Care Home: St Catharines Residential Home

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What the care home does well The service provides a homely, safe and stimulating environment for the residents to live in, and this includes the attractive landscaped garden which has seating for the residents and their visitors. Residents are given choices in their daily routine and their preferences are respected. They are encouraged in therapeutic and stimulating activities and trips out. On the day of the inspection residents appeared well dressed and well cared for. Some were observed in the lounge chatting among themselves and with members of staff who appeared gentle and softly spoken in their approach to each resident. The individual was treated with respect and dignity. The residents spoken to were complimentary about the service and care given. They felt well supported by an effective staff team. The following were some of the comments residents and visitors had commented: "Staff helpful, gentle and kind to residents." "Helpful and sincere." "The care is very good." "Good food and the chef makes good cakes as well." "I have seen individual staff members sitting and chatting with residents in the lounge." "Good one to one attention given." "(The resident) seemed very content here and settling in very well." "Staff very helpful and very polite." In our recent surveys, the respondents gave the following comments: "Look after people well." "I am happy with everything." "Everyone I have met here have been kind and helpful." "Looks after me." "Looks after us and take care of us." "Quite happy with everything." "Staff listen to me and help me." I am quite content with everything." "The home makes me happy because there is always someone here that you can tell anything to and speak to." "The home is always fresh and clean and smelling sweet." "Creating a friendly, family atmosphere." "I don`t thing they can do anything better than what they are doing at present. Since the new manager came, it`s been a lovely home." What has improved since the last inspection? The general standards of administration and management of the service have improved under the new management. Residents interviewed during the site visit were complimentary about the new management style. The new manager is currently going through the process of registration with us. What the care home could do better: Work is in progress to improve the internal environment and to refurbish some rooms, including converting a double room into a single room with en suite facilities. The manager ensures the safety of residents during refurbishment work. Key inspection report Care homes for older people Name: Address: St Catharines Residential Home 24 St Catharines Road Broxbourne Hertfordshire EN10 7LE     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: Yoke-Lan Jackson     Date: 1 5 0 4 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 22 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 22 Information about the care home Name of care home: Address: St Catharines Residential Home 24 St Catharines Road Broxbourne Hertfordshire EN10 7LE 01992462224 01992442632 stcatharines@bmcarehomes.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): B & M Investments Ltd t/a B & M Care Name of registered manager (if applicable) Ms Susan Rose Jarvis Type of registration: Number of places registered: care home 25 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home St Catharines is a residential care home provided by B&M Care Ltd. It was first registered as a residential home under the Registered Homes Act in 1983. It is situated in a quiet residential area in Broxbourne a short distance away from the local shops. There are bus and rail links nearby. The home is a large detached property converted to provide accommodation on three floors all of which are accessible by a lift. Three bedrooms on the first floor are reached by a further short flight of steps. There are 19 single bedrooms, 6 of which have ensuite facilities and 3 double bedrooms, which have en-suite facilities. On the ground floor there are two lounges, a separate dining room, a conservatory, the kitchen and a small office. Care Homes for Older People Page 4 of 22 0 Over 65 25 Brief description of the care home The home has very attractive landscaped gardens with pathways and a patio area which is accessible to wheel chairs. The home charges £594 to £708 per week. Information about the home and the service it offers is contained in the Statement of Purpose and Service Users Guide. A copy of these and the most recent CQC inspection report are available in the home. Care Homes for Older People Page 5 of 22 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: This unannounced key inspection was carried out on 15/04/2010. The home manager was present. There were 23 people in residence. The inspection visit included a tour of the premises, lunchtime observation and observation of how the staff interacted with the residents in the dining room and during activity sessions. Staff and residents were spoken with and key documents were examined. The inspection ended with a thorough discussion with the home manager. Survey questionnaires were sent to the residents, relatives and staff and their responses and other information received by us were reviewed. This included the Annual Quality and Assurance Assessment (AQAA) which providers of registered services are required to ccmplete annually. The AQAA focuses on how the outcomes are being met for thepeople using the service and also provides us with statistical data. Care Homes for Older People Page 6 of 22 What the care home does well: The service provides a homely, safe and stimulating environment for the residents to live in, and this includes the attractive landscaped garden which has seating for the residents and their visitors. Residents are given choices in their daily routine and their preferences are respected. They are encouraged in therapeutic and stimulating activities and trips out. On the day of the inspection residents appeared well dressed and well cared for. Some were observed in the lounge chatting among themselves and with members of staff who appeared gentle and softly spoken in their approach to each resident. The individual was treated with respect and dignity. The residents spoken to were complimentary about the service and care given. They felt well supported by an effective staff team. The following were some of the comments residents and visitors had commented: Staff helpful, gentle and kind to residents. Helpful and sincere. The care is very good. Good food and the chef makes good cakes as well. I have seen individual staff members sitting and chatting with residents in the lounge. Good one to one attention given. (The resident) seemed very content here and settling in very well. Staff very helpful and very polite. In our recent surveys, the respondents gave the following comments: Look after people well. I am happy with everything. Everyone I have met here have been kind and helpful. Looks after me. Looks after us and take care of us. Quite happy with everything. Staff listen to me and help me. I am quite content with everything. Care Homes for Older People Page 7 of 22 The home makes me happy because there is always someone here that you can tell anything to and speak to. The home is always fresh and clean and smelling sweet. Creating a friendly, family atmosphere. I dont thing they can do anything better than what they are doing at present. Since the new manager came, its been a lovely home. 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 22 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 22 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 who use this service can be confident that they will be supported since the home will only admit a prospective resident after a thorough pre-admission assessment is carried out to ensure that the home can meet all their care needs. Evidence: The pre-admission documents for two new admissions were examined and they were found to be detailed and informative. The manager had carried out a thorough assessment of each prospective residents personal, healthcare and social care needs. This ensures that the individuals needs can be met on admission. The manager said that the home will only admit prospective residents whose care needs can be appropriately met. We saw that the two new admissions seemed settled in their new home. Care Homes for Older People Page 10 of 22 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be assured that they will be treated with respect and they will receive personal care and support in the way they prefer and require. They are safeguarded by the homes Medication Policy and Procedure. Evidence: Each resident has a care plan. The care plans examined have details of each residents health, personal and social care needs. Appropriate risk assessments had been carried out and documented. The daily notes were kept updated. There were specific care plans for Parkinsons Disease, Diabetes and other conditions. The key worker reviews the persons care needs and the management updates the written care plan monthly. There is an annual review of care needs that involves the resident, their next of kin and relevant healthcare professionals. On the day of the site visit, it was noted that all the residents seemed content and well cared for. The members of staff present have knowledge of each residents likes and dislikes and each residents choices and preferences were respected. Care Homes for Older People Page 11 of 22 Evidence: All residents have access to specialist services according to their needs. Each resident has their own doctor. One resident was referred to their doctor on the day of the site visit and is waiting for the test result before the doctor presribed their antibiotics. None of the residents have developed pressure sores. The manager said that the district nurse will be informed immediately to assist if pressure sores develop in a resident. Two residents will be attending a training session (for staff) provided by the Parkinsons Society. This helps the resident and staff to have a better understanding of the disease and the staff can support the resident to cope better as well. On the day of the site visit, a member of staff was seen assisting a resident whose hearing aid was not working. The resident was treated with respect and dignity. A trained member of staff administers the medication. The controlled drug cupboard is securely attached to the wall within a storage room. A drug trolley is used to store the residents daily medicines. The trolley is kept in the storage room and attached to a wall when not in use. The home uses the Monitored Dosage System for each resident. All medicines are clearly labelled and the opening date is written on each container. The Medication Administration Record (MAR) charts were examined. The manager said that there is a regular medication audit and that there have been no further medication errors since the last inspection. Care Homes for Older People Page 12 of 22 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 use the service can be assured that they will be given the opportunity to make everyday choices and that their preferences and requests will be respected. They will be encouraged to maintain links with their friends and families and they will be encouraged to have a nutritious and balanced diet. Evidence: Residents are given choices in their daily routine and their preferences are respected. On the day of the inspection, it was noted that residents have access to all community areas. One of the residents who preferred to sit in the armchair by the window in a corner of the lounge was given their space daily together with a table for their personal effects. Staff interviewed said that residents were encouraged in therapeutic and stimulating activities and trips out. Recent trips included visits to the garden centres, shows in the local civic hall and a show and lunch in a social club. The home has an additional activity worker who engaged with the residents on a one-to-one session in their own bedrooms or in the lounge two days a week, working alongside the activity coordinator. Care Homes for Older People Page 13 of 22 Evidence: On the day of the site visit, residents had the pleasure of meeting and stroking two pet dogs brought in by their owner, a volunteer entertainer who brought the pet dogs weekly to visit the residents. Individual staff members were observed chatting with residents in the lounge over a cup of tea before and after lunch. This daily practice by staff encourages residents to also chat among themselves. Staff interaction with residents was positive and each resident was given one to one attention now and again. Lunchtime was unhurried. Some residents preferred to sit together in a second lounge rather than the dining room for their meals and they were given their preferences. The majority of the residents had their lunch in the dining room. The hot meals and the dessert provided were appertising and residents seemed to enjoy themselves. The members of staff interviewed said that residents have a choice of menu and the meals provided are nutritious and wholesome. Care Homes for Older People Page 14 of 22 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 who use the service can be assured that the service has a robust Complaints Policy and Procedure and people can be assured that their complaints will be listened to and that any concerns raised will be investigated and appropriate action will be taken. Evidence: The home has not received any complaints about the care and service provided since the last inspection. A residents meeting is held regularly and the management deal with any issues raised promptly and effectively. All members of staff have received training on the Protection of Vulnerable Adults and on the Hertfordshire Joint Safeguarding Procedure. They are aware of the WhistleBlowing Policy. Since the last inspection, there have been no safeguarding referrals made. Staff have training on the the Mental Capacity Act 2005 and the Deprivation of Liberty safeguards to ensure that staff have an awareness of the assessment of capacity and that decision-making for a resident is being undertaken in a way that complies with the law. This also ensures that people living in the home are not deprived of their liberty without an authorisation. The home manager confirmed that there have been no cases subject to the Deprivation of Liberty authorisation. Care Homes for Older People Page 15 of 22 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be assured that they live in a homely, comfortable and safe environment and have access to both internal and external communal facilities. Evidence: The premises are well maintained, including the surrounding landscaped garden which is attractively designed and is accessible to wheelchairs. The garden has garden furniture and seating for residents and visitors. On the day of the site visit, the exterior and interior of the home appeared clean and tidy. All the bedrooms are cleaned daily and they reflect the lifestyle of the individual occupant. The manager said that the bedrooms are being refurbished and decorated as the rooms become vacant. Since the last inspection, all the external windows have been replaced and a new kitchen unit has been installed. Some old carpets have been replaced. Work is in progress to refurbish one of the bedrooms. Care Homes for Older People Page 16 of 22 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. People who use the service can be assured that the home has an effective staff team who will support them and can be confident that they will be safeguarded by the homes robust recruitment policy and procedure. Evidence: The homes recruitment policy and practices comply with legislation. There has been one new recruit for the deputy post since the last inspection. The records examined were satisfactory. The new staff had Criminal Record Bureau (CRB) checks and the Protection of Vulnerable Adult (POVA) checks. The manager confirmed that all new staff only commenced working after these checks had been cleared. The home has an effective staff team. The skill mix of staff benefits the residents. Most of the staff have attained NVQ2 and some are currently in training for NVQ3. There is an ongoing training programme for staff. The induction programme is in line with the Skills for Care guidelines. The manager confirmed that staff have ongoing training and refresher courses to ensure that they have the skills and knowledge to care for the residents. Recent training included Dementia, Medication, Parkinsons Disease and staff have access to e-learning. Care Homes for Older People Page 17 of 22 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. People who use the service can be assured that the home is run in their best interests and they can be assured that their health, safety and welfare are promoted and protected. Evidence: The general standards of administration and management of the service have improved under new management. Residents interviewed during the site visit were complimentary about the new management style and they were very pleased with the service and care given. The home manager is currently undergoing the registration process with us. The home manager is an A1 Assessor and will soon complete NVQ4 and Registered Management Award training. The home manager is well supported by senior management and an experienced deputy manager, appointed since the last inspection. The provider carries out an annual quality assurance and monitoring survey. This Care Homes for Older People Page 18 of 22 Evidence: includes written questionnaire feedback from residents, relatives and others. The audit documents were readily available for inspection. There is a monthly visit and report carried out by the provider in compliance with regulations. Staff handled confidential information in accordance with the Data Protection Act 1998. The home is not involved in the financial affairs of the residents except for their personal allowances. All transactions are appropriately documented. The servicing records have been well maintained. The management promote equality and diversity. All members of staff are trained to ensure they follow the homes policy and procedure on equality and diversity issues and they are aware of the Mental Capacity Act 2005 and the Deprivation of Liberty safeguards. The home manager confirmed that there have been no cases subject to the Deprivation of Liberty authorisation. The Annual Quality Assurance Assessment (AQAA) forms issued by the Commission were received on time for this inspection. The information provided was detailed and informative and was included in this report. Care Homes for Older People Page 19 of 22 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 20 of 22 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 21 of 22 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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