Inspection on 21/01/09 for St Mary`s House

This inspection was carried out on 21st January 2009.

CSCI found this care home to be providing an Good 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.

Other inspections for this house

St Mary`s House 01/02/07

St Mary`s House 01/03/06

St Mary`s House 18/10/05

St Mary`s House 09/12/04

St Mary`s House 29/06/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: St Mary`s House 38/39 Preston Park Avenue Brighton East Sussex BN1 6HG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Gwyneth Bryant     Date: 2 1 0 1 2 0 0 9 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 24 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 24 Information about the care home Name of care home: Address: St Mary`s House 38/39 Preston Park Avenue Brighton East Sussex BN1 6HG 01273556035 01273556035 stmaryshousebrighton@tiscali.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): The Grace and Compassion Benedictines Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 22 Number of places (if applicable): Under 65 Over 65 22 old age, not falling within any other category Additional conditions: 0 The maximum number of service users who can be accommodated is 22 The registered person may provide the following category/ies of service only: Care home only - PC 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 - OP Date of last inspection Brief description of the care home St Marys House is a residential home registered to provide care and accommodation for up to twenty-two older people. The home is owned and run by the Benedictine Sisters of our lady of Grace and Compassion. No nursing care is provided at this home. District nurses will provide nursing input for those residents requiring this. The home is comprised of two detached properties, which have been joined together for its current use. It is situated within walking distance of local shops and bus routes into Brighton Care Homes for Older People Page 4 of 24 Brief description of the care home and overlooks Preston Park. All rooms are for single occupancy and are located over three floors. All rooms are provided with en suite facilities. There is passenger shaft lift available to assist residents in accessing all areas of the home. There is a good-sized lounge room and dining room for residents to use. There is a chapel on site and a large accessible garden at the rear of the home. There are five communal toilets located throughout the home and five assisted bathing facilities; four assisted baths and one wheel in shower. There is limited parking available at the home, however free parking is available in adjacent streets. There are six rooms available at the home that are designated for visitors that may require accommodation when visiting. The current fees range from £300 to £389.55. per week. There are additional fees for hairdressing and dry cleaning. Prospective residents find out about the home through social services referrals, word of mouth and from themselves/relatives living in the area and through the church. Care Homes for Older People Page 5 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home 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: This was an unannounced inspection and took place over 4.5 hours hours. The purpose of the inspection was to check compliance with key standards. There were sixteen people in residence on the day of which nine were spoken with. The appointed Manager, an administrator and a carer were also spoken with. A number of documents and records were viewed; including personnel files, medication charts and care plans and a tour of the premises was also carried out. Prior to the site visit we asked the Registered Providers to complete an Annual Quality Assurance Assessment (AQAA). The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. This was provided a but was very brief and Care Homes for Older People Page 6 of 24 did not accurately reflect the positive and proactive aspects of the service. An Expert by Experience accompanied the inspector on the day. An expert by experience is a person who, because of their shared experience of using services, and/or ways of communicating, visits a service with an inspector to help them get a picture of what it is like to live in or use the service and their comments and findings are included in this report. Prior to the site visit surveys were sent to residents and six were returned and comments were positive with people indicating that they are satisfied with all aspects of the care given. The last key inspection was carried out on 1 February 2007 and an Annual Service Review undertaken on 31 March 2008. 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. 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 8 of 24 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 9 of 24 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 moving into the home benefit from an admission process that ensures their care needs are assessed and identified as being able to be met prior to moving into the home Evidence: The pre admission assessments for four residents were viewed and although they were of a tick box format it was good to note that the space for additional comments had been completed for each person. This enables the home to gather detailed information on individual care needs and use it to inform the care planning process. Care Homes for Older People Page 10 of 24 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care planning systems ensure that the health, social and personal needs of those living in the home are identified and planned for in a consistent and comprehensive manner. Evidence: Four care plans were viewed and were found to include all aspects of care needs and clear direction to staff as to how to best meet those needs. The plans clearly outline the individual preferences in respect of the delivery of care with particular reference to respecting choice, privacy, dignity and independence each of which gives residents control over their daily lives. Each residents care plan includes details of their preferred daily routines such as food likes and dislikes and times for getting up and going to bed. Daily notes are well maintained and provide detailed information as to how individual residents spent their day and to inform the review process. One of the Sisters is trained in Aromatherapy and she has begun to provide this for residents following consultation with the GP. Each care plan included detailed risk assessments for those people who go out alone, for the environment within the home and for those Care Homes for Older People Page 11 of 24 Evidence: who manage their own medication. The risk assessments are reviewed regularly and adjustments made based upon the current needs of the individual resident. There was clear information on healthcare needs such as opticians, chiropody and other medical needs. The home provides assistance for healthcare appointments if required but the autonomy of others is respected and they arrange their own appointments. It should be noted that there is agreed processes to ensure residents share some information with the manager to ensure she remains fully informed on their healthcare needs. Medication Administration Records (MAR) were viewed and found to be well maintained with all signatures clear and providing evidence that medication has been given. Residents are encouraged to manage their own medication within a risk assessed framework and many do so. The risk assessments for self medicating were found to be very detailed and reviewed monthly. People spoken were highly complementary of staff with comments such as: - I cant fault them in any way. - They are all marvellous. - I feel very lucky to live here. Care Homes for Older People Page 12 of 24 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. People in the home have the opportunity to experience a lifestyle that matches their expectations, choice and preferences in respect of leisure activities and meals. Evidence: Residents have a wide range of opportunities to participate in a variety of activities both within the home and in the wider community. The home has a daily programme of activities and a record is maintained detailing which residents took part in particular activities as part of the monitoring process. One resident said they preferred to spend most of their day in their room reading and this is respected by staff. Comments in surveys included: - Meals are good both in quality and quantity. - St Marys is a perfect home The expert by experience found that the activities provided appeal to some residents more than others with the most popular one being the armchair exercises held on Thursdays run by someone from outside the home. While the lift has been out of action the exercise person has visitied individuals in their rooms to provide one-to-one exercises. A number of people remain independent and go out for walks or shopping Care Homes for Older People Page 13 of 24 Evidence: alone, with staff escorting those residents who need support to access the wider community. One person told the expert by experience that although their room is small they use the tea station adjacent to their room which enables them to pursue their chosen activity of writing articles. There is a Chapel within the home with services held throughout the day, in addition to arrangements for ensuring residents are able to worship in local churches of their chosen denomination. There are policies and procedures on respecting residents dignity and privacy and all are offered keys to their bedrooms. Throughout the site visit staff were seen to treat individuals with care and respect and it was evident that comfortable working relationships had been developed. The home operates an open house visiting policy with visitors welcome at all reasonable times. Residents spoken with confirmed that their families and friends visit and staff make them feel welcome. Menus were viewed and found to be varied, nutritious and well balanced. Although the menu does not include alternative meals all residents spoken with confirmed that they are able to have a choice at all mealtimes. The provision of tea stations throughout the home enable residents to make drinks and snacks when they choose and one person said they use the nearby tea station to make their own breakfast and drinks every day. The expert by experience spoke to one resident who felt that the time between the supper meal breakfast was too long. This was discussed with the manager following the site visit who agreed to ensure all residents are aware they can have a drink or snack later in the evening. The expert by experience joined residents for lunch and found the meal to be well presented and tasty. The meal was unhurried and staff were on hand to assist residents with their food if required. After the meal the cook came in to ask if everyone had enjoyed the meal and explained why mashed potatoes were served rather than plain boiled as advertised. Care Homes for Older People Page 14 of 24 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a satisfactory complaints procedure with evidence that residents feel that their views are listened to and acted upon and service users are further protected by satisfactory safeguarding adult procedures. Evidence: Information in the AQAA indicated that there are policies and procedures on both complaints and Safeguarding Adults. There is a complaints and compliments book held in the entrance to the home and this showed that no complaints had been recieved. There is also a suggestion box in the communal area which allows residents to raise issues anonymously but the box was empty. All of the residents spoken with said that they would be happy to approach the manager or any of the staff if they had any concerns. Other documents such as care plans showed that the manager and staff consult with both residents and their families on a range of topics to ensure all parties are happy with the way the home is run. Staff training records showed that all staff are trained in Safeguarding Adults and this is included as mandatory training within the homes staff training programme. Care Homes for Older People Page 15 of 24 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. All parts of the home are homely, safe, well maintained and comfortable ensuring that it is a pleasant place in which to live. Evidence: On the day of the site visit the passenger lift was being replaced, however the situation was well managed. For those residents accommodated on the upper floors who were unable to manage the stairs a room had been arranged to enable them to take their meals as a group. For those who chose to eat in their rooms staff took meals to them. Each of the people spoken with were very happy with the arrangements. A tour of the premises was carried out and a random selection of rooms viewed. The home continues to provide a safe and comfortable place in which to live. Individual bedrooms were well maintained and pleasingly decorated as were communal parts of the home. Care plans showed that people in the home are encouraged to bring in their own possessions and furniture to personalise their rooms and many have done so with ornaments, pictures and photographs. All bedrooms have locks fitted and residents offered keys to promote independence and privacy. Individual bedrooms were of variable sizes with those in the older part of the building tending to be smaller than those in the extension, however there is ample communal space and all of the Care Homes for Older People Page 16 of 24 Evidence: residents spoken with were happy with their chosen room. The expert by experience noted that the dining room was light and pleasantly laid out with tables set for four people. There are two sitting rooms, one which includes a television, DVD and CD players and while the smaller lounge is used as a quiet room. There is an on site laundry that has washing machines that can wash clothes at temperatures that reduce the risk of infection. Staff receive training in infection control and it was good to note that all bathrooms and communal toilets had a plentiful supply of gloves and aprons. Care Homes for Older People Page 17 of 24 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. Residents benefit from a dedicated and competent team of staff and are protected by the robust recruitment procedures. Evidence: Recruitment records for the last three people to be employed were viewed and all had provided all the required documentation including Criminal Record Bureau checks, two written references and proof of identity. All new staff have an induction period that is carried out in line with the Skills for Care requirements. At the time of the inspection, the atmosphere was observed to be friendly and relaxed and the positive relationships between staff and residents were obvious. There are twenty-three permanent care staff some of whom are also Sisters of the Order. In addition cooks, administration staff and a maintenance person are employed with two volunteers, one of whom does the shopping for individual residents. Of the twenty-three care staff all but two have already achieved National Vocational Qualification at level 2 in care and the remaining two are in the process of gaining this qualification. Discussion with the manager and examination of the staff training records found that training is ongoing with mandatory training in fire safety and moving and handling treated as priority for all new staff and additional training is provided such as Food Safety, Infection Control and First Aid. One of the Sisters is qualified in Aromatherapy and other Sisters have specialist training in Dementia Care, Diabetes and Parkinsons Disease. Care Homes for Older People Page 18 of 24 Evidence: Care Homes for Older People Page 19 of 24 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. The service is well managed and all aspects of the welfare, safety and health of people living in the home are protected and promoted. Evidence: The Manager has experience of managing a care home and has an National Vocational Qualification in Care at level 4 in addition to holding the Registered Managers Award. She is in the process of applying to become the Registered Manager and it is evident that she provides clear leadership and direction to staff. Both staff and residents said that she was approachable and they felt they could raise any concerns with her or senior staff. It would be good practice to ensure that the next AQAA submitted is more detailed and accurately reflects the quality of the services provided. The atmosphere of the home is open and throughout the site visit staff were obviously comfortable approaching the manager with any queries. She is very knowledgeable about the dayto-day practice of the home and equally knowledgeable about the individual needs and preferences of people living in the home. The home holds some monies on behalf of Care Homes for Older People Page 20 of 24 Evidence: residents and all transactions are recorded and receipts provided. In addition all transactions are signed and witnessed by two staff and the resident also signs for each transaction. The overall feeling of the expert by experience was that St Marys is a good Home, well run with concern for the residents paramount. The AQAA indicated that there are regular meetings with all staff and residents to ensure they are consulted on how the home is run and as part of the quality monitoring service. Information in the AQAA showed that regular safety checks are carried out on all equipment, including electrical and gas appliances and systems. In addition there is an on-going programme of maintenance, upgrading and renovation of all parts of the home, including individual rooms. Work on the lift was due to finish within the week but the manager had ensured that fire safety arrangements were adjusted to take into account those residents who were unable to use the stairs in the event of fire. All staff receive regular fire safety training and a fire risk assessment has been carried out to ensure no part of the home poses a fire risk. Regular fire drills are carried and fire alarm systems regularly tested ensuring neither staff nor people living in the home are at risk in the event of fire. Self-closing devices, triggered by the fire alarm are fitted to all internal doors that require them. All accidents are recorded and monitored as part of the quality monitoring process to ensure that any risk areas can be addressed promptly. Care Homes for Older People Page 21 of 24 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 22 of 24 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 Older People Page 23 of 24 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 24 of 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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!