Inspection on 09/12/08 for St Marks Court

This inspection was carried out on 9th December 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

St Marks Court 15/01/10

St Marks Court 31/03/08

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: St Marks Court 73 Split Crow Road Deckham Gateshead Tyne and Wear NE8 3SA     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: Irene Bowater     Date: 0 9 1 2 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 Older People 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 Older People Page 2 of 28 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 Older People Page 3 of 28 Information about the care home Name of care home: Address: St Marks Court 73 Split Crow Road Deckham Gateshead Tyne and Wear NE8 3SA 01914901192 01914901797 stmarkscourt@schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Southern Cross BC OpCo Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 60 Number of places (if applicable): Under 65 Over 65 0 60 dementia old age, not falling within any other category Additional conditions: 20 0 The maximum number of service users who can be accommodated is: 60 The registered person may provide the following category of service only: Care Home with Nursing, Code N To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following categories: Old Age, not falling within any other category, Code OP - maximum number of places 60 Dementia, Code DE, maximum number of places 20 Date of last inspection Brief description of the care home St Marks Court is a purpose built detached care home standing in its own grounds and registered to provide personal and nursing care. This can include offering care to people who have a diagnosed dementia or mental health as well as a physical disability. Care Homes for Older People Page 4 of 28 Brief description of the care home It is located in the Deckham area of Gateshead and is close to a local housing estate and community shopping facilities. It is on a recognised bus route, which offers easy access to the surrounding estates and shopping areas and also to Gateshead town centre and Newcastle city centre. The accommodation consists of 60 single bedrooms all with their own en suite toilet facility. Accommodation is spread out over three floors and a passenger lift offers easy access to all floors. There is a variety of living space throughout the home with six lounges and three dining rooms. There are bathrooms, showers and toilets on each floor. All are easily accessible. The ground floor is occupied by people who have personal care needs, people with assessed nursing needs occupy the first floor and the second floor is currently used for people who have a diagnosed dementia or mental health illness. The fee rates range from 348 pounds up to 535 pounds. This includes the nursing contribution, which is set nationally. Care Homes for Older People Page 5 of 28 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 Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: Before the visit we looked at information we have received since the last visit on the 25 March 2008. How the service dealt with any complaints and concerns since the last visit. Any changes to how the home is run. The providers view of how well they care for people. The views of people who use the service,their relatives,staff and other professionals. We checked the cost for people living in the home.And the fee rates vary from 400 pounds from social and personal care to 596 pounds for nursing care. Items such as toiletries,clothing,newspapers and hairdressing are extra. We have reviewed our practice when making requirements,to improve national Care Homes for Older People Page 6 of 28 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. The Visit. An unannounced visit was made on the 9 December 2008.This visit was carried out by two inspectors and took seven hours to complete. During the visit we: Talked with people who use the service,staff,relatives and the manager. 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. Checked that staff have the knowledge,skills and training to meet the needs of the people they care for. Looked around the building to make sure it was clean,safe and comfortable. We told the manager what we found. What the care home does well: What has improved since the last inspection? The staffing levels on the dementia care unit have been increased which means people Care Homes for Older People Page 8 of 28 are receiving a more person centred care delivery.This in turn promotes their well being. Despite the lack of a permanent manager the staff have continued to be very professional and have maintained the previous excellent standard of care for those who live in the home. 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. 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 Older People Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive clear information about the service and a comprehensive assessment of need before admission.This helps them make the right decision about using the service. Evidence: The home sets out the aims and objectives of the service in a Statement of Purpose and Service User Guide,both are readily available in the home. The Service User Guide is easy to understand and is also available in audio style if necessary. There is reference to supporting the diversity of needs,cultures and beliefs of all those involved in the home. Care Homes for Older People Page 11 of 28 Evidence: Before anyone is admitted a full needs assessment is undertaken by a Care Manager,the Home Manager and where necessary the nurse assessor.From this information the staff complete a care plan based on individual needs. Also the home confirms in writing to each individual that they can meet their needs and everyone has a contract that sets out the terms and conditions while living in the home. Care Homes for Older People Page 12 of 28 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Excellent care planning and access to heath care means people receive a quality and person centred approach to care which means they can have a quality of life. Evidence: Each person has a plan of care based on the admission assessment which has been carried out by care managers,the home manager and when necessary nurse assessors. Staff have completed pressure ulcer risk,dependency,moving and handling,nutritional assessments using the Malnutrition Universal Screening Tool(MUST),continence and fall risk assessments. These tools help the staff understand the level of risk for each person and helps them complete a plan of care. Care plans and risk assessments are reviewed and updated on a monthly basis. Staff have contacted Speech and Language Therapists (SALT) when there have been concerns about people having difficulty swallowing and being at risk of choking. Care Homes for Older People Page 13 of 28 Evidence: People who have been identified at having lost weight have risk assessments in place to show how they are being supported with eating and drinking. Food charts are clear about what alternatives are offered and accepted which means staff can be sure that individuals have a nutritionally sound diet.Those who are at risk have their weights regularly recorded and advice sought if necessary. Care plans state when hoists and slings are to be used and staff specify which hoist and sling and detail the moving technique that everyone should follow. Appropriate pressure relieving devices are available.Several people have air cell mattresses and cushions to prevent pressure damage. Advice is sought from the tissue viability nurse and clear records are available to show whet action is being taken. Information about peoples lifestyles and preferences are recorded.And plans show that a person centred approach to care is being given. Everyone has access to all NHS facilities to ensure their health care needs can be met.There are regular visits from GPs and other health care professionals including occupational therapists,physiotherapists,dentists,opticians and chiropody services. Medication policies and procedures are readily available for staff to use. Records are in place for all medicines received,administered and disposed of. An audit of Controlled Drugs and the Medicine Administration Records (MAR) showed no discrepancies. Handwritten directions on the MAR did not have two signatures. There are medicine storage facilities on each floor and the arrangements for storage needs to be reviewed in line with current requirements. Many of the staff have worked at the home for some times and know the people they care for well. All of the staff worked very hard to make sure everyone was treated with respect and their rights to privacy and dignity maintained. Care Homes for Older People Page 14 of 28 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. 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. Opportunities to take part in meaningful activities and keep control of everyday decisions are excellent and mealtimes are well organised. This makes sure people can lead full and active lives. Evidence: The home benefits from two enthusiastic activities people who organise events both inside and out of the home. Some events take place in groups, other people have some individual time allocated to them. The home also produces a monthly newsletter to let people know what is happening and lets then and any other visitor and keep abreast of current events in the home. Various activities have been planned for the Christmas Season and people said they were looking forward to having a nice time. An activity programme is in place and includes bingo,exercises,board games, one to one and coffee mornings. Comments from surveys included: We have bingo,raffles,pie and pea suppers and Care Homes for Older People Page 15 of 28 Evidence: concerts. The dementia care unit is now using prompts and signage to help people find their own way around the unit and there are items displayed on the corridor walls to encourage people to touch and provide items of interest. Visitors are welcome at any time and are able to use the lounges or their relatives bedrooms for visits. Information about advocacy is available in the home. Many people have brought small items with them making their rooms homely and reflective of their previous lifestyle,religious beliefs and cultural backgrounds. There are three dining rooms in the home.Should anyone prefer to eat their meals in their own rooms this service is provided. At breakfast time people were having bacon, eggs, porridge, cereals, preserves, juices, jams, bread and toast.All of the tables were appropriately set for this meal and everyone said they always enjoy breakfast. Tables were set to a very high standard through out each unit. Napkins were in napkin holders with matching table cloths, appropriate cutlery and condiments. Each table had a small vase of fresh flowers and an up to date daily menu. Choices for lunch included chips,salad,chicken and vegetable pie,bacon steaks tomatoes,mashed potatoes,cauliflower,swede. Dessert choices included chocolate pudding and custard,ice cream fruit and yoghurts. Pro cal calorie food enricher was available and staff were aware of the need for some people to have supplements in their nutritional intake to maintain their weight. Meal times on each unit was very well organised.People remaining in their rooms were served and then staff assisted people into the dining room when the meal was ready to be served. The atmosphere during the meal time was quiet, there was good choice being offered, and the staff were attentive,pleasant and gave assistance where needed in a sensitive unhurried manner. Comments from surveys included: The food always looks nice. Meals are varied and appetising. Care Homes for Older People Page 16 of 28 Evidence: There was only about two and a half hours between breakfast finishing and lunch starting and there was quite a lot of food wastage at lunch.The timings of meals should be looked at so that main meals are offered at more reasonable intervals. Care Homes for Older People Page 17 of 28 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. 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. Excellent complaints and protection systems are in place which protect people from harm. Evidence: The Company have detailed complaints and safeguarding procedures which are easy to understand and they are readily available in the home. The home keeps a full record of all complaints including detail of any investigation and action taken within timescales. Six complaints have been received at home level.Five have been resolved and one is being investigated by the home. There have been no complaints or safeguarding referrals made to the the Commission. Staff have completed Safeguarding training and training in dealing with potentially difficult situations. Staff were able to discuss what action they would take should there be any suspicion or allegation of abuse and there is written information and procedures in the home should they need further guidance. Care Homes for Older People Page 18 of 28 Evidence: Comments from surveys included: When there have been any problems the staff have always listened and acted as necessary. Care Homes for Older People Page 19 of 28 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, 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. 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 offers accommodation which is clean and well maintained and promotes peoples comfort and welfare. Evidence: The home is purpose built and set in a residential area close to local facilities and bus routes. There are three floors which can be accessed by stairs or a passenger lift. All of the communal areas have been furnished and decorated to a high standard and on the day of the visit all of the areas were nicely decorated for the Christmas period. The dementia care unit is on the second floor and the decoration is being changed so that people with memory loss can find their own way around and maintain their independence for as long as possible. Bedrooms for single use and have an en-suite facility.People living in the home have been encouraged to bring small items with them making their rooms individualised and reflective of previous lifestyles. Care Homes for Older People Page 20 of 28 Evidence: There is some scuffing to walls from wheelchairs and trolleys throughout the home. The laundry is large and had soiled and clean areas.Infected or soiled linen is dealt with by using specialist bags so there is no direct handling. Hand washing facilities are readily available in all areas and staff have completed training in infection control procedures. The staff work very hard to keep the home clean and free from any odours. Care Homes for Older People Page 21 of 28 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. 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. Staffing levels and systems around recruitment and training are good and meet the needs of the people currently using the service. Evidence: The home does not have a permanent manager.Managers from sister homes come to manage the service for short periods of time. Also the deputy manager is allocated some supernumerary time. Staffing levels in the dementia care unit have now increased to one senior and two care staff during the day.This is a good improvement as people are receiving care based on a person centred approach to care . On the day of the visit there were two qualified nurses on duty with six care staff. Ancillary staff included administration,chef,kitchen assistants,housekeeper,domestics and maintenance staff. The procedures for recruitment and selection of staff are followed.There was evidence of Criminal Record Bureau checks,two written references,proof of identity and professional identity numbers for registered nurses. Care Homes for Older People Page 22 of 28 Evidence: The files show that all staff complete an induction programme and mandatory training including fire,first aid,moving and handling, infection control and food hygiene is completed. The training matrix shows that although this training has been completed it needs to be reviewed and updated for the coming year. Over 84 of staff have a National Vocational Qualification and know peoples care needs very well.Staff turnover is low and they know peoples care needs very well. Training also includes use of a syringe driver,verification of death,resuscitation,continence care,safe administration of medication and dementia care training. Comments from surveys included: The staff are really understanding Care Homes for Older People Page 23 of 28 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. 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. There are good management arrangements in place which take into account the views of the people living in the home. The appointment of a manager will give additional leadership and make sure that there continues to be good outcomes for the people living there. Evidence: The home is without a permanent manager.Managers from other services are deployed to make sure consistent care delivery and management of the service. Also the deputy manager has been given some supernumerary time for management of the service and she is said she is supported by them and the Regional Manager. During the visit the inspectors were approached by a number of care staff who were concerned about the management situation and their ability to provide the care they feel they should provide given the staffing levels when there was sickness. They agreed that they were managing to provide good care as they were committed to Care Homes for Older People Page 24 of 28 Evidence: doing so and that they had received the appropriate training to allow them to do so. Comments from surveys included: Length of time without a manager has caused some complications. Hand overs are not always 100 . Audits of care and other services are carried out with actions and outcomes recorded.The regional manager visits on a monthly basis to make sure the quality of the home continually improves. The AQQA was completed and the information gave a good picture of what was happening in the home and also gave clear information about how it plans to develop over the next year.This was completed by a manager who was in the home for only a short period of time and could be speculative. Staff,relative and resident meetings take place with minutes kept. The last relative meeting took place in October 2008 and was attended by five relatives. One comment included,can we expect the same level of care as we have had in the past and another saidmy wife is getting excellent care. The personal allowance records demonstrate that receipts and double signatures are maintained for all transactions.These can be cross referenced and regular checks are carried out to make sure there are no discrepancies. Records of monthly staff supervision is available.Records show that formal supervision is falling behind the required six times a year. Mandatory training is up to date and further training is planned.Health and safety risk assessments are clear and up to date. Accidents are recorded and best practice is used to examine and track trends which prevents as fare as possible the same accidents or incidents happening. Internal health and safety checks are available but there are gaps in recording between October and December 2008.External contract certificates are up to date. Care Homes for Older People Page 25 of 28 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 Older People Page 26 of 28 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 9 13 The storage of medication 30/06/2009 must be reviewed and appropriate metal cupboards provided. This will ensure the safe storage of medicines in the home 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 1 15 It is recommended that the timing of the main meal is reviewed so that staff can make sure peoples nutritional needs are being met. It is recommended that an ongoing decoration programme is implemented so that the home maintains current good standards. It is recommended that the training programme is reviewed to make sure all staff have up to date training. It is highly recommended that recruitment of a permanent manager progresses as soon as possible. The current managers should continue to update formal supervision with all grades of staff. Page 27 of 28 2 19 3 4 5 30 31 36 Care Homes for Older People 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 Older People Page 28 of 28 - 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!