Care Home: St Edmunds

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What the care home does well The service provides well planned and well managed support to the people living in the home, meeting the identified needs of these people in a way suited to them as individuals. People living in the home contribute through regular meetings, and a very open management style to day to decision that affect them, and receive a high standard care. Staff are well trained, and prepared to adapt their working practices to ensure that the needs and wishes of the people they look after are at the fore All staff receive regular support and supervision. What has improved since the last inspection? Since our last visit a number of improvements have been made including redecoration of part of the home, a new shower room, better bedding for the individual rooms, more events and activities and a new boiler. Staffing is more stable and working in a more flexible manner to meet the support needs. The manager felt that overall the residents all seem happier than they were when she became manager. What the care home could do better: The service needs to ensure that the maintainance and redecoration continues, and that planned replacement windows are installed or the security arrangements on the existing windows changed. The manager also felt that the events and activities they arrange need to be better organised, and the new activity co-ordinator will help with this. Inspecting for better lives Key inspection report Care homes for older people Name: Address: St Edmunds Surrogate Street Attleborough Norfolk NR17 2AW     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Alan Buttery     Date: 0 8 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: St Edmunds Surrogate Street Attleborough Norfolk NR17 2AW 01953452011 01953457463 sue.brockett@norfolk.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Norfolk County CouncilCommunity Care care home 35 Number of places (if applicable): Under 65 Over 65 35 old age, not falling within any other category Additional conditions: 0 That Service Users who need a wheelchair to assist with independent mobility at point of admission can only be accommodated in rooms 30, 35, 36, 40, 41, 44, 72, 74 and 75. The Home may accommodate one (1) named Service User who is mentally disordered. Maximum not to exceed 35. The home can accommodate up to 35 Service Users who are Older People, not falling into any other category. Date of last inspection Brief description of the care home St Edmunds Home is situated close to the market town of Attleborough. It is a purpose built home, providing residential care to up to thirty-five elderly people, operated by Norfolk County Council. Accommodation is on two floors and there are bedrooms, sitting and dining rooms on both floors. Access between the floors is by a shaft lift or one of three staircases. Care Homes for Older People Page 4 of 24 Brief description of the care home The premises were not built to comply with space standards now applicable under the Care Standards Act 2000. This has been partially resolved by a reduction of numbers of service users and the attachment of conditions in relation to rooms occupied by those needing wheelchairs to move independently around their rooms. The home itself is situated by the side of part of the one-way, traffic system around the town centre and there is limited parking on the site. The current fee levels for the home are individually assessed with a maximum weekly charge of #382.00 Care Homes for Older People Page 5 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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: This was an unannounced visit during which we discussed the provision of support to the resident of the home with the manager, care co-ordinator, other staff and residents. We looked at a range of records including staff and resident files, maintainance records, complaints and compliments and training records. We also looked around the premises, including some of the residents rooms and at the gardens. We looked at notifications that the service had submitted to us the last year, and at Care Homes for Older People Page 6 of 24 other correspondence received. 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 set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 24 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Before moving into the home, all new residents have their support needs assessed so that they can be confident the service will meet those needs, in a manner suited to them. Evidence: During our visit, we discussed the process of admissions to the home with the manager of the service and the Care Co-ordinator. The same process applies to people funding their own support and local authority funded packages. Initial referrals normally come form local the local Social work team, even where the support is self funded, and initial details are recorded. The manager or Care coordinator would then arrange to visit the prospective resident, and complete an initial assessment. On some occasions, they may have to visit the prospective resident in hospital. Care Homes for Older People Page 10 of 24 Evidence: The needs of the prospective resident are then discussed with the care team to ensure they are happy that they can provide appropriate support, and discussed with the persons social worker to arrange admission, or placement on a waiting list. Initial care plans are prepared and the move arranged, and wherever possible this is preceded by a visit to the home by the new resident and family. As part of our inspection, we looked at the individual records for four people living in the home, and these files all contained details of the admission and assessment process followed and described above. The service does not provide intermediate care. Care Homes for Older People Page 11 of 24 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individual plans are in place which show the involvement of the person in their preparation, and which show the support to be provided and how this is given in a way suited to the person. Evidence: As detailed earlier in the report, we looked at the individual files for four people living in the home, and at the individual care plans. Theses are written first on admission to the home, and showed evidence that the person they related to was involved in their preparation, and evidence that the plans were reviewed on a regular basis. The manager advised us that they receive excellent support from the local Doctors surgery, and in many instances, they talk to one of the GPs before arranging a new admission. Care Homes for Older People Page 12 of 24 Evidence: Specialist support is available through the local health team as required, including an out of hours rapid response service, and district nurses have treatment facilities available in the home for their use. Procedures are in place for the administration of medication, and those responsible for the administration of medication have undertaken suitable training. Storage facilities are in place for the medication in the home, and a monitored dosage system used. Care Homes for Older People Page 13 of 24 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A range of activities and events are available, giving people who live in the home a choice of how to spend their tile. Evidence: The service provides a number of events and activities for people living in the home, and arranges trips and outings on a regular basis. Some of the activities available include bingo, games such as skittles, dominoes, boards games, events for special occasions and activities around them such as card making, arts and crafts and Musical entertainment. A reminiscence team visits two weekly, and an activity co-ordinator is now in place working two hours daily with one of her hours spent taking people out of the home. People living in the home are supported to go to local shops and hairdressers, and also attend their local church and individual sessions are held with some residents particularly those who cant get out, talking and reading newspapers with them. Care Homes for Older People Page 14 of 24 Evidence: Catering in the home is provided centrally by the County Council, but individual snacks are available, and the home has a weekly fruit round with fresh fruit for residents rooms. There have been some concerns raised around the standard of food, but these have now been resolved, and the County Council are providing a new cook who will start shortly. A choice of main meal is always available, and both hot and cold teatime meals available, and a range of breakfasts served. Menus and food are usually discussed at residents meeting, and recently lap teas have been introduced at the weekend served to those who wish to have them in the lounge. Soft diets are available where required and support is given by the local health team and the service always tries to maintain a healthy food programme. Care Homes for Older People Page 15 of 24 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Procedures are in place to ensure that any concerns, complaints or allegations raised by residents are dealt with quickly. Evidence: The service is owned and operated by Norfolk County council, and follow the corporate complaints procedure. A log of complaints is held in the home, and this was examined and discussed with the manager of the home. Although a large number of complaints had been received in the past year, these related mainly to problems with meals, which have been addressed as described earlier. The previous cook did not interact well with the residents, but as mentioned earlier a new cook will be joining the catering side of the home shortly. Procedures are in place to ensure that all safeguarding issues are dealt with in line with the county council, and all staff working in the home receive initial and refresher training. There have been no safeguarding issues reported in the two years since we last inspected the service. Care Homes for Older People Page 16 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. he home provides spacious accommodation for people who live there which is clean and well maintained and provides a homely and safe environment. Evidence: As pert of our inspection, we looked around the home, and at some of the individual residents rooms. The home was clean with no offending odours. Facilities are good, and since our last visit, some refurbishment has been carried out, with further decorating shortly to be done. The entrance hall has been redecorated with staff help and new heating and hot water boilers installed. At our last Inspection we were told that replacement windows were being considered, however this has not happened, and the padlocks used for security do not portray an acceptable image to the home. if replacement windows are not be installed, then an alternative method of security should be considered. The home has attractive grounds, which are accessible to people living in the home. Care Homes for Older People Page 17 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Procedures are in place ensuring all the required recruitment checks are undertaken, and that staff are suitably trained and people living in the home can be confident their needs will be met in a way suited to them. Evidence: During our visit we looked at the recruitment procedures followed by the service, and at records of staff employed in the home. The recruitment process is in line with the County Council procedures, and with the National minimum standards, and details the information the home gathers about prospective employees. The recruitment process includes a formal interview, a look around the home and time to complete the required documentation including CRB checks. Two written references are always obtained, and the process is collated by the County Councils Human Resources department, with copies of all records held securely in the home. Staff receive a detailed induction training and all mandatory training is on schedule. Records were seen in the individual staff files we examined, and a plan of training provided by the manager of the service which shows planned future training. Many of Care Homes for Older People Page 18 of 24 Evidence: the staff have completed or are undertaking NVQ training, and again a record of this was provided. The service operates with 4 care staff during the day, including a senior and 2 overnight as well as domestic staff. As already mentioned, the homes catering staff are employed and provided by the County Council, and not directly employed by the home. Care Homes for Older People Page 19 of 24 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is well managed and run in the interests of the people living there who contribute to decisions affecting their day to day lives, and are consulted on changes planned. Evidence: The service is well managed, and has a welcoming atmosphere when you first enter. The manager of the service, who joined shortly before our last inspection clearly puts the interests of the residents at the fore, and has a good relationship with staff. We spoke with two members of staff who both commented on the positive relationship they have with the manager. Staff are regularly supervised, and evidence of this was seen on the files we examined, and the manager told us that she receives excellent support from the area manager. The manager also has twice yearly appraisal meetings, and all staff in the home have an annual appraisal. Care Homes for Older People Page 20 of 24 Evidence: The home is well maintained, and the county council maintainance department together with a handyman employed in the home ensure any problems are quickly dealt with. Staff help raise money for decoration projects in the home by fund raising including raffles, car boot sales and sponsored events. All the required safety checks are undertaken and regular fire and health and safety training provided to all staff. A recent evacuation drill was held, and fire drill noted that the fire extinguishers were mounted out of reach for some staff, and have now been lowered. Care Homes for Older People Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 19 Alternative means of securing windows should be considered Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 24 of 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!