Care Home: Saint John of God Care Services Lindisfarne

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What the care home does well People are given good opportunities to participate in social activities and links with families and friends are actively encouraged. living and working at the home. People continue to feel that their views and opinions are acted upon. A good standard of care is provided for the people who live at the home. People said they enjoyed living there, and that the staff were kind and helpful. When asked about what the service does well, people living in the home said, `Good staff, nice room, very good meals it is always very clean, I get out in the community often`. Another said ` The home is always friendly and welcoming with a good homely atmosphere`. `Treats us well and looks after our needs`. One other person said `Everything`. Comments from professionals included, `I think Lindisfarne is a shining example of how it can be done I always make a point of taking my final year medical students there to show them`. `The service provided is always 100% and all needs are met at all times`. And `Ensures that clients live a fulfilled life. Ensure clients needs and wishes are acknowledged and advocate these`. The environment was nicely decorated and well maintained. Staff were motivated and enthusiastic about their work. Comments included `The home provides a welcoming, homely and friendly place to work. It encourages staff to work in a professional manner and promote an ethos of cooperation and team work which is beneficial to both staff and residents`. What has improved since the last inspection? The requirement and recommendations from the previous report have been met. The manager has been registered with the CQC. Care plans have been updated and are now signed and dated. Assessments have been reviewed and outdated ones have been archived. What the care home could do better: There is only one recommendation contained in this report. The manager told the inspector that the assessment which would indicate that a person was at risk of pressure damage is carried out by the district nursing service. The home should carry out this assessment on a monthly basis so that any risk is identified at an early stage. Key inspection report Care homes for adults (18-65 years) Name: Address: Saint John of God Care Services Lindisfarne Lindisfarne Court Haughton Village Darlington Durham DL1 2DZ     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: Susan Lowther     Date: 1 3 0 1 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 Adults (18-65 years) 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 Adults (18-65 years) 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 Adults (18-65 years) Page 3 of 24 Information about the care home Name of care home: Address: Saint John of God Care Services Lindisfarne Lindisfarne Court Haughton Village Darlington Durham DL1 2DZ 01325365428 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): lindisfarne@sjogcareservices.org.uk www.sjog.co.uk Saint John of God Hospitaller Services Name of registered manager (if applicable) Miss Amanda Ashdown Type of registration: Number of places registered: care home 13 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 physical disability Additional conditions: The registered person may provide the following category of service only: Care Home with Nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following categories: Physical Disability, Code PD, maximum number of places 13. The maximum number of service users who can be accommodated 13. Date of last inspection Brief description of the care home Lindisfarne Court is a care home providing personal care and accommodation for up to 13 people with physical disabilities. Lindisfarne Court is one of a number of care homes and care services throughout the country opened by the Hospitaller Order of Saint John of God. Lindisfarne Court was purpose built as a care home. It comprises 3 inter-linked Care Homes for Adults (18-65 years) Page 4 of 24 Over 65 0 13 0 3 0 3 2 0 0 9 Brief description of the care home bungalows, all suitably equipped to meet the needs of people with physical disabilities. All bedrooms are for single occupancy and are suitable for people who use wheelchairs. Two bedrooms have en-suite facilities. The service user guide, statement of purpose and last inspection report are available at the main office. Care Homes for Adults (18-65 years) 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: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. The inspection was unannounced and carried out between the hours of 12 noon and 5pm. Prior to the inspection the home were asked to complete an annual quality assurance assessment (AQAA) which gives the providers viewpoint of how well they care for people. During the inspection time was spent talking to people who use the service, relatives, staff and the manager. Feedback from which has been included throughout the report. Records were looked at and a tour of the building took place. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. Care Homes for Adults (18-65 years) Page 6 of 24 In future, if a requirement is repeated, it is likely that enforcement action will be taken. Details about the level of fees charged and what is included can be obtained from the manager. Care Homes for Adults (18-65 years) 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 Adults (18-65 years) Page 8 of 24 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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. The home is able to provide people with information about the service prior to them moving in and admissions to the home are well managed. Evidence: The home has a statement of purpose and service users guide which describes the services available within the home. There have been no new admissions since the last inspection. However all care files which were looked at during the inspection, had an assessment in place to ensure that peoples needs could be planned for and met by the home. Assessments form the basis from which the care plan is written. Assessments also cover areas such as risk management so that risks to people can be minimised. People living at the home had been given license agreements which set out the terms and conditions of residence, these were available in pictorial formats to make them more accessible to the people living at the home. Care Homes for Adults (18-65 years) Page 10 of 24 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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 way in which peoples health and personal care needs are to be met is documented within their individual plan of care. People are supported in making decisions about their lives. Evidence: Each person who uses the service has an individual care plan, which showed involvement from the person, his or her key worker. These are reviewed on a monthly basis. Two sets of documentation were examined, which showed the information was detailed. Within the plans there was also a personal profile of the person and a pen picture. Daily notes detailed how the person spent their days, for example a visit to the local pub, shopping and overnight stay with family. Each person also has an essential lifestyle plan. The plans covered areas such as important people, likes and dislikes of food, activities, how the person wants to be Care Homes for Adults (18-65 years) Page 11 of 24 Evidence: supported, routines, things that must not change and things that can be changed, hopes and dreams for the future. Risk assessments were in place for each person: financial management, medication, and emotional and sexual exploitation, cooking and bathing. There was evidence to show that the risk assessments were reviewed. However the manager told the inspector that the assessment which would indicate that a person was at risk of pressure damage is carried out by the district nursing service. The home should carry out this assessment on a monthly basis so that any risk is identified at an early stage. Care Homes for Adults (18-65 years) Page 12 of 24 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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 are offered their choice of daily activities and can live their lives as they wish. Staff care for people in the way they want. People are encouraged to have a healthy and varied diet. Evidence: People living at the home are encouraged and supported to participate in a range of social and leisure activities. People are offered the opportunity to experience new activities and leisure pursuits as well as being supported to continue with existing interests. Links between families and friends are encouraged and there are no restrictions on visiting times. Staff said that trips out included visits to the theatre and pantomime trips, days out to places like Blackpool, shopping trips and holidays to a range of places. Comments about the food were positive and people said that they are offered a choice. The manager told us that daily records are now kept of food and drink intake Care Homes for Adults (18-65 years) Page 13 of 24 Evidence: so that it can be monitored on an individual basis. Care Homes for Adults (18-65 years) Page 14 of 24 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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 have their personal, physical and emotional health needs met by the home. Evidence: People are supported in a way which protects their dignity and maximises their independence. Staff were observed throughout the inspection to treat people with respect. They always knock on doors before entering and they communicate well with people living at the home. There was clear evidence of support from other health care professionals where this is needed. People who use the service also have individual health plans, which are completed by themselves, their family and key worker. Some of the plans had been personalised with pictures relating to a health need. Health needs are identified such as oral hygiene, weight management and eye sight. Staff support people to address their individual healthcare needs by assisting them to visit local GPs and attend other healthcare appointments. The outcomes of such visits are recorded in the individual care files along with other healthcare information. Evidence was seen to confirm that healthcare professionals visit the home where this is deemed appropriate. Care Homes for Adults (18-65 years) Page 15 of 24 Evidence: People are encouraged to be independent and they choose what clothes they want to wear. The mix of staff team ensures that people have a choice of who works with them and this also takes into account gender. Staff are encouraged to promote the rights of the people and if needed will challenge the health systems if they feel the person needs them to advocate for them. Specialised aids to assist with mobility are provided for people who require them. Policies and procedures are in place for the ordering, receipt, storage, disposal and administration of medication. Prescribed medicines are administered by senior staff, all of whom have received accredited training in the safe handling of medicines. An audit of medications was undertaken. The recording, storage and administration systems were satisfactory. Records were appropriately maintained. Staff have received training in the safe handling of medicines as well as the certificate in medication. Care Homes for Adults (18-65 years) Page 16 of 24 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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. There are clear polices in place to deal with complaints and adult protection, which are known by staff and accessible to people living at the home. Evidence: Information about complaints, how and who to make them to, is made available to the people who live in the home and their families through information displayed in the entrance to the home and in the Service Users Guide. These are available in both both written and pictorial formats. There have been no complaints recorded since the last inspection. The home had a comprehensive adult protection procedure. This gives staff the support they need to make a referral should this be required. The staff spoken to during the inspection were asked about abuse and what they would do if they saw or heard anything inappropriate. All said that they would tell someone, for example the manager, or make a referral themselves if this was more appropriate. Training is provided for all staff in adult protection. Staff have received training on the Safeguarding Adults. Care Homes for Adults (18-65 years) Page 17 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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 home is clean, tidy and furnished and decorated to a high standard with appropriate equipment to support peoples needs. Evidence: Lindisfarne Court was purpose built, to a high specification, as a care home to provide personal care and accommodation for up to thirteen people with physical disabilities. The homes three inter-linked bungalows were designed to accommodate people who use wheelchairs. Each bungalow has a large lounge, a kitchen/dining room and a conservatory. One of the conservatories has been turned into a sensory area. There are large spacious corridors and people can move freely between the bungalows. All of the bathrooms are fitted with adapted bathing equipment and ceiling tracking hoists. All of the rooms were individually furnished and decorated to a high standard. The manger told us that all of the rooms have recently been refurbished. Care Homes for Adults (18-65 years) Page 18 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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 are appropriately recruited, trained and in sufficient numbers to meet the needs of the people who live in the home. Evidence: From the rota supplied at the inspection there was sufficient care staff on duty to meet the assessed care needs of the people who were using the service. The manager told us that since the last inspection staffing levels have been increased to ensure the service provision is of a high standard. The home had staff files in place, which provided evidence that the appointment of a new staff member is in the main made through proper recruitment processes. This includes the vetting of staff through the use of references, POVA first checks and Criminal Record Bureau (CRB) checks. There is a commitment at the home to having a trained workforce with most of the staff having an NVQ at level 2 or above. As well as mandatory training, recent training has also taken place in Deprivation of Liberty, palliative care, medication awareness and challenging behaviour. Staff said that they are also supported with regard to personal training needs. Staff comments in this area were positive. Comments included There is always plenty of training going on and you can ask for additional training if you want to. Another said, I have regular supervision with the manager where personal training needs are discussed. Care Homes for Adults (18-65 years) Page 19 of 24 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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 can be assured that the home is well managed and they are given the opportunity to comment on how the home is run. Policies and procedures are in place to safeguard their health, safety and wellbeing. Evidence: The manager is qualified and competent to run the home. There was an open and friendly culture between the management team and staff working at the home. Since the last inspection the manager has been registered with the CQC. People living at the home and visitors who were spoken to during the inspection confirmed that the manager is approachable and that they would go to her if they had any concerns. Staff also confirmed this to be the case. Regular meetings are held and there are a number of systems in place to consult with people living at the home. Relatives and the people who live in the home can approach the staff at any time. The manager carries out regular audits covering all environmental and care aspects which may result in improvements being made. Care Homes for Adults (18-65 years) Page 20 of 24 Evidence: The manager confirmed that all equipment in the home is regularly checked. The maintenance certificates that were seen at this inspection were found to be in order. Health and Safety checks are carried out regularly to safeguard people living and working at the home. Care Homes for Adults (18-65 years) 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 Adults (18-65 years) 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 1 6 An assessment should be carried out on a monthly basis with regard to the risk of a person developing pressure damage. This is so that any risk is identified at an early stage. Care Homes for Adults (18-65 years) 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. Copyright © (2009) Care Quality Commission (CQC). 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