Care Home: St John's

Similar services:

• Ashlea Mews Residential Home
• Eastwood
• West Lodge
• Arran House
• Avenue Community Nursing Home
• Cosin Lodge
• Farmborough Court
• Cragston Court

What the care home does well The home provides a good range of information to people thinking of coming to the home, so they can make an informed decision. The home makes a full assessment of a person`s needs before deciding if it can meet all those needs. The home draws up plans to meet the care needs of its service users. Service users health care needs are also fully assessed and properly met. Service users say that staff treat them well and treat them with respect. The staff are working hard to provide a stimulating atmosphere in the home, with appropriate social activities for service users. Service users are encouraged to keep in regular contact with family and friends. Service users are also encouraged to take as much control over their own lives as they are able, and make their own decisions. Service users were very complimentary about the food, and there is a balanced diet, with service users choice included. Complaints and concerns are taken seriously and are responded to properly. The home is kept clean and hygienic and free from odours. The home has enough staff to meet the needs of service users. The home is very careful as to how it recruits new staff, and runs all the necessary checks on them to protect its service users. The manager is very experienced and is providing positive leadership to the home. The home is being run in the best interests of the service users. Service users finances are protected by the home`s policies and accounting systems. The health and safety of the service users and of the staff are protected by the home`s policies and systems. This service has the potential to achieve a three star rating in the future. What has improved since the last inspection? This is the first key inspection since the home was registered on 01/02/09. What the care home could do better: No requirements were identified during this visit. The manager intends to complete the registered manager`s award within the next twelve months. Key inspection report Care homes for older people Name: Address: St Johns Hundens Lane Darlington Co Durham DL1 1DT     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: Jim Lamb     Date: 1 0 0 7 2 0 0 9 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 27 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) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: St Johns Hundens Lane Darlington Co Durham DL1 1DT 01325382622 01325354717 stjohns@c-i-c.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): St Johns Name of registered manager (if applicable) Mrs Judith Henman Type of registration: Number of places registered: care home 24 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 24 The registered person may provide the following category of service only: Care Home only - Code N To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Mental Disorder Code MD, maximum number of places: 24 Dementia - Code DE, maximum number of places: 24 Date of last inspection Brief description of the care home St Johns specialises in providing care and treatment for 24 older people aged 65 and over with mental health illnesses. The service provides a friendly theraputic environment where service users receive treatment and care to meet their individual needs. Care Homes for Older People Page 4 of 27 Over 65 0 0 24 24 Brief description of the care home St Johns is located in a quiet area of Darlington, close to local amenities with good access to various transport links. The home is purpose built with spacious accommodation consisting of 24 single ensuite bedrooms. The home was registered on 01/02/09. Information about the home and copies of the most recent inspection report are available in the home. Fees for the home are 437. 47 per week. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The quality rating for this service is 2 stars. This means that the people who use the service experience good quality outcomes. 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 complaints and concerns since the last visit, any changes to how the home is run, the providers view of how well they care for people, and the views of Care Homes for Older People Page 6 of 27 people who use the service and their relatives, staff and other professionals. During the visit we talked with people who use the service, staff, and the manager, 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/parts of the building to make sure it was clean, safe and comfortable. We told the manager/provider what we found. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: Care Homes for Older People Page 8 of 27 No requirements were identified during this visit. The manager intends to complete the registered managers award within the next twelve months. 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 27 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 27 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. Prospective service users are provided with enough information about the service to enable them to make an informed choice about whether this is where they want to live. Evidence: The care records for three service users were looked at. These showed that the manager makes sure that a full assessment of a new service users needs is carried out by the persons social worker before they come into the home. The manager also carries out her own assessment, to be doubly sure that the home can meet all of the new persons needs. More detailed assessments are carried out once the new service user has come into the home. These include assessments of risk, of nutritional needs, social needs, moving and handling needs and of behavioural needs. A dependency rating scale is Care Homes for Older People Page 11 of 27 Evidence: also completed. Skin care assessments are also carried for those at risk of developing pressure sores. As a result of all these levels of assessment, the manager can clearly demonstrate that all the service users are in a home that can give them the care that they need. The homes service users guide is available, and information will soon be available on compact disc. All are provided with a contract explaining the homes terms and conditions, and fees. Care Homes for Older People Page 12 of 27 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. The care planning system is clear enough to ensure that staff have the information they need to meet the assessed needs of the service users. Evidence: A comprehensive range of assessments is completed to identify each service users current health, personal and social care needs. This information is used to devise and update individual care plans. Service users are involved in planning their care and have a key worker who monitors and helps to update care plans. A sample of three service user care plans were examined. These addressed physical health, personal hygiene, continence, memory and cognition, skin integrity, communication, social and spiritual needs. The recording was detailed, specific and personalised to the persons requirements. The plans demonstrated care and support to be provided by staff and what the person can do independently. There were also good examples of plans that showed how risks to the person are managed or minimised. Care Homes for Older People Page 13 of 27 Evidence: Service users said they always receive the care and support they need, and that the staff always treated them with respect and maintained their privacy and dignity. One service user said, This is a very good place, the staff are very caring. Another said, My nephew visits quite often, i have no complaints. Service users have a choice of local GP practices. There are arrangements for an optician, dentist and podiatrist to make home visits. Service users also receive input, if required from mental health care professionals, physiotherapist and occupational therapists. All contact with health care professionals is well recorded. Service users have their moving and handling, nutrition, continence, and pressure sore risk needs assessed. Falls assessments are also completed. There were some very good examples of care plans linked to specific health care needs and medical conditions. Where identified these incorporated appropriate aids and equipment used. All staff who administer medication undertake relevant training. A sample of medication charts was examined. These were appropriately recorded and have service users photographs for identification purposes. All personal care and medical examination/treatment is carried out in private. Service users confirmed that staff treated them with respect and personal care is always carried out in a dignified manner. Care Homes for Older People Page 14 of 27 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. The service users are offered a good quality lifestyle, which includes varied social contact and activities. Evidence: The home draws up a detailed social history for each person, including hobbies and interests, likes and dislikes, social networks, spiritual needs etc, and there was evidence in the care plans that individual interests are catered for. The manager has plans to display a whole range activities and events in the home. Activities include favourites such as reminiscence sessions, bingo, carpet skittles, quizzes, crafts, baking, dominos and cards. There are regular film shows and weekly pamper days such as hairdressing and manicures. The usual range of festivals and other significant days are celebrated. These include Valentines Day, Shrove Tuesday (pancake tossing), Burns night, Halloween etc. The service has appointed two activities co-ordinators 16 hrs per week, and they are in the process of devising very specific programmes for service users individually and collectively. Care Homes for Older People Page 15 of 27 Evidence: There are occasional trips out and service users have access to local facilities. There are no visiting restrictions. Care assessments and care plans showed that service users are encouraged and supported to be as independent as possible. They are free to choose their daily living patterns, in terms of when they get up and go to bed, what to wear, when to bathe, what to eat and when. (The kitchen is never locked). They are assisted to vote, if they so choose. They are also encouraged to comment on the running of the home in their meetings, relatives also attend these meetings. The menus promote healthy eating. Alternative choices are available for every mealtime, there is provision for individual choice of, omelette, jacket potatoes, soup etc, on request. The menus were drawn up with the help of a dietician. The Chef had excellent knowledge of the service users nutritional needs, and these are discussed with the nursing staff on a weekly basis. Finger snacks are available at all times, day and night. Specialist diets will be catered for, but, at the time of the inspection, only diabetic and soft diets were required by service users. There is a suitable budget for the catering staff to work to. The service users said that they always like the meals and confirmed that they are always offered a choice. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints management is effective, and this results in the service users being protected from harm and abuse. Evidence: There is a complaints procedure. It contains details of how to contact the CQC to make a complaint, if complainants are not happy with the homes investigation and response. The procedure is written in a way that ensures service users fully understand its contents. Copies are available in service users bedrooms. For those service users without capacity, advocacy arrangements are in place. One service users said she had been given copies of the procedure and that staff listened to her concerns and always dealt with them fairly. The home has a system and procedures to record complaints. Since the service was registered in February 2009 there have been no complaints received. The home has a Whistle Blowing policy, a copy of the Local Authorities Vulnerable Adults procedures, and a copy of the Department of Healths document, NO SECRETS. Staff are aware of these procedures and have easy access to them. Safeguarding adults training is ongoing for all staff. Care Homes for Older People Page 17 of 27 Evidence: Service users can deposit cash for safe keeping, and records are kept of accounts. A sample of personal finance records was examined all transactions were appropriately recorded. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a very comfortable and safe environment for those living there. Evidence: All parts of the building seen were clean, suitably equipped and have good quality decoration, (new furniture, soft furnishings and carpets are being delivered next week for all communal areas). There is an ongoing programme of decoration and refurbishment. The grounds are well maintained and are used regularly by service users. A number of service users spoke positively about their bedrooms and the accommodation in general. The home was clean, well decorated and well maintained. The grounds were attractive, tidy, safe, and accessible. The home has an appropriate amount of sitting, recreational and dining space. There are enough rooms for a variety of activities to take place. During the last six months, there has been some significant improvements made to the environment, there is new flooring in the corridors, all communal areas are being Care Homes for Older People Page 19 of 27 Evidence: refurbished, new fire doors have been installed, and all windows have been replaced. Next year there are plans to refurbish all 24 bedrooms, and replace the conservatory. The manager intends to display Orientation boards providing information depicting: date/day, weather, the names of the staff on duty, appropriate signs on toilet doors, bathrooms, dining and lounge areas. This will enhance and promote the orientation for people with memory problems. The management team plan to contact Stirling university who will provide appropriate information about environmental design, and colour schemes suitable for this client group. Service users can see visitors in private in their own rooms. Furnishings and fittings were domestic in design and in reasonably good condition. All bedrooms have got ensuite facilities. Lighting was bright and domestic in design. All doors have privacy locks and room sizes meet the required standards. There is space on either side of beds when necessary, to enable access for carers and specialist equipment. Service users bedrooms have opening windows and restrictors are in place that have been approved by the Fire Brigade. The rooms were centrally heated and the heating level could be controlled within each bedroom. Radiators and pipes were guarded. There was emergency lighting throughout the home. The kitchen was spotlessly clean and well organised. Water is stored at over 60C. Valves at water outlets ensure water is provided close to 43C to prevent scalding. The home was clean and free from offensive odours. Staff receive infection control training. There is suitable hand washing facilities throughout the building. Disposable gloves and aprons are provided for staff use. Arrangements are in place to dispose of clinical waste. Care Homes for Older People Page 20 of 27 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 is a good match of well-qualified staff, who are appropriately recruited and supervised. Evidence: Staff levels on the day of the inspection were sufficient to meet the needs of the service users. On the day of the inspection there were 24 service users. In addition to the manager, the required numbers of staff were on duty across the day: 2 qualified staff, and 5 care staff from 8am to 8pm. From 8pm to 8am there is 1 qualified staff, and 3 care staff. There are additional staff on duty as and when necessary. There is a full time administrator. Staff turnover is very low. There are enough domestic, laundry, maintenance, and catering hours. All staff were over 18 years of age and those left in charge were at least 21. The training needs of the staff are identified in supervision and appraisal sessions. Care Homes for Older People Page 21 of 27 Evidence: The homes induction training programme meets the National Training Organisation requirements for the first six months. All statutory training was up to date and 85 of the staff team has completed NVQ level 2/3. The personnel records of two staff were examined. Both had completed application forms, the dates of employment were clear, making it easy to follow a clear employment audit trail. The manager also completes an audit check list and this ensures that all the necessary checks have been completed prior to commencing employment. Both had the required two work references, (crb) criminal record bureau check, documentary evidence of identity, induction and training and development information. The service employs a training and development officer, and all staff have an annual training matrix drawn up, this covers all mandatory training needs, and other core training needs, such as Dementia Awareness and Adult Protection. Individual staff members have his or her individual training needs analysis on their personal file. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager is supported by the organisation in providing good leadership throughout the home, with staff demonstrating an awareness of their roles and responsibilities. Evidence: The registered manager has the required qualifications and experience to run the home. She is a qualified RMN and RGN, she also has a diploma in cognitive behavioural therapy, and ENB (English National Board Teaching Certificate). She plans to complete the Registered Managers Award within the next twelve months. There is a range of quality systems in the home. These include monthly audits, and there is an annual survey of the views of the service users and their families. The findings are collated and an action plan drawn up to address any areas of concern. There are also regular meetings held with both the service user groups, relatives and with the staff group. These are minuted and action points listed. Care Homes for Older People Page 23 of 27 Evidence: Both individual and central supervision records were studied. These records show an appropriate bi-monthly pattern of supervision for all staff. All staff receive annual health and safety training. This is good practice. Checks of the fire log book showed that all the required checks and tests of equipment and systems take place at the proper intervals, as does fire safety training. The homes accident book is kept up to date and information is fully recorded. Each accident is reviewed after 24 hours to check the outcomes of the accident and any treatment given. There is a monthly audit of accidents, and a detailed audit of all falls. Servicing and maintenance records are comprehensive and well maintained. Care Homes for Older People Page 24 of 27 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 25 of 27 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 31 The manager must complete the registered managers award within the next twelve months. Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - 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!