Care Home: Franciscan Convent Residential Home

What the care home does well The service users, and visitors to the home say that it is a small, clean, comfortable and homely place to live, with a Manager and staff team who make every effort to provided a service that is individualised. Routines in the home are flexible and varied according to individual needs and wishes. New admissions to the home are only made following a thorough assessment of the person`s needs. The Manager does not admit people to the home if their needs cannot be met. Choice and individuals rights were seen to be respected and staff were seen to be dedicated in ensuring service users retained skills and independence. This is acheived by the committment of the staff who work at the home, and the quality of the care plans which are regularly reviewed and updated. Policies and procedures relating to complaints, and safeguarding are good, and the staff have a good understanding of what they should do if they receive a complaint or concern. What has improved since the last inspection? Two requirements and seven recommendations were made at the last inspection in 2007. All of these had been met. This has included the completion of risk assessments relating to the refurbishment of the premises. Care plans have been updated, and completed within the set timescales when new service users are admitted. An activity co ordinator has been employed, which has improved the level, and variety of activities offered to service users. All staff now attend safeguarding `update` training on a two yearly basis, and the manager through supervision ensures staff are aware of any changes in procedures or policy. What the care home could do better: The service has demonstrated a high quality of care to service user`s over several inspections. However on this occassion one service users medication was not being recorded correctly and a requirement was made in relation to standard 9. Key inspection report Care homes for older people Name: Address: Franciscan Convent Residential Home 2 Broad Road Bocking Braintree Essex CM7 9RS     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: June Humphreys     Date: 1 0 0 8 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Franciscan Convent Residential Home 2 Broad Road Bocking Braintree Essex CM7 9RS 01376326654 01376340401 marybraintree@gmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: The Missionary Franciscan Sisters care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 12 The registered person may provide the following category of service only: Care home only - Code 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 - Code OP. Dementia - Code DE. Date of last inspection Brief description of the care home The Franciscan Convent Residential Home forms part of large, two-storey listed building situated close to Bocking village and Braintree town. The home is owned by the Order of Missionary Franciscan Sisters and part of the building forms the Franciscan Convent, although some Sisters from the Convent are resident within the home. Premises are spacious, and there are extensive landscaped and well-maintained grounds. The home also has the use of the Chapel belonging to the Franciscan Convent, which forms part of the building. Care Homes for Older People Page 4 of 26 0 0 Over 65 12 12 Brief description of the care home The building has been completely refurbished over the last three years, during which time the residents were temporarily accommodated in neighbouring premises that were registered for the purpose. The refurbishment was finished earlier this year, and the residents and Sisters moved back into the original home in July 2007. The conditions of registration were changed at this time, and the home is now registered to accommodate for up to 12 older people, including people who may suffer with dementia. The building has been adapted to meet the needs of people with limited mobility. The registered manager is Mary McGrath. Information on the home is available in the home?s Service User Guide, a copy of which is available in the hallway of the home. The homes current fees range from £550 - £650. 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: 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: The quality rating for this service is 3 stars. This means that people who use this service experience excellent quality outcomes. This was a routine unannounced inspection, which included a visit to the home on the 10th August 2009. One inspector undertook the site visit, and all of the key national minimum standards were inspected. Opportunity was taken to speak with residents, relatives, staff, and the registered Manager. The Manager completed and returned the Annual Quality Assurance Assessment to the Commission, which is a self-assessment of how the service is doing. Information from the document has been included in the report. As part of the inspection 5 staff surveys, and 6 service users/relatives surveys were returned. The comments made have been useful, and have helped in understanding Care Homes for Older People Page 6 of 26 what it is like to live at the home. Records and documents were looked at in detail, including a sample of care plans, Two staff files and supervision records, the staff rota, complaints, medication and accident records. Care Homes for Older People Page 7 of 26 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 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 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them 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. Prospective service users can expect to look at the homes statement of purpose and service users guide as part of the assessment process, and can be confident that they will only be admitted if their needs can be met. Evidence: The home has a Statement of Purpose and Service Users Guide, which provided perspective service users with information regarding the structure of the service,and the facilities provided by the home. The document also included information on the homes complaints and admission process. Two initial assessments were looked at as part of the inspection. Both contained sufficient information to ensure staff were aware of the persons needs, and also that care would be offered in the manner preferred. The manager told us in the AQAA, We have an atmosphere and environment that is unique. We do a thorough assessment of potential residents involving both the resident and Care Homes for Older People Page 10 of 26 Evidence: their family. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive is based upon their individual needs, and the principles of dignity, privacy and respect are put into practice. Evidence: The service users spoken with were satisfied with the level of care and support received. The staff know the service users well, and most had worked in the home for a lengthily period of time. Two care plans were looked at as part of the inspection. Both contained a family history, health, social and recreational needs and interests. The health care of people living at the home is monitored through the documents contained in the care plans. These include health professional visits and their outcomes, monitoring sheets for weight and dietary intake etc. All people providing feedback confirmed they receive the medical support they need, with one saying The staff are very helpful, and if I have a problem the staff contact my G.P. An examination of the homes medication room including records, ordering, storage, administration, and controlled drugs was undertaken. Generally practices for the Care Homes for Older People Page 12 of 26 Evidence: recording and administration of medication within the home are good. However there was one case of insufficient recording.The medication name, and the amount administrated had been written on the back of the Medication Administration and Record (MAR )sheet. The registered manager was advised to liaise with General Practitioners regarding information being included on prescriptions to ensure that instructions to people dispensing medicines are correct. People living at the home made many positive comments about the staffs attitude to wards them. They felt that their dignity and privacy were respected. Good practice was observed during the inspection for example, staff were seen to talk quietly and respectfully to people. Staff ensured that doors were closed when attending to service users personal care needs. Discrete, sensitive assistance was provided at mealtimes. Comments received from the people at the home included I found it difficult to let someone help with my personal care, but they always make sure that they help me discretely and keep me covered as much as possible, they provide me with dignity, The staff are excellent, nothing is too much trouble and they do things the way I want them to. A visitor said I am confident that residents are treated with respect and dignity. 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. Service users can be assured that their rights to make decisions for themselves, and undertake appropriate activities will be upheld; and individual responsibilities are recognized and supported. Evidence: Service users are able to make a choice of what they would like to eat from the menu and are offered drinks at set times throughout the day. On the day of inspection the majority of service users had selected fish, but a few had requested omelettes. Meals are prepared in the main kitchen and served in the dining room. The meals were observed to be wholesome and nicely prepared, and the service users interviewed said they enjoyed the food. Staff were observed talking and assisting people when required. From observations and discussions with people living at the home, it was evident that there is an option of being involved in a range of activities. The manager advised that extra funding had been made available to appoint an activity co-ordinator for 12 hours per week. The manager stated in the AQAA that the Activity co-ordinator is very pro active in encouraging the residents to be involved and giving them lots of choices.. Recording of activities has improved and there was clear written evidence that showed Care Homes for Older People Page 14 of 26 Evidence: residents are given choices about activities, meals and outings. The manager acknowledged that it was unclear how long the Co-ordinator would be employed, once the funding had come to an end. However staff were being encouraged to be more pro active and work alongside the activity co-ordinator to develop new skills, and encourage service users to be involved in activities. Three visitors were spoken with during the course of this visit. All were very positive about the care and support provided for their friends and relatives living at the home. They said they were able to visit when they wanted to, and always made welcome. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are supported to express their concerns, and have access to a robust, effective complaints procedure. Evidence: The service has a comprehensive complaints procedure in place. Staff spoken to were knowledgeable of the policy and procedure to follow should a service user wish to make a complaint. The manager stated in the AQAA that We have a good complaints procedure that is easy to understand and that is displayed in the entrance as well as being incorporated into the service user guide. Service users have regular contact with staff they know well, and concerns are addressed immediately wherever possible. Service users spoken to did know how to make a complaint, and one person said we are encouraged to express our wishes and concerns freely. At the time of the inspection visit there had been one complaint made which had been fully investigated and recorded. The service user said that they felt it had been dealt with well and that the matter was resolved. The prevention of abuse, and adult protection are covered during the induction of new staff. The manager discussed how this was covered as part of the induction process. More in depth regular training was also offered to staff to ensure they had received the most up to date information. The staff members on duty said that they had received safeguarding training, and had a fair understanding of the basic principles involved, and the responsibilities as a members of staff in responding to allegations, or Care Homes for Older People Page 16 of 26 Evidence: suspicions of abuse. Care Homes for Older People Page 17 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are provided with a high quality of accommodation, which is safe, comfortable, clean and well-maintained. Evidence: The communal areas in the home have a comfortable and homely atmosphere and are decorated to a high standard. The premises were re-designed and refurbished to a high standard in 2007, retaining many of the attractive listed features of the home. Bedrooms are light and airy, and all provide sufficient space for a range of furniture. Bedrooms were seen to be personalised, with service users photographs and pictures on display. All bedrooms have ensuite toilet and shower facilities, and there is a separate assisted bathroom in the home. There is one communal lounge overlooking the gardens, and a separate dining area with an adjacent courtyard area. A small room on the first floor, used for hairdressing and visiting professionals (e.g. chiropodist). the room has comfortable seating and can also be used by service users and their visitors; there is also a room for any visitors who wish to stay overnight. The home has extensive grounds: the area close to the house has been landscaped, with safe footpaths and seating provided on a covered veranda area adjacent to the lounge. A staff room is available on the ground floor, with a further staff room on the first floor so that night staff are close to Service users (as all bedrooms are on the first floor). The redesign of the premises has made every effort to make the building accessible to service users: although the first floor is on a number of different levels, Care Homes for Older People Page 18 of 26 Evidence: wherever possible small ramps have been fitted to minimise mobility difficulties, and in one place a stair lift has been fitted to a small flight of steps. A fully mechanised bath is available, and toilet areas have been fitted with drop down handrails to promote independence. Although ensuite showers have slightly raised shower trays, and therefore can only be used by people who are still mobile, all are equipped with shower seats. Most people are still weight-bearing, but the home does have mobile hoists available and was noted to have good storage areas for hoists and wheelchairs so that these did not present a hazard in bedrooms or corridors. The home has good arrangements for the ongoing maintenance of the property. The home employs a person responsible for maintenance and health and safety, who demonstrates good knowledge of all issues relating to the safety and maintenance of the premises. There were systems in place for staff to identify any repairs required, and to record when these have been actioned. Laundry facilities were seen to be well- equipped with the necessary facilities to meet the needs of the people living in the home, including industrial style machines and hand washing facilities. Policies and procedures for the control of infection were in place, and records relating to cleaning materials are kept. Staff training records indicated that staff had received training in infection control and other health and safety related areas. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent 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. Staff have appropriate skills, knowledge and experience to identify and respond to individual peoples needs in a consistent way. Evidence: There is an experienced dedicated staff team working in the home. Several Staff spoken to said they had been in post for a considerable period of time, and that this made a difference to the quality of care that they were able to provide. The care staff were also enthusiastic about their work in the home, and one said, that there is an open and happy atmosphere here. There are currently ten service users who require support. Rotas examined on the day of the inspection showed that there was sufficient staff on duty during the day and night to meet the needs of people living at the home. During the day, there is three staff on duty at peak times, when people require most assistance, and two on at other times (with one waking and one sleep-in at night). If further service users were admitted i.e. further people with dementia who require greater care, or the home increases it numbers, then the manager gave assurance that staffing numbers would be reviewed. Service users spoken to were very positive about the level and quality of support received. One service user said I am very happy here, the care and support I receive from staff is excellent. A visitor said The quality of care offered is always of a very good standard. Care Homes for Older People Page 20 of 26 Evidence: Two staff files were looked as part of the inspection. All staff files identified the training staff had undertaken. The homes mandatory training i.e. first aid, manual handling, safeguarding and medication administration, had been completed by staff. Staff felt that they had good access to relevant training opportunities, and new staff undergo a thorough induction programme, which the manager oversees to ensures staff are familiar with the policies, procedures and routines of the home. Two staff recruitment files were examined and demonstrated that the homes recruitment practices do satisfactorily protect residents. Both files contained all of the specified information required including, employee evidence of employment history, medical questionnaires, declarations of criminal record, and evidence of ID. Care Homes for Older People Page 21 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home continues to provide a high standard of care under the guidance of an experienced Manager. Evidence: The manager is experienced in the care of the elderly and regularly updates her practice by attending training; an example of this is her recent attendance on training on The Mental Capacity Act. Through supervision the manager has discussed with staff what this means when caring for people living in the home. The manager stated in the AQQA We strive to be individual in our approach and constantly try to improve our service. A random sample of health and safety documents were examined and these were up to date. The home had a completed fire risk assessment, which had been regularly updated, and there was evidence of fire drills and fire alarm tests. There had been some difficulties with fire doors not closing after the home had been refurbished, and the manager clearly demonstrated the action taken to ensure this had been recitified. Care Homes for Older People Page 22 of 26 Evidence: Service users monies were examined, and these were seen to be well managed and to be accuratly recorded. Feedback from service users and staff about the registered manager was positive with comments received about her being approachable, supportive and always on hand for advice. The Manager stated that both herself and the assistant manager are on hand to support and work as part of the team when necessary. The home has appropriate systems and procedures in place to ensure service users are kept safe; as part of the inspection, recruitment, training and supervision records were looked at. All staff are supervised regularly, and team meeting and service user meetings are happening regularly. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 The manager should ensure that the current medication, administration, recording sheets reflects current medication being administrated and must not be hand written to ensure Service users are kept safe from possible errors. To keep service users safe. 31/10/2009 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 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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) Care Quality Commission (CQC). 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