Inspection on 10/03/09 for The Franciscan Convent

This inspection was carried out on 10th March 2009.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Franciscan Convent 24/01/07

The Franciscan Convent 14/03/06

The Franciscan Convent 20/09/05

The Franciscan Convent 15/03/05

The Franciscan Convent 16/08/04

The Franciscan Convent 04/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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: The Franciscan Convent 26 East Park Road Blackburn Lancs BB1 8BB     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: Marian Whittam     Date: 1 0 0 3 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 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: The Franciscan Convent 26 East Park Road Blackburn Lancs BB1 8BB 0125453962 01617946420 janet-con@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Franciscan Missionaries of St Joseph care home 13 Number of places (if applicable): Under 65 Over 65 13 old age, not falling within any other category Additional conditions: 0 The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Female whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 13 Date of last inspection Brief description of the care home Franciscan Convent is a registered charity, run by the Franciscan Missionary of St. Joseph. The Roman Catholic faith underpins the life of the home, and many of the routines are those of Convent life. Franciscan Convent is a home caring for the elderly Sisters of the Congregation; there are also places for lay people. The house is a detached property set in its own grounds in a quiet residential area of Blackburn. There is level access to the lawned gardens and flowerbeds surrounding the house, and garden furniture is provided. There is ample car parking space. There are local shops within walking distance and a bus stop nearby. Accommodation is provided for thirteen people in 9 single and 2 shared bedrooms, Care Homes for Older People Page 4 of 29 Brief description of the care home some bedrooms are en-suite. Bedrooms are situated on the first floor. A passenger lift enables ease of access. There is ample communal space in 3 lounges and 1 large dining room. The convent also has its own chapel on the ground floor and services are held daily. Offices are situated on both ground and first floor. The kitchen is on the ground floor and the laundry at basement level. Various aids and adaptations are provided throughout the home. Bathrooms and toilets are well equipped with appropriate aids to help independence. There is ample space to ensure staff can offer assistance if necessary. Information about Franciscan Convent is sent out to prospective residents in the Statement of Purpose and service users guide when they enquire about admission. The latest CSCI inspection report is also available for people thinking of coming to live there. At the time of the last visit to the home the weekly fees were three hundred and ninety five pounds per week. There are additional charges for hairdressing and extra newspapers. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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: This site visit to The Franciscan Convent forms part of a key inspection. It took place on 10th March 2009 and we (The Commission for Social Care Inspection, CSCI) were in the home for seven hours. This visit was just one part of our inspection of the service and we looked at other information we had about the home. We gathered other information in the following different ways. Before the site visit the homes registered manager was asked to complete and return to us an Annual Quality Assurance Assessment (AQAA). This is a self assessment questionnaire to give us up to date information about the home, what they do well, how they can show this and also what they have identified as a problem or something that needs to be improved. It also gives us information about the people living there Care Homes for Older People Page 6 of 29 and using the services. We looked at the homes service history and how the manager had dealt with any complaints or requirements made. We sent out questionnaires to staff and people living in the home to get their comments on aspects of the service. We spoke with people living in the home about their experiences of life there. We spent time with people during their day and observed staff interaction and daily routines people had chosen. We also joined the people living there for a meal in the dining room during our visit. We spoke with people visiting the home and also with staff working there to get their views and opinions. During the visit we also looked at peoples care plans and their assessments of need and individual preferences. We did this to help make sure that the level of care people received met with their needs as individuals. We made a tour of the building and grounds to look at the environment people lived in to make sure it was clean and safe and had suitable equipment and adaptations to meet the needs of people living there. We looked at a sample of records and documents required by the regulations including training and supervision records and staff personnel files. We assessed the handling of medicines through observation, the inspection of relevant documents and storage facilities and meeting with the manager. The home provides information on the fees charged and what these include to all people living there. At the time of the inspection the fees were three hundred and ninety five pounds a week. What the care home does well: People living in the home that we talked with spoke very highly of the staff and the manager and sisters living in the home and the help, support and comfort they get from them. The home provides a very comfortable, homely and supportive atmosphere for the people living there and enabled them to lead the kind of lives they want and that meets all their needs, health, personal, social and cultural and religious. We could see that staff had a good rapport with the people living there and they demonstrated that they knew them well and their families. People living there commented to us: I just marvel at how the home is run, it works so well. It really is a good place to be, plenty of staff and full of goodwill. I decide what I do, it is run for us and I have settled in very happily and would not live anywhere else. I made the right choice. I had no problem settling in, I settled straight away, the staff were so helpful and so happy. I am very happy and everyone is so friendly. The food is very good, its all home made and always looks so good. The home is kept clean and tidy and is attractively furnished to a high standard throughout. Attention is paid to details that show respect for the individual such as the high standard of laundry which one person described as done beautifully and ironed so perfectly down to the last frill. Peoples rooms reflect their tastes and interests with pictures, ornaments, photographs and soft furnishings and items of their own furniture. Although not a large home there is a high level of support and provision for people to follow their own interests and beliefs. Opportunities for leisure and recreation are provided on an individualised basis both inside and outside the home. People told us how much they had enjoyed their regular trips out, social events, shopping trips and even holidays but that did not have to join in if they did not want to but have their privacy respected. People from the local community and from other religious communities visit the home and take part in the daily religious services. Local people who attend also take coffee and stay for a chat with residents and there is an informal and welcoming atmosphere. One visiting relative told us I have never once had a reason to complain, its so clean and welcoming. I am always made to feel at home and involved. People living here are encouraged to handle their own affairs and remain as independent as they can. People who wish to and are able are supported to handle and take their own medication and some cook meals for themselves to help maintain their independence and live the life they chose. The home works well with health care professionals and other agencies to provide nursing care if needed and obtains specialised support and advice. There is a stable staff team that provides continuity of care and the robust recruitment procedures and high level of staff training help to ensure that people living there are cared for competently and safely. The high level of quality monitoring and consultation with the people living there also helps to make sure that the home is run in the best interests of Care Homes for Older People Page 8 of 29 people living there. 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 9 of 29 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 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them 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 coming to live at the Franciscan Convent are given information about the home and have their needs assessed to make sure that the service they receive is based on their personal needs and preferences. Evidence: Clear and comprehensive information is available in the statement of purpose and service user that is given to all people living in the home and people asking about using the service. This level of information helps to make sure that people thinking of coming to live there and their families know what the home can provide to meet their needs and helps them make an informed decision. People living there have contracts and terms and conditions of their residence so they are aware of their rights and responsibilities whilst living there The registered manager makes sure an assessment of peoples needs and expectations Care Homes for Older People Page 11 of 29 Evidence: is done before and when they come to live there so they can be sure they can give them the care and support they need. This includes gathering information from other agencies and health care professionals involved in their care and any treatment. There is a trial period when people first come into the home to make sure it suits them but because the home provides for the needs of people who want to live in a religious and holistic environment many of the people living there have made previous visits or they have lived at the convent. Therefore they are familiar with with the convent and lifestyle and the manager and staff know them already and the people we spoke with confirmed that this was the case. When people have asked to live there the manager makes sure they come for a visit and given information about the service. They are also given a copy of the last inspection report. Admissions to the home are managed sensitively with the emphasis on supporting people and providing a homely atmosphere. Relatives of people who have previously lived there still visit to give support and be involved in the life of the home. They say it is like coming home. Care Homes for Older People Page 12 of 29 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. People living at the Franciscan Convent receive the care and support they want in a way that protects their privacy and dignity and meets their individual expectations. Evidence: All the people living in the home have a clear and easy to follow individual plan of care, based on their initial assessments and preferences. Each persons care plan we looked at set out clearly their health, personal and social care needs and people had signed their plans indicating their agreement to it. We looked at four peoples care plans in detail and these had relevant and clear risk assessments in place. These included nutrition assessments, mobility and dexterity, moving and handling, personal care, social and cultural needs and preferences, assessments for self medication and skin and pressure area care. These assessments had been reviewed and changed as needed to make sure they correctly reflected peoples needs and expectations. Staff we spoke with and people living there all confirmed that the care given was focused on the individual and what they wanted from their care and life in the home. One person living there told us about the care that staff provided for them and that, They go at Care Homes for Older People Page 13 of 29 Evidence: my pace, they ask what I want and how I want things done. They have respect for everyone. The level of information in the care plans and on individual perspectives helps ensure that care staff are aware of needs on a very individual basis and people have their own daily activities plans. For some this plan includes how they like to structure their day around their faith and attending the chapel within the home. We could see that care plans are frequently reviewed so information is up to date and discussions take place with GPs, relatives and advocates when care is reviewed and this can be on a weekly basis if a persons health is deteriorating. There is evidence of prompt referral to health services and support agencies such as dental, chiropody and district nursing services, mental health professionals, the memory clinic and of effective working with these. Some members of staff have completed courses on care of the dying and others are due to go on this training. Systems are in place to provide care and comfort for people whose condition is deteriorating with support from appropriate health care professionals. From information in care plans, from letters received from relatives and from speaking to people living there and the staff it was evident that great care is taken to support people towards the end of their lives according to their specific wishes. Family and friends are supported to remain with people and there is accommodation available for them to use so they can be close by. We did a spot check of the medicines storage, handling and records and how these were appropriately monitored and managed. The home receives regular medicines in a monitored dosage system (MDS). The designated place for storing the MDS was secure and only staff who handle it have access. Staff administering medicines take the MDS out to people in the home. We discussed with the manager the need to consider how to transport these medicines securely and safely in the home at medicine rounds. A mobile lockable drugs trolley was not used but for safe practice there needs to be a secure way to transport these medicines from the storage area to people. A mobile trolley may not be very homely in this environment and it may be difficult to balance the wishes of the people living there with a structured system. However in keeping with The Royal Pharmaceutical Society of Great Britain guidance on Handling Medicines in Social Care the manager needs to have an effective way to quickly secure medicines being taken out to people should the need arise. The manager should consider how to do this to fully safeguard the safety of people living there. There was evidence of good practice with regards to the checking and recording of the receipt and disposal of medicines and a stock balance was maintained. We looked at the policies and procedures in use and the medication records we checked were generally completed correctly. However we did find that where medicines had been prescribed on the medication administration record (MAR) chart to be given as Care Homes for Older People Page 14 of 29 Evidence: required there were no clear instructions or protocols in place to guide and instruct care staff giving this. The information on the MAR chart needs to be supplemented by the persons care plan and /or protocols for staff to follow. One such medicine we found to be given as required was a strong painkiller. We discussed the reasons behind the current system of recording as required medicines at set times or some as homely remedies and why this was not best practice on all occasions. We recommended to the manager that to make sure that any medicines prescribed by the doctor to be taken as required for when there is a specific need, such as pain, they should have clear instructions or protocols for staff to follow. These instructions should make it clear what the medicine is, what it is intended to do, how much and how often it can be taken, if there any special precautions to be aware of and if there are any known adverse reactions to watch for. This helps make sure that people only get these as required medicines safely and when they need them for a specific reason. The manager was aware of the need for this and it was to be discussed with their pharmacist at their forthcoming visit. We spoke with the manager about the daily life in the home and found that because there is no pressure to keep the home occupancy at maximum staff can concentrate their time and resources on meeting the needs of people living there. People living there and their visiting relatives, confirmed the high levels of personal attention and support they received. We received many very positive comments and examples form them about their life in the home and the care and support they receive. Comments made to us included, There is a wonderful spirit here, all the carers are good, so willing and obliging and they all work so well together and I have settled in so well, I wouldnt live anywhere else, I made the right choice. A visiting relative told us It is absolutely fantastic, so efficient, so friendly and I can feel content when I leave knowing she is here and so well cared for. Why cant all homes be like this one?. Care Homes for Older People Page 15 of 29 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. People living at the Franciscan Convent have support to make choices about their lifestyles and following their cultural, religious and social preferences. The quality and choice of meals provided meet the expectations and needs of people living there who appreciate the variety of home cooked food. Evidence: The Franciscan Convent promotes peoples right to live a life that is fulfilling and meaningful within the home and within their local community. Emphasis is given to the individual and one person told us I can have as much company as I want or as much privacy as I want, it is run for us. They also told us, I decide what I do, go out with friends, out for meals and trips out, there are no restrictions. Peoples interests and hobbies are recorded and their capabilities and these are considered when supporting them to enjoy their interests within and outside the home. There is very good provision for people to follow and maintain their religious and cultural beliefs and support them to remain actively involved. Because the home provides for people who want to live in a religious and spiritual environment many chose to focus their time around religious reflection and mass that is celebrated daily. Some Sisters spend their time together in community prayer or individually in their own rooms or the chapel. Care Homes for Older People Page 16 of 29 Evidence: There is the provision, via a speaker system, for services in the chapel to be heard in peoples bedrooms. People living in the home with different faiths and beliefs are supported to attend the church and services of their choice. The home has its own priest available day or night and sisters who are staff members and live there are in the home every day. The care plans of some of the people living there we looked at showed that they liked to structure their day around religious services and observance and did not like alterations. One person told us they had got up at 6 am all their life and wanted to continue to do so. This they did and had breakfast in their room, then read the bible and went to Mass. Regular outings are arranged for people living there and these vary according to individual abilities and preferences. People told us about their trips out for meals, to the canal and places of interest locally, the seaside, trips to markets and the local park. Staff also take people out for walks in the garden. For one person living there this was very important as they told us they were a keen gardener and had previously done a lot of the gardening so they liked to see how the garden was doing. From speaking with people living there, staff and visitors, looking at peoples care plans and observing daily life and routines it was evident that the emphasis is upon the individual and what they need and expect from their lives there. Time is spent on understanding and meeting individual social, cultural and religious needs. There is provision for group activities and one to one with staff assisting people with their correspondence, with card and board games and people may have reflexology or aromatherapy on request. There are also activities such as keep fit, singing and video shows and one person likes to play bingo so staff take them into town once a month so they can play and also do some shopping. There is also a computer room for people to use and access the Internet. Some people have used this for keeping in touch with family and friends who live further away. There is also a communal telephone but some people have their own telephones in their rooms. People living there and visitors did comment on the peaceful atmosphere in the home and we found it to be a calm and homely place for the people living there. One person said to us, This really is a good place, plenty of staff and so full of goodwill, I trust them all. The local community is welcomed into the home and many local people attend services there and have coffee and chat with people living there. Church groups visit and people from other congregations and people living there can have friends and relatives stay for meals or even a few days. One person was supported to go on holiday and this is available to others who want it. We joined people living in the home for lunch which was a very sociable and pleasant Care Homes for Older People Page 17 of 29 Evidence: occasion with people being served at their tables by staff. We noticed during the meal that the atmosphere was warm and friendly with people chatting and time taken to enjoy the food. The food is freshly prepared in the homes kitchen each day and people have a choice of meals including any special diets. People may take their meals where they wish, most people had their breakfasts in their bedrooms and main meals in the dining room. The days menu is written on the board in the dining room and all those we spoke with at lunch said the food was very good and excellent and that they always had a choice at mealtimes. People we spoke with made very positive comments about the food offered to them including, The food is lovely, a good selection and its all home made and The catering is very good, in all honesty I cant think of anything that could be done better. At the homes last inspection by the Food Hygiene Agency they obtained the maximum 5 stars for food hygiene compliance. We visited the kitchen and found it to be clean, tidy and well stocked. One person who lives there likes to make their own meals one day a week and is supported to do this to help promote their independence and because they said they had always been used to a busy life and liked to do as much as they could for themselves. Care Homes for Older People Page 18 of 29 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. People living at the home know how to raise a complaint through an effective and accessible complaints procedure and are confident that their concerns will be listened to and acted upon to make sure they are safe and protected from harm. Evidence: The home has a clear complaints procedure and this is provided to all people living in the home and is on display and within the statement of purpose and guide. All the people we spoke to in the home, people living there and visitors, expressed confidence in the manager to deal with any complaints and concerns. One person told us I see the manager every day and if I want anything attended to I just tell her, there is always a listening ear. People told us they knew how to make a complaint and one person told us, but there is nothing I could complain about. The home has not logged any complaints since the last inspection. We discussed this with the manager who felt this was because even minor day to day issues are dealt with immediately and people we talked with confirmed that the manager and all the staff deal quickly with any problems. One visitor told us that, They (staff) anticipate what people may need. One person we spoke with said, We have regular meetings and I can say what I like. People living there confirmed that they spoke to the manager and Sisters every day and that they spent time with them having a chat and a coffee. This way staff are aware of any grumbles or concerns people have on a daily basis and so attend to them promptly. It was evident that people living there have several opportunities to Care Homes for Older People Page 19 of 29 Evidence: make their opinions and ideas known to all levels of management on a daily basis. Trustees of the home periodically inspect the complaints procedures to help ensure any matters raised have been fully dealt with and do not happen again. The Provider comes in once a month to have a private chat with all the people living there, to look at the premises and records and writes a report as required by regulations. Systems are in place to make sure that people can exercise their right to vote. This can be done either by using a postal vote or transport can be arranged for people to vote in person if they prefer. There are also clear procedures in place for whistle blowing processes so staff can raise any poor practice issues and know they will be supported. The service has a clear policy on gifts and gratuities that people may give to staff to protect their interests. We saw that there are clear policies and procedures in place on safeguarding vulnerable adults and that staff have training on this and updates are booked as part of the homes annual training programme. Staff we spoke with were aware of the procedures and confirmed they received training on this. Senior members of staff have done the training course to provide this training for staff and one staff member has just completed a teacher training course to support staff training systems. Training plans for the year show that refresher training is due for staff on dementia care, dealing with challenging behaviour and dealing with aggression. Policies and procedures are in place to support staff practices on these areas of practice. There have not been any referrals made to social services under safeguarding procedures. Records indicate that all policies and procedures have been reviewed annually to ensure they reflect best practice. Care Homes for Older People Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, 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 living at the Franciscan Convent enjoy a suitably adapted, clean, homely and comfortable environment that encourages safety and independence. Evidence: The home is well maintained, it is warm and comfortable and has a staff team that encourage all those living there to see it as their own. Repairs and maintenance are well planned and ensures that the home remains an attractive and safe place for those living there to enjoy. The whole of the building had a major refurbishment last year to maintain the high environmental standards for people living there. There is ample communal space for people to use on the ground floor and this is accessible by passenger lift. There is a separate dining room and two large sitting rooms, a computer room and a smaller sitting room for quiet and privacy. On the top floor of the home is a sewing room, storage and quiet areas and accommodation for the Sisters who live in. All areas of the home are accessible to people using wheelchairs and there are appropriate aids and equipment provided to suit individual needs and help maintain peoples independence. The providers of the service will make changes to ensure peoples needs can be met in a way that promotes their independence. For example a wash basin was lowered for one person because this was easier for them to use themselves. All areas used by people living there have accessible call bells for them to summon assistance if they want it. Care Homes for Older People Page 21 of 29 Evidence: The home was clean and tidy with ample storage and smelt fresh and pleasant. There are sufficient cleaning staff to make sure it is kept clean and people living there also commented on the high standards of cleanliness. One person told us Its always very clean and such lovely decoration. I was always a bit fanatical about cleanliness so I really do appreciate it. A regular visitor to the home told us Its very welcoming, so clean and no smells. I have been in other homes but never anywhere as good as this. The home has infection control procedures in place, including communicable diseases and protocols for shared rooms. Records show that staff are given training on the prevention and control of infection and food hygiene training. We observed that staff followed good hygiene practices. The home has been commended by the Infection Control Team and used as an example of good practice and training. The home has visits from a consultancy firm each year who check the building and facilities and review their policies and procedures. This helps ensure that the service is in line with relevant legislation and any changes in regulations in regard to health and safety and so make sure the environment is safe and suitable for the people living there. Currently there is one room used for double occupancy with all others being single. Rooms are shared only in agreement with the people occupying them and there is appropriate screening in place to maintain peoples privacy and dignity during care. Some bedrooms have en suite facilities and there are sufficient accessible toilet, bathing and washing facilities for the people living there. People are encouraged to personalise their bedrooms with their own possessions, furniture, ornaments, paintings and photographs from their own homes to help them feel at home. There are large and well organised laundry facilities in the home that promote good infection control. There were separate dirty and clean areas to minimise any cross infection and peoples clothing is stored neatly and discreetly to be returned to them. People living there commented on the laundry service saying it was very good and that It is done beautifully, with such attention to detail. The home has large garden areas and well kept out door space for people to sit and walk in and the home is adjacent to the local park that some people like to use. Care Homes for Older People Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are being supported by a well trained and experienced staff group and the robust recruitment procedures in operation mean that the safety and well being of people is promoted. Evidence: The home has a stable staff group providing continuity for the people living there and a high level of individual care and support to people. The home has an effective and robust recruitment and selection procedure with very little staff turnover. Many of the care staff have worked in the home for several years and those we spoke with said it was a very supportive and and pleasant working environment. We looked at recruitment records for the newest staff and these were in good order with completed application forms, all necessary references taken up and interview records kept. All staff had appropriate security checks in place, a Criminal Records Bureau (CRB) check and a check on the Protection of Vulnerable Adults (POVA) register to make sure that they were appropriate to support vulnerable people. The staff rotas show that the ratio of care staff to people living there is consistently good both day and night. Records show that recently additional staff have been recruited to provide the extra support and attention some people require due to changing needs. Staff we spoke to and survey responses indicated that staffing levels are consistently Care Homes for Older People Page 23 of 29 Evidence: good and that this is given a high priority. Having consistently good levels of staffing also allows staff time to give one to one support and accompany people to go out or accompany them to any appointments. There are more staff on duty at busier times of the day and Sisters from the convent are available to give support and extra attention if needed and sleep on the premises. From talking with staff, from the comments and responses on their completed surveys and from looking at training records it was evident that staff training and development is given a high priority within the home. NVQ training programmes are well established with a high percentage of staff with NVQ level 2 and above in care. Staff are rewarded when they achieve their NVQ qualification through pay increases . This motivates staff to achieve higher levels of training and acknowledges their skills and commitment. There is an on going and planned staff training and development programme which we looked at and the records of completed training. New staff follow a week long induction programme covering all relevant areas before they start work with people living there. This includes moving and handling, health and safety, medication and safeguarding. These are followed up by annual training as well. The training plan showed what was organised for the year to make sure all staff got the training and updates they needed to fulfill their roles and care for people safely. The care team and manager have also done a variety of training,in addition to mandatory training , that is relevant to their roles including spiritual awareness, palliative care, training on dementia and mental illness, skin care and continence. Staff told us that they are supported in any reasonable request for training and they are paid whilst attending all training and staff paid to cover for them. One staff member commented I have been able to attend every training course I have asked to go on to keep me updated. People living there and relatives also commented on the high standards of care. One person told us I am very impressed by the staff, it justs shows what can be done with good will and also the staff work very well as a team. A regular visitor to the home told us their relative had thrived since coming here to live, its very individual and the staff are always around for people, they seem to anticipate what they will need. Care Homes for Older People Page 24 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and daily running of the home is based on openness and respect and the high level of consultation means that staff and people using the service can contribute to its development. This helps make sure that the Franciscan Convent is run in the best interests of the people who live there. Evidence: We spoke with several people living in the home, visitors and staff during the visit and from their comments it was evident that they thought the home was being well run in the best interests of people living there. Records showed and staff confirmed that they had regular supervision and annual appraisal to support them in their work. Everyone we spoke to praised the way the home was run for them. Sisters working in the home were praised for their commitment and good will and one person told us The manager is very competent and approachable, I can tell her anything and I see her everyday. The registered manager is well qualified and experienced and provides a clear sense of direction and leadership. Records show that she updates her practice Care Homes for Older People Page 25 of 29 Evidence: and has attended several training courses to keep her up to date. Both staff and residents found her approachable and supportive and both residents and visitors commented on how the home is run for us and one relative told us Its so homely, I am made to feel really involved in the home and they always keep me informed and call me if I am needed. Staff in the home meet regularly and staff told us that We have good communication and hand overs. We looked at a sample of records required by regulation and found these up to date and in good order. The manager does not routinely handle money for anyone living there, people are encouraged and supported to manage their own affairs. Some people have support from their families and representatives. Where any transactions do occur for day to day matters a full record and receipts are being kept. The home has effective quality monitoring systems in place to get the views of people living there and their families and to measure their success in meeting their aims and objectives. The manager uses a range of assessment methods including surveys, meetings, audits and outside consultants to regularly monitor important areas like the environment, maintenance and health and safety and also review and update procedures as good practice and legislation changes. The service has consistently developed and improved its quality assurance and monitoring systems and has achieved the Quality Assurance Enhanced Award and been recommended by the Infection Control Team as an example of good standards and training. Regular visits are made, as required by regulation, by the Mother General to see and speak to each person living there and produce a report. Records of maintenance showed that the home has systems, training and practices in place to promote peoples health, welfare and safety. There are working practices in place to identify and minimise risks to staff and people living there and the home has a comprehensive range of policies and procedures to support current best practice. All equipment is maintained under service agreements. Care Homes for Older People Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 9 We recommend that in order to make sure that medicines prescribed by the doctor to be taken as required are given only as needed the manager has clear instructions or protocols for staff to follow. This will make sure that people only receive as required medicines when they need them for a specific reason. The manager should look at developing a secure system for transporting medicines from the storage area to people at medicine rounds. This will enable staff to quickly secure medicines during a round if the need arises. 2 9 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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. 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