Inspecting for better lives Key inspection report
Care homes for older people
Name: Address: St Marthas Residential Home 17 Thornhill Park Sunderland SR2 7LA The quality rating for this care home is:
one star adequate 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: Hilary Stewart
Date: 1 2 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 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 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 Older People Page 3 of 26 Information about the care home
Name of care home: Address: St Marthas Residential Home 17 Thornhill Park Sunderland SR2 7LA 01915656443 01915656411 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Gwendoline Swalwell Type of registration: Number of places registered: care home 24 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home St Marthas is a care home that provides personal care for up to 24 older people, some of who may have dementia or mental health needs. Nursing care is not provided. A day care service, meals at home, and a domiciliary care agency are operated from a designated area of the building. The house is a Victorian semi-detached property that has been converted to a care home and extended. It is over three floors and most of the bedrooms are on the upper floors. A passenger lift is provided. There is a large front garden with a paved terrace where residents and visitors can sit. The home is located in a quiet tree lined street in a residential area. It is a short walk into Sunderland City Centre where there are a range of amenities and shops. Care Homes for Older People
Page 4 of 26 Over 65 0 0 24 8 4 0 Care Homes for Older People Page 5 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: one star adequate 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: The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. How the inspection was carried out Before the visit We looked at the following; Information we have received since the last visit on 14th November 2007. 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 and the staff. The Visit Care Homes for Older People
Page 6 of 26 An unannounced visit was made on 12th November 2008. During the visit we, talked with people who use the service staff 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 had 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. Checked what improvements had been made since the last visit. 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. The fees for the home are from 381.00p to 394.00p per week. We told the manager what we found. What the care home does well: What has improved since the last inspection? All of the people at the home now have a copy of the terms and conditions so they know what to expect as a service when they live at the home. Some care plans and risk assessments have more detail so the staff have more information about some of the people who live at the home. More checks are carried out on medication so this helps to safeguard the people at the home. Some improvements and repairs have been carried out at the home so the people who live there have a more comfortable place to live. The staff now have better sluice facilities and protective clothing so the risk of cross infection has been reduced which will safeguard the people who live at the home. Care Homes for Older People Page 8 of 26 A trainee manager has been employed and they are about to start their training. The views of residents are being sought by the manager which are to be used in the planned quality assurance system. All wardrobes and exposed piping have been secured and repaired so this will help to keep the people at the home safe. 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 26 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 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 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 have an assessment by their care manager before they move into the home. The manager looks at this assessment to see if the home can meet the persons needs. They then carry their own assessment out prior to the person moving in so they can use this information for the care plan. People can visit the home before they make a decision. Evidence: People have an assessment by their care manager before they move into the home. The manager looks at this assessment to see if the home can meet the persons needs. They then carry their own assessment out prior to the person moving in so they can use this information for the care plan. People can visit the home before they make a decision. Care Homes for Older People Page 11 of 26 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 adequate 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 at the home have individual care plans, through which staff monitor and promote the health of the people at the home to maintain their wellbeing.This helps the people stay healthy.Some care plans did not have enough detail. Furthermore the manager and staff respect the privacy and dignity of the people who live at the home. This is so the people know that they are valued as individuals. Evidence: The trainee manager said and records showed that each person who lives at the home has an individual care plan. Records showed that the plans covered health and areas of daily living. The care plans looked at were general and each persons needs were presented in a similar way. Some needed more detail about how to meet the individual needs of each person. For example one persons care plan said that staff need to put the person in their wheelchair using the hoist but it didnt say how many staff, what size sling or how they should go about this task. Another persons care plan said take them back upstairs and tend to their needs but again did not give any detail about what the persons needs were, how many staff or of what gender were needed to carry
Care Homes for Older People Page 12 of 26 Evidence: out the tasks. Another persons care plan had sufficient detail for staff to know how to support them with their daily routine however another did not. One care plan stated needs help with personal hygiene but did not give any detail of what support the person needed and whether this should be carried out by male or female staff. It was not clear if risk had been assessed during the care planning process, especially around people who staff need to move and handle or who have continence issues. The trainee manager said that they have been working on the care plans but some still need to be improved. Care plans did not look as thought they had been reviewed. There are procedures for staff to follow when they deal with medication. The manager said that only staff who have received training in how to safely administer medication are given this task. Staff said and records showed that any changes of medication or medication procedures are recorded and followed. Two staff always sign them as a safety measure. The trainee manager said that people are supported to manage their own medication however this was not being risk assessed to see if it was safe enough. The medication records were up to date however when people had refused their medication the reason for this had not been recorded. Records showed that the peoples health care needs are met at the home. Details of visits by the district nurse, visits to their GP and hospital appointments are recorded in the individual files. The manager said that the health and welfare of the people who live at the home is monitored all of the time. One person who lives at the home said the staff look after me very well. Another said they keep an eye on you. The people who live at the home looked comfortable. One person said I get very good care another said I have no complaints. Care Homes for Older People Page 13 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live at the home are able to follow their own daily routines which satisfy their social cultural and religious needs. They can see their family and friends at any reasonable time. This helps to prevent them from feeling and becoming isolated. Evidence: The trainee manager and staff said that they arrange a variety of outings for the people who live at the home. Records showed that people are asked to suggest what they would like to do. The manager said that they have made staff aware of the need to include social activity in the care of the people at the home during their induction training. Records showed that some people had been involved in a variety of activities such as trips to the Alnwick Garden, the cinema, sing a longs and going out shopping. The manager said that people from Church visit weekly and they have singers. During the visit some people were playing dominoes. The manager said that during the summer people can have their lunch in the garden. One person said there is usually something to do another person said I just like to stay in my room. Staff and the people at the home said that relatives and visitors are welcome and encouraged to visit at any reasonable time throughout the day and evening. Visitors
Care Homes for Older People Page 14 of 26 Evidence: were observed during the visit. One visitor said I always feel welcome and another said the staff are very kind. The manager said that the people have been asked for their opinions about the food provided and the menus are based on the likes and dislikes of the people who live there. Menus are discussed in the residents meeting. A cook is employed and they said that there are choices at meal times and if people want something different they will make it for them. Special diets can be catered for. One person said the food is good another person said the food is fine. Hot drinks and snacks are always available throughout the day and evening. The kitchen was well stocked and there was fresh fruit and vegetables. Staff were observed sitting with people at meals times and talking with and supporting them. Care Homes for Older People Page 15 of 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints are dealt with so any problems are taken care of quickly which helps good relationships to be maintained however the home does not keep a record. Staff know about and most have had training in how to protect people from harm, so the people who live at the home are kept safe. Evidence: Copies of the homes complaints procedure are in the information about the home. The manager and staff said that the people who live at the home and their relatives know how to make a complaint. The trainee manager said that there had not been any complaints made since the last visit. A record of complaints is not kept at the home. One of the people at the home said I would tell the staff if I had a complaint another person said that they did not have any concerns. The manager said that all staff have had training in the homes safeguarding procedures during their inducation. There is a copy of the Local Authority procedures and the home keeps copies of their own adult protection procedures for staff. Staff said and records showed that most have had the homes training and they could describe what they needed to do if someone disclosed abuse to them. Staff said that they were familiar with the homes whistle blowing policy and procedure. Care Homes for Older People Page 16 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, 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. People live in a safe and clean home, although some repairs and improvement are necessary. Evidence: The home is comfortable, warm and clean. There are enough bathrooms and showers for the people who live at the home. Improvements had been made to some of the bedroom upstairs and they now have en suite facilities. Staff were observed cleaning the stairs and the bathrooms. All of the bathrooms had hand soap and paper towels to help avoid the risk of cross infection. Each person has their own bedroom and they looked comfortable and clean. They were all personalised and made very individual. One of the rooms had a noticeable odour, the manager dealt with this immediately. The laundry is organised and clean. There are adequate sluice facilities and the staff are provided with the necessary protective equipment. The hall had pictures of the people who live at the home on the wall. Thy were of the people when they were younger, the manager said this is partly to remind staff who the people are and their individuality.
Care Homes for Older People Page 17 of 26 Care Homes for Older People Page 18 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 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. Sufficient numbers of staff are in post to meet the diverse needs of the people who live at the home and they have opportunities for training so they know how to give them good care and meet their needs. Furthermore the home has a recruitment procedures in place, which help to prevent risk of harm to the people who live there. Some records did not show that all checks had been carried out. Evidence: Staff said that they receive training, which helps them with their work. The trainee manager said that all staff receive the training and support they need. Staff said and records showed that they all have mandatory training such as first aid food hygiene and fire training. The manager said that some staff have vocational qualifications. Sufficient staff were on duty at the time of the visit. Staff said and records showed that sufficient staff had been on duty in the home the previous week. One member of staff said there are plenty of staff which means you can spend time with the residents one of the people who live at the home said there always seems to be enough staff . The manager said that all staff have been CRB Criminal Records Bureau checked at an enhanced level to make sure they are suitable people to work at the home. All staff go
Care Homes for Older People Page 19 of 26 Evidence: through a recruitment process and they cannot not start to work at the home until this is completed. They are interviewed and are only successful when they have two satisfactory references. Copies of staff records showed that checks had been carried out. Some records showed gaps in staffs work history that had not been explored during the recruitment process. Care Homes for Older People Page 20 of 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The registered person is qualified and experienced and runs the home in the best interests of the people who live there and there are procedures in place that make sure they are protected as much as possible. Staff supervision does not happen as often as required and the home does not have a fully developed quality assurance system. Evidence: The trainee manager said that the people who live at the home and their families are asked their views about the running of the home as much as possible. One person said the staff are very nice and another said if I need staff they always listen. However the trainee manager was not sure if the home had a quality assurance system in place. The self assessment pre inspection questionnaire had not been returned at the time of the visit. Safety checks have been carried out on the equipment in the home such as testing
Care Homes for Older People Page 21 of 26 Evidence: electrical equipment and the servicing the central heating boiler. The manager said that fire safety risk assessments had been completed. The fire logbook showed that fire drills and fire instruction take place but fire instruction was not as regular as it should be. Staff said that they have fire drills and instruction. Records showed that regular training is provided for staff in fire safety and first aid. The manager said and records showed that they are qualified and experienced to run the home effectively. They have employed a trainee manager who they hope will take over from them. It was observed that there was a friendly atmosphere at the home and a pleasant rapport between the people who live at the home the manager and staff. The staff said that they could approach the manager and trainee manager with any concerns. Staff said that they liked working at the home. The trainee manager said that staff receive individual supervision and they have regular staff meetings but not as often as they should. Records confirmed this. The home has procedures for staff when they deal with the peoples money so it is kept safe. Records showed that staff sign records when any of the residents money is used and the manager checks them regularly. The transactions had not been signed by two staff to show that it was witnessed. Care Homes for Older People Page 22 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 Older People Page 23 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 1 7 15 The care plan must set out in detail the action to be taken by care staff to make sure that all aspects of health,personal and social care needs of the service user are met and they should be reviewed every month. Care plans must have enough detail which is up to date and accurate so staff have the information they need to meet each persons needs and keep them safe. 31/01/2009 2 16 22 The registered person must keep a record of any complaints made about the home. People at the home and their relatives must be sure that their complaints will be taken seriously and acted upon. 31/01/2009 3 29 19 The registered person must have a full employment 31/01/2009 Care Homes for Older People Page 24 of 26 history for every member of care staff they employ at the home , together with a satisfactory written explanation of any gaps in employment. This will help safeguard the people who live at the home by making sure only suitable people are employed to work there. 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 1 The home should review the Service Users Guide, make sure it is up to date and accurate as well as being in a format that people with dementia can understand. When people refuse their medication this should be recorded in the medication records. If people self medicate this should be risk assessed. The registered person must establish and maintain a system for evaluating the quality of the service provided to the people at the home. Written financial records of residents money should be signed by two staff when a transaction occurs. 2 9 3 33 4 35 Care Homes for Older People 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 Older People 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!
