to address any suggestions or concerns raised. People are also consulted informally on a regular basis and are encouraged to express their views. The home has health and safety policies and procedures in place. Training files showed that staff have received training in health and safety and fire Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: safety. Care Homes for Adults (18-65 years) Page 23 of 26 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 24 of 26 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 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 25 of 26 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. 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. Care Homes for Adults (18-65 years) Page 26 of 26 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!