Care Home: Seton Hall

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What the care home does well Good systems are in place to make sure that people have enough information about the service before they come to live in the home. Peoples` care and health needs are well met by the service in a way that suits their individual needs and preferences. Individual records are well maintained to show how staff meet peoples` needs. Good systems are in place for dealing with medicines and these protect people living in the home. Peoples` individuality and diversity is respected and met by the good service offered at Seton Hall. Social activities and outings are well organised and planned to suit peoples` needs and they are encouraged to become involved in planning these . The people using the service enjoy the varied programme of events. The food is well cooked and presented with good options available at each mealtime. Care is taken to ensure that people are consulted about the menu and they are able to put forward suggestions for meals. People feel able to make their views about the service known and have plenty of opportunities to raise issues with the manager and staff. People are protected by the home`s systems for dealing with complaints and safeguarding matters. Staffing levels are sufficient to meet the individual needs of the people living in the home. Good recruitment practices and procedures are in place to protect people using the service. Staff training is well organised and delivered to staff to ensure that they have the skills to meet peoples` individual needs. Good management systems are in place to make sure that the quality of the service is regularly reviewed and changes are made to improve the service. Good health and safety systems protect people living and working in the home. What has improved since the last inspection? The decor in the corridors, main hallway and lounges has been improved. This makes the home a more pleasant environment. Two wet rooms have been constructed to make it easier for people to take a shower. A summer house is available in the garden so that people can enjoy the views from the garden. The garden paths have been improved since the last inspection to make the garden more accessible. Thermostatic controls have been fitted on all radiators to make it easier to control the temperature in each room. All bedrooms are now used as single room to provide more privacy for the people using them. The equipment in the laundry has been upgraded. What the care home could do better: All pull cords in bathrooms and toilets should be easily accessible. Key inspection report Care homes for older people Name: Address: Seton Hall Ord Road Tweedmouth Berwick upon Tweed TD15 2UT     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: Anne UrwinBrown     Date: 0 5 0 3 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 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) © 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 26 Information about the care home Name of care home: Address: Seton Hall Ord Road Tweedmouth Berwick upon Tweed TD15 2UT 01289306391 01289306391 shirley.mcdougal@setoncare.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Seton Care Ltd Name of registered manager (if applicable) Mrs Shirley Isabella McDougall Type of registration: Number of places registered: care home 47 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: Two identified persons under 65 years with dementia can be admitted for periods of respite. The total number of residents should not exceed the total registered. Date of last inspection Brief description of the care home Seton Hall provides residential care for up to forty-eight elderly people about a mile from the centre of Berwick upon Tweed. Bus and train links are available in Berwick town centre and a local bus service passes the drive entrance. The home is operated by Seton Care Ltd, a subsidiary of Berwickshire Housing Association. The accommodation is provided on two floors and there are very pleasant views of the surrounding area. The home is situated within its own grounds and has a short drive Care Homes for Older People Page 4 of 26 Over 65 10 2 36 0 0 0 Brief description of the care home from the main road. Ample parking is now available. Day care is provided by separate staff from Mondays to Fridays. The Statement of Purpose is regularly reviewed and is available at the home. Information for prospective residents is also available. Copies of the last Inspection Report and Statement of Purpose are available in the front entrance hall at the home or on request to the home. Fees are £444.60 per week and the only additional charges are for newspapers and hairdressing. 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 the people who use the service experience excellent quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use the service are not put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. How the inspection was carried out Before the visit we looked at: Information we have received since the last visit. How the service dealt with any Care Homes for Older People Page 6 of 26 complaints and concerns since the last visit. Any changes to how the home is run. Information from surveys sent out before the inspection. The providers view of how well they care for people. The Visit: An unannounced visit was made on 1 July, 2009. The visit lasted a total of eight hours. During the visit we: Talked with people who use the service, staff, the manager and visitors. Looked at information about the people who use the service and how well their needs are met. Looked at other records which must be kept. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the building to make sure it was clean, safe and comfortable. Checked what improvements had been made since the last visit. We told the manager what we found. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? The decor in the corridors, main hallway and lounges has been improved. This makes the home a more pleasant environment. Two wet rooms have been constructed to make it easier for people to take a shower. A summer house is available in the garden so that people can enjoy the views from the Care Homes for Older People Page 8 of 26 garden. The garden paths have been improved since the last inspection to make the garden more accessible. Thermostatic controls have been fitted on all radiators to make it easier to control the temperature in each room. All bedrooms are now used as single room to provide more privacy for the people using them. The equipment in the laundry has been upgraded. 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 9 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 10 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. There are good assessment and admission procedures in place so that people have enough information about the service and are sure that their needs can be met at Seton Hall. Evidence: People have sufficient information about the service before they move into the home. A comprehensive Statement of Purpose and Service User Guide is available and these give good information about the service provided. One person said that she had enough information before she came to live at the home about what Seton Hall was like. She said she had visited and talked to staff and other people living in the home and was satisfied that she wanted to live there. Pre admission assessments provide good information about peoples needs and these are completed by senior staff. These together with information from care management assessments are used to prepare individual care plans. One person said that when she Care Homes for Older People Page 11 of 26 Evidence: came to live at the home staff had known what she needed help with and she was very satisfied with the support she received. Care Homes for Older People Page 12 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. Good systems in care planning ensure that people get the care they need. Evidence: Each person has a care plan in place that provides information about their care needs and how these are met. The provision of personal care is arranged to suit the individual needs and preferences of the people living at Seton Hall. Good use is made of assessment tools to identify changes in peoples care needs. Records were up to date and good information was available about individuals. People living in the home said that they were well cared for and staff were kind and helpful. Staff demonstrated during the inspection that they had a good knowledge of peoples needs. One relative said ...the complete care and kindness towards my mother and our family have been just perfect. Six professionals responded to the survey sent out before the inspection and all provided very positive comments about the quality of the service. One professionals survey says Seton Hall provides A sensitive, person centred approach to all users and significant others. The home will endeavour to provide care even in some challenging circumstances, as well as knowing when to request assistance. A dedicated staff/management who have values including empathy and Care Homes for Older People Page 13 of 26 Evidence: empowerment that contribute positively to the service. Good records of healthcare interventions are kept and there was evidence that peoples health care needs are identified and met. Peoples individuality, privacy and dignity is respected. Staff training is provided for all staff that includes reference to these areas and to equality and diversity. Induction training for new staff is provided that covers these areas. There are policies and procedures in place for the administration of medicines. Individual records were up to date and clearly recorded. Good systems are in place for ordering and disposal of medicines. Staff training has been provided for all staff administering medicines. Care Homes for Older People Page 14 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. People are encouraged to make choices about their routines and lifestyle. Social, emotional, cultural and recreational needs are met in a way that suits individuals. Evidence: Good opportunities are provided for people to make choices about their routines and lifestyle. Information about peoples social needs is available to show peoples preferences and choices are known to staff. People are informed of any arranged activities by staff and on the notice boards in the home. Two people said that they were satisfied with the choice of activities and outings available. One person said that she attends every event organised and enjoys the opportunities to chat to people living in other areas of the home, while the other person said that generally she prefers to spend time in her room reading and watching television. It was evident that people are able to make choices about how they spend their time. The food was well presented and cooked. A choice is available at each mealtime and the menu shows that a varied diet is provided. Special diets are catered for. People having the meal said that they enjoy the food and are able to make their views known to the staff and the cook. Thirteen surveys returned said that they liked the food, while one said only sometimes did they like the food. Staff working in the kitchen have Care Homes for Older People Page 15 of 26 Evidence: completed Food Hygiene training. Drinks are provided throughout the day and snacks can be prepared in the kitchen area of each unit in the home. This area can be used by visitors to prepare hot drinks. Visitors are welcomed to the home by staff. Surveys returned indicated that staff were friendly and pleasant. Bedrooms are personalised and people are encouraged to bring in items from their previous home. People living in the home said that they were happy with their rooms, although one or two people said that they would like an en-suite toilet. Care Homes for Older People Page 16 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected by the good systems in place at Seton Hall for dealing with complaints and safeguarding matters. Evidence: A comprehensive complaints procedure is in place and records show that complaints are dealt with appropriately and within timescales identified in the procedure. Four complaints have been made in the past year and records showed that these have been dealt with appropriately. Good information was available to show the action taken to investigate these and what the outcome was. Two safeguarding referrals have been made and records show that appropriate action was taken to safeguard the people concerned. Staff have completed safeguarding training and were aware of what to do in the event of an allegation being made. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Seton Hall provides comfortable, well maintained accommodation that suits the needs of the people living there. Evidence: The home is clean, well maintained and odour free. The home is purpose built and is light and public areas of the home are spacious. The lounges and dining rooms are comfortably furnished and well decorated. A shaft lift is fitted to provide access to the first floor. The gardens are well kept and a summer house is available for people to sit in when the weather is nice. Since the last inspection the garden paths have been improved so that people are able to walk round the building. There is an ongoing programme of maintenance and decoration. Repairs are addressed promptly. Berwickshire Housing Association are working on plans for the replacement of Seton Hall with a new build home. No timescales have yet been identified. The home is arranged in four separate group living units. Since the last inspection some of the sitting rooms, main entrance hall and some of the corridors have been redecorated. Bedrooms are refurbished as part of the ongoing maintenance works. Wet rooms have been installed on each floor and thermostatic controls have been fitted on all radiators. There are sufficient bathrooms and toilets. All bathrooms and toilets are fitted with Care Homes for Older People Page 18 of 26 Evidence: appropriate aids to meet the needs of the people living in the home. During the inspection it was noted that alarm pull cords were sometimes tied up out of reach of people using the facilities, which can mean that some people may be unable to call for assistance. The pull cords were checked during the inspection to ensure that people could reach them. All bedrooms are now used as single rooms. People have personalised their rooms to suit their taste and interests. One person said that she did like her room, but would prefer to have an en-suite toilet so that she did not have to share the toilet with other people. This was repeated in some of the surveys received before the inspection. The laundry is well equipped, organised and clean. Washing machines have appropriate sluice cycles for washing soiled linen. Staff are aware of the need to maintain good infection control systems and policies and procedures are in place. Staff have completed appropriate training. 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. There are sufficient trained and experienced staff to meet the needs of the people living at Seton Hall. Evidence: Staffing levels are adequate to meet the needs, activities and wishes of individuals living in the home. During the visit to the home there were enough senior staff, carers, domestic and catering staff. Two people living in the home said that there were always enough staff and they were very kind and supportive. The manager said that existing staff members work additional hours to cover sickness and annual leave. Staff said that they are well supported by the manager and that there is good communication within the staff team. Good procedures are followed for the recruitment of staff and these take account of equality and diversity principles. Records showed that the manager recognises the importance of effective recruitment in protecting people living in the home. Appropriate checks are carried out and individual staff records evidence this. Staff receive the training they need to equip them with the skills to meet the needs of the residents. Training is focused on achieving better outcomes for people living in the home. Staff said that they get enough training opportunities and are well supported by the senior staff. Individual training records are in place and are kept up to date. Care Homes for Older People Page 20 of 26 Evidence: Ninety five per cent of staff have completed national qualifications in care. Staff meetings are held regularly and a staff supervision programme is in place. Staff said that they are able to raise issues and concerns and their views are taken seriously. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from living in a well managed home and are encouraged to put their views forward. Evidence: The manager is qualified and experienced to run the home and meet its stated aims and objectives. She has a good understanding of the organisations strategic and financial planning systems and how the business plan for the home is developed and implemented. She has a clear vision of the homes priorities and communicates a clear sense of direction. Equality and diversity, human rights and person centred service delivery are all given priority by the manager. She is well supported by an experienced senior staff team. The manager undertakes regular training that has included equality and diversity. One professionals survey said All in all, I am a big fan of Seton Hall .....and I think the manager and her team do a superb job. The staff always give the impression that nothing is too much trouble if it is for the patients benefit and they are excellent patient advocates. Care Homes for Older People Page 22 of 26 Evidence: There are good systems in place for assessing and reviewing the quality of the service that provides detailed information. There is evidence that the manager and the senior staff team are involved in improving and developing systems that monitor practice and compliance with the plans, policies and procedures of the home. Good systems are in place to ensure that the quality of the service is regularly reviewed. There was evidence that staff seek out the views of people living in the home and others such as relatives, care managers and health care professionals. People are encouraged and supported to retain control of their own money. If people are unable to manage their money information is kept in their individual records about the reasons for this. All transactions relating to money held are clearly recorded and appropriate procedures for managing residents money are in place so that staff are clear about their responsibilities. Lockable storage is provided in each persons room so that they can keep money or valuables safely. Health and safety policies and risk assessments are in place and staff receive appropriate mandatory training at regular intervals. Good records of training are kept. Regular checks and servicing of fire equipment are carried out and records show staff have received appropriate fire training. Good records are kept of all accidents and there was evidence that these are monitored by senior staff. 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 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 21 All alarm pull cords in bathrooms and toilets should be easily accessible to people using these rooms. The practice of tying them up or to a rail should be discontinued. 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. 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