Care Home: St John`s Nursing Home

What the care home does well St. Johns delivers a good standard of care; it does this by maintaining competent care practices and good relationships with the service users and their families; the result is a homely, friendly atmosphere. The home has a wealth of knowledge and expertise within its management about caring for people with a dementia. The staff group are well trained and knowledgeable about the needs of residents; one visitor said `I couldn`t give you a bad point about it` and another said `the staff are so pleasant, so helpful - they see everything`. The building is decorated and maintained to a good standard and the grounds and gardens are well tended with raised sensory flower beds for people to enjoy. It is very well managed and organised and visitors made many positive comments about the manager; one said `It`s improved immensely in all ways in the two years the manager has been here`. Residents have care plans and reviews are carried out frequently; families and other professionals are involved in the reviews. Staff members are well trained and feel supported by the registered manager. They have a sound knowledge of the needs of people. The staff team work well together and have established a good working relationship with the community health care teams and local GPs. The building is decorated throughout to a high standard and is well maintained. What has improved since the last inspection? The newly-registered manager and her team have worked hard to address the issues identified in the previous inspection report. These have included a revised statement of purpose and service users` guide, more in-depth care plans, more staff dedicated to activities for people and increased staff training on issues such as dementia and the Mental Capacity Act.. What the care home could do better: The number and size of rooms should be included in the statement of purpose. Inspecting for better lives Key inspection report Care homes for older people Name: Address: St John`s Nursing Home White House Lane Fishtoft Boston Lincs PE21 0BE     The quality rating for this care home is:   two star good 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: Julie Western     Date: 1 4 0 1 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. the things that people have said are important to them: They reflect 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 23 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 23 Information about the care home Name of care home: Address: St John`s Nursing Home White House Lane Fishtoft Boston Lincs PE21 0BE 01205366059 01205311659 management.stjohns@virgin.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Denise Margaret Lee Type of registration: Number of places registered: Lifeline Nursing Services Limited care home 37 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users who can be accommodated is 37 The registered person may provide the following category of service only: Care Home with Nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Dementia Code DE Date of last inspection Brief description of the care home St Johns Nursing home is situated on the outskirts of the town of Boston in the suburb of Fishtoft. The home has a registration for 37 beds, providing long-term personal and/or nursing care for residents of both sexes over the age of fifty, who have been diagnosed as having a dementia. The purpose-built single storey building was originally owned by the Local Health Authority and was built and managed by Lifeline Nursing Services Ltd., a company owning two other homes in Lincolnshire. Accommodation is offered in seventeen single and ten twin-bedded rooms. There are enclosed gardens Care Homes for Older People Page 4 of 23 Over 65 0 37 Brief description of the care home and a patio area for residents to sit out in. Car parking is available at the front of the home and a regular bus service passes the home to and from the centre of Boston. Care Homes for Older People Page 5 of 23 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 was an unannounced visit and it formed part of a key inspection, focusing on key standards, which have the potential to affect the health, safety and welfare of people who use the service. Throughout this report the terms we and us refer to The Commission for Social Care Inspection [CSCI]. The visit lasted approximately three hours and we took into account previous information held by us including the previous inspection report, their service history and records of any incidents that we had been notified of since the last inspection. Before we made our visit the provider had returned the Annual Quality Assurance Assessment (AQAA). This gave us information about their own assessment of how well they are meeting standards and their plans to improve aspects of the service. We sent Care Homes for Older People Page 6 of 23 out surveys to people before we visited the service. The main method used to carry out the inspection is called case tracking; this includes following the care of a sample of people through their records and assessing their care. We spoke to three people who use the service and to one staff member. The manager was present throughout the visit and the general outcomes of the visit were discussed with her. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 23 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 23 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. The home clearly sets out what it intends to do for people and this information is freely available to relatives. Prospective residents are encouraged to take time before making decisions about permanent stays. Evidence: We saw the statement of purpose and the service users guide. Both had been updated and contained all the information needed, except for the number and size of the rooms in the statement of purpose. The manager said this would be rectified immediately. The manager confirmed that she, the deputy manager or the senior nurse carried out pre-admission assessments, either in their own homes or in a hospital or care setting. Some residents were admitted from outside the county. We saw contracts that contained terms and conditions. The manager said that people could visit the home for coffee, a meal or for the day and this helped them to settle into the home. A relative described how her relative was invited to stay overnight before deciding to move in Care Homes for Older People Page 10 of 23 Evidence: permanently.Another relative said I had all the information I needed and they were very helpful. The home does no provide intermediate care. Care Homes for Older People Page 11 of 23 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. The homes records give a full and clear picture of the health care and personal needs of people. They enable staff to meet these needs with sensitivity and regard for their privacy and dignity. Evidence: We looked at four care plans in depth. They contained full assessments, risk assessments and clear details of peoples mental capacity. There were comprehensive life histories for each person, which helped to give a clear picture of individual lifestyles, needs and wishes. Signatures and comments throughout gave clear evidence of people and their relatives being involved and regular reviews were held. There was a clear medication policy and the pharmacist visited regularly, the most recent visit being 16/12/08, from which no issues of concern were identified. People we spoke with and their relatives said they felt safe and well looked after; one relative said The staff tell you immediately when theres a problem and they treat them all like a person. We saw the staff team carrying out their duties with kindness and sensitivity towards people, especially when attending to their personal needs. Care Homes for Older People Page 12 of 23 Care Homes for Older People Page 13 of 23 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. Social activities are extensive and create a variety of events and activities which people are informed about. People exercise choice about which activities, if any , they wish to take part in and what meals they want to eat. Evidence: Twenty-eight hours are allocated weekly for an activities co-ordinator Monday to Friday. In addition there are fifteen hours for an assistant and there is also a volunteer on three days. Activities are recorded for each person and there is a full timetable of events, displayed in the entrance area. We saw that people had been doing arts and crafts, including weaving. Some people were listening to music and there were one-toone activities with staff such as manicures. We saw a sensory room which the manager said was used regularly. Relatives said that in the summer there had been trips out to a local garden centre and lunches.One relative said They really do the best they can for these people; nothings too much trouble. We saw the mid-day meal being served; it was well presented and balanced and people were showing signs of enjoying it. Menus showed variety and choices and a relative said If theres nothing they like the cook will always do them something special. Several people were having pureed food, which again was well presented. Some people needed assistance with eating and this Care Homes for Older People Page 14 of 23 Evidence: was carried out by staff members with respect for their dignity. The kitchens had been awarded a gold star in the Environmental Health Officers award scheme. Two kitchen staff members had the National Vocational Qualifications in food hygiene and safety and all staff had the basic food hygiene award.. Care Homes for Older People Page 15 of 23 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 procedure is clear and gives people and their relatives the confidence that comments and concerns will be listened to. there is a robust adult protection procedure to safeguard people. Evidence: We saw the complaints records; they showed that there had been three concerns or complaints in the last 2 years and all had been addressed satisfactorily. The complaints procedure was displayed on the wall in the entrance area. The manager said that all staff had received Protection of Vulnerable Adults training in the last year. We saw a current copy of the Local Authoritys adult protection procedures. People we spoke to said they had no wish to complain but knew how to make a complaint. Care Homes for Older People Page 16 of 23 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 live in a safe comfortable environment, with both private and communal space being generally suitable for their needs. Evidence: Internally the bilding was well maintained and decorated to a high standard. The manager said that risk assessments are carried out on the premises to ensure that people are safe from any potential hazards. Recent improvements to the environment have included redecoration of all rooms, refurbishment of some bedrooms, new curtains in small lounge area and a new lounge carpet. All rooms are en-suite and there are three separate bathrooms and two separate showers. There are ten shared rooms; although the recent extension has given seven extra single rooms, making sixteen in total, the ratio of double to single rooms is still high. Externally, there is a secure courtyard area with a sensory flowerbed, where people can sit out in good weather in safety. The home was clean and smelled fresh throughout, with the exception of the entrance lobby, which, the manager said, was due to have windows to circulate the air better. Care Homes for Older People Page 17 of 23 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. Staff numbers are in sufficient quantity for them to be able to care for people well. Staff are suitably trained, qualified and competent to carry out their tasks. Evidence: We saw the rota which showed that there were two trained staff and seven care staff on the early shift and two trained plus five care staff on the late shift, with four night staff. People and relatives we spoke with said they thought there were enough staff to attend to their needs and staff agreed with this. There is a full training programme and an individual training record form for all staff. We saw that besides the mandatory training, staff had also received training in challenging behaviour, dementia awareness and the Mental Capacity Act. Training records we saw showed that 14 care staff had achieved the National Vocational Qualification [a nationally recognised award] at level 2, with four working towards it and one was working towards NVQ level 3. Staff records we saw were well documented and there was evidence of Criminal Records Bureau checks. We saw minutes of regular staff meetings. Care Homes for Older People Page 18 of 23 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 home is managed competently and the staff are supported and supervised in carrying out their respective roles. The views of people and their supporters are listened to and they are involved in decisions affecting them. Evidence: The manager has been in post for two years and was previously deputy manager for four years; she is a qualified Registered General Nurse with 34 years experience in nursing. Staff members we spoke with said that she was approachable and her door was always open. Two relatives mentioned the manager in particular and said that since her appointment there was more communication; comments made were the atmospheres better and I couldnt give you a bad point about her and the staff. There is a receptionist who manages all records for servicing of equipment and the manager has a computer with broadband, enabling her to keep up to date with current good practice. The home acquired the Investors in People award given to businesses in November 2005. Care Homes for Older People Page 19 of 23 Evidence: We saw a recent questionnaire which showed that the views of people and their relatives were sought and acted upon. Care Homes for Older People Page 20 of 23 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 21 of 23 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 22 of 23 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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 23 of 23 - 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. 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