Care Home: Holy Cross Care Home Limited

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What the care home does well This home has an admissions procedure that is designed to ensure that an individual`s needs can be met. The staff in the home identify the needs and preferences of all of the people who live there. People who live in the home were very complimentary about the staff. They made comments such as "I`m perfectly happy. I`m looked after very well". They were aware of the care needs of the people they look after and spent time talking with them and keeping them occupied. People told us that the home provides and environment that is pleasant for them to be. The manager provides positive guidance to the staff team on how to meet the needs of the people living in the home. What has improved since the last inspection? Since the last inspection the way the home administers people`s medication has improved so that they can be sure that the right people get the right medication at the right time. We also found that people`s needs are fully assessed before they are admitted so that the home can be sure that they can meet the needs of the individual concerned. The home has more formally looked at any risks to the safety of the people who live and work there so that any risks to their safety can be reduced to a minimum. What the care home could do better: No requirements or recommendations have been made as a result of this inspection. Key inspection report Care homes for older people Name: Address: Holy Cross Care Home Limited 150 Abbey Foregate Shrewsbury Shropshire SY2 6AP     The quality rating for this care home is:   two star good 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: Michael Moloney     Date: 2 4 0 5 2 0 1 0 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 24 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Holy Cross Care Home Limited 150 Abbey Foregate Shrewsbury Shropshire SY2 6AP 01743343138 01743343138 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): None Holy Cross Care Homes Limited Name of registered manager (if applicable) Miss Deborah Jane Welsman Type of registration: Number of places registered: care home 57 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 57 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 (OP) 57 Date of last inspection Brief description of the care home Holy Cross is a privately owned Care Home registered with the Care Quality Commission to provide a service for 57 Older people. The home is situated on Abbey Foregate close to Shrewsbury town centre. It is a well established Home set in elegant and comfortable surroundings. Ms Jane Welsman and Mr Leslie Jones own the Home. Ms Welsman has day-to-day management responsibility for the Home assisted by three deputy managers. The accommodation, originally a vicarage, has been further Care Homes for Older People Page 4 of 24 Over 65 57 0 3 0 1 1 2 0 0 9 Brief description of the care home extended and refurbished to provide a 52 bedroomed facility over three levels. There is an established Staff group providing residents with consistency in a warm comfortable atmosphere. Holy Cross makes their services known to prospective service users in The Statement of Purpose and Service Users Guide. The care home rates are reviewed annually and service users are notified one month in advance. The only additional charges to service users are for hairdressing, toiletries and newspapers. This is clearly laid out in the terms and conditions. Consultation with people who live at the home takes the form of regular surveys. Residents meetings enable people to discuss issues and make suggestions for improvement and the manager also meets informally with people to gain direct feedback as to the quality of the service. 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: We, the Commission, used a range of evidence to make judgements about this service. This included: the report of the inspection carried out on 30th September 2009, information from the provider for that inspection which included a self assessment document that they are required by law to complete and notifications that have been received by the Care Quality Commission form the home about incidents, bereavements and other incidents that affect the welfare of the people who live in the home. The visit to the home was unannounced with the purpose of carrying out a Key Inspection which is where the homes performance is measured against a set of standards identified by the Department of Health. This inspection was undertaken by one inspector, Mike Moloney, and lasted four hours. On this occasion we did not involve an Expert by Experience which is someone who Care Homes for Older People Page 6 of 24 has experienced the care provided by this type of service and is asked by the Care Quality Commission to assist and give their views during an inspection.. During that time we Case Tracked a number of the people who live in this home. This means that we talked to them and/or their relatives, where this was practical, to find out their views of the care that was being provided to them. This also enabled us to see if the records that identified peoples needs such as the care plans that are provided for the staff to follow were accurate and covered each individuals personal issues. We also talked to members of the staff team to check that they were aware of the identified needs of the people who live in this home were and whether or not they had the approach and training required to meet them. The standards set out by the Department of Health are in seven different groups. Each group can be judged as being either poor, adequate, good or excellent. The inspectors reach their judgement by following the guidelines laid down in the document known as the Key Lines Of Regulatory Assessment (KLORA) which is available on the Care Quality Commission web-site: www.cqc.org.uk Care Homes for Older People Page 7 of 24 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 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 looking to live in the home and their representatives have the information needed to choose a home which will meet their needs They have their needs assessed before they move into the home. Evidence: We looked at the records of someone who had been admitted to the home since the last inspection and these showed that their needs had been assessed before admission so that a plan for their care can be produced. The assessment covered such things as a persons ability to look after their own personal hygiene, how steady they were on their feet, what help they would need when moving around, how good their speech was and what medical conditions they had. We also saw documents that are available to people who are considering living in the home and these contained the information that they would need when making their decision. 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 health and personal care that a person living in this home receives is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: We looked at the records of a number of people who live in this home and these show that peoples needs are assessed on admission and a plan of care is produced which is reviewed and amended as their needs change. Peoples health care needs are kept under review and relevant professionals, such as Doctors or Community Nurses, are consulted and involved as and when necessary. We spoke to residents and relatives who were very positive about the care that is provided and one person particularly said Im perfectly happy. Im looked after very well. Assessments of the risks posed by peoples disabilities and the guidance to the staff on how to support them, such as assisting them to move around the home, are in place. Care Homes for Older People Page 11 of 24 Evidence: We looked at how medication is managed and the records kept to show that people have received the medication that is prescribed for them. This is largely through a monitored dosage system which means that tablets are provided to the home in ready prepared packs for them to use to administer drugs to people. There is additional medication - liquids, creams and short course medication - which has to be kept in more traditional bottles and containers. People who work in the home told us that only senior staff administer medication but all staff are trained in its management so that they can be aware of any harmful side effects that they could observe. The system to ensure people get the correct medication appeared to be working well and no problems were found. 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 who live in this home are able to choose their life style, social activity and keep in contact with family and friends. Social, cultural and recreational activities meet their expectations. They receive a healthy, varied diet according to their assessed requirement and choice. Evidence: At an inspection on 30th November 2009 we found that, People living at Holy Cross are able to spend their days as they choose and although activities are on offer, people do not feel that they have to take part. This means that people feel in control of their lives. The majority of people we spoke with however enjoy taking part in a range of activities. The arrival of a new puppy within the home has made a positive impact on people who look forward to its daily visits. People we spoke with felt that activities have again continued to improve over the last six months and the homes self assessment completed by the manager said that the home listens to the views and requests of the people who live at the home to improve opportunities and activities. Records of residents meetings showed that entertainment and activities are discussed and peoples suggestions are actioned. Visitors to the home told us that they are always made very welcome. People tell us that they like Care Homes for Older People Page 13 of 24 Evidence: the meals at Holy Cross and are able to choose what they eat. One person told us the food is excellent and one family member was pleased that since her relative had moved to Holy Cross he had put on weight and was now much healthier as a result of the meals. The menu reflected the food on offer on the day of our visit and people were seen to enjoy lunch either in the dining room or in their own rooms. Although staff were clearly busy at this time the people living at the home were enjoying a relaxed and unhurried meal. Care plans contain nutritional risk assessments and changes are made to peoples diets to enable them to receive the foods they need to keep them fit and well. People that we spoke to during this visit told us that this is still a true reflection of this aspect of living in this home. 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 people who live in this home have access to a robust and effective complaints procedure, are protected from abuse and have their legal rights protected. Evidence: We looked at the homes complaints policy and this was seen to contain information on how and with whom issues of concern could be raised. We spoke to a number of the people who live in this home who all said that they knew how to raise any issue and that they were confident that they would be dealt with. No referrals had been made into the local procedures that deal with allegations of abuse of vulnerable people. We saw that staff had received training in the identification of abuse and the procedures that they must follow if they see such an instance. 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. The physical design and layout of the home gives anyone living there a safe, wellmaintained and comfortable environment which encourages independence. Evidence: We looked around the home and we saw that it is an older building that has been extensively modified for its current purpose with the addition of building extensions that contain extra bedrooms and communal space. It is on a number of floors with bedrooms being available on all levels. We saw that there are both stairs and lifts between the various levels. We also saw that there are numerous communal areas. These are spread around the home on the various levels. Throughout the inspection people were seen using all the rooms and chatting and resting as the mood took them. We looked at the well maintained patio area that the people who live can use during the better weather. Car parking is available to the front of the house. We saw that the home was clean and odour free with the decor being in good repair. Care Homes for Older People Page 16 of 24 Evidence: We saw that the home has the laundry facilities that are needed to keep peoples clothes and linen clean and hygienic. 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. Staff in the home are trained, skilled and in sufficient numbers to fill the aims of the home and meet the changing needs of people who live in this home. Evidence: We watched and listened to the staff as they went about their duties. We saw that they were polite, friendly and professional with the people who live in this home. We heard them chatting to people as they were helping or passing them. We talked to a number of people who live in the home and they were all complimentary about the attitude of the staff. People said such things as, Im perfectly happy and looked after very well. We looked at the staffing rota and this showed that there were enough staff on duty to meet the needs of the people who live in the home. We talked to the staff and they said that the rota was an accurate record of who had been on duty. We talked to a number of the people who live in the home and they told us that they received help from the staff promptly when they asked for or needed it. We also saw this happening. We looked at the training that the staff had received. At a recent inspection we saw Care Homes for Older People Page 18 of 24 Evidence: training records that showed that the home has an ongoing programme of training in such things as manual handling, food hygiene and infection control all of which means that they are more aware of ways of meeting the safety and hygiene needs of the people who live in the home. We spoke to the staff on duty at the time of this inspection and they confirmed that they had undertaken this training. No new staff had been recruited since the last inspection. We looked at the records provided by the home before the last inspection and these showed that a number of the staff had achieved a National Vocational Qualification that was relevant to their meeting the needs of the people who live in this home. 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 management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a qualified, competent manager. Evidence: We talked to the manager and she told us that she had attended local briefings about procedures relating to the Deprivation of Peoples Liberties, known as DOLS. She told us about the local procedures that are designed to protect the human rights of people who lack the capacity to do so for themselves. She told us that nobody in the home had any restrictions placed upon them as a result of these. We saw that the home had recently carried out a lot of work to make sure that they had written instructions for staff that help them to reduce the risk of harm to people during various activities. We found that the home stores small amounts of cash on behalf of some of the people Care Homes for Older People Page 20 of 24 Evidence: who live there. We saw that these sums are kept and recorded in a clear and easily checked way. We asked for and were shown the records of the regular testing of such things as hot water temperatures, fridge/freezer and fire alarm systems. We saw that these records were clearly and regularly maintained showing that the safety of the people who live in this home is monitored on a regular basis. We looked for details of staff training. We saw that records contained a comprehensive outline of what training staff had received. 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: 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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