Care Home: St John`s Residential Care Home

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What the care home does well The home is in a part of Spalding within easy reach of the town centre. A visitor commented that a reason for choosing the home was that it was the best of those viewed. People are cared for in a clean and comfortable environment and the home is decorated to a good standard. All people spoken with made positive comments about the care they received; one said it was very good and another said that she enjoyed going into the garden and especially sitting with the staff when they had their breaks. The staff group is well trained and knowledgeable about the people living at the home and how they prefer to be cared for. The manager has put much hard work into establishing a team atmosphere among staff in the home and staff members we spoke with said they were very happy to work at the home. This has enabled the staff to have good knowledge of the needs of people. People are encouraged to make choices about their daily lifestyles and individual likes and dislikes are catered for. Surveys returned to us were positive and comments included praise for the staff and the manager. What has improved since the last inspection? Care plans now contain more information to enable staff to meet the needs of people, including a life history. There are more organised events and activities, especially for people with dementia. There is also more one to one activity based work with people. The garden area has been redesigned and work has started on redecoration of bathrooms. More staff have achieved NVQ`s. What the care home could do better: The service user guide is not in an easy style for people, some of whom may have a dementia, to read and understand. Key inspection report Care homes for older people Name: Address: St John`s Residential Care Home 66 Hawthorn Bank Spalding Lincs PE11 1JQ     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: Julie Western     Date: 1 5 1 0 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 21 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 21 Information about the care home Name of care home: Address: St John`s Residential Care Home 66 Hawthorn Bank Spalding Lincs PE11 1JQ 01775710567 01775714147 pambateman@hotmail.co.uk www.countrycourtcarehomes.com Mr Abdulaziz Alykhan Kachra Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Type of registration: Number of places registered: care home 55 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: The maximum number of people in the MD category must not exceed 4 in total The maximum number of service users to be accommodated is 55. The registered person may provide the following categories of service only Care Home only Code PC to service users of the following gender either whose primary care needs on admission to the home are within the following categories Old age, not falling within any other category Code OP Dementia excluding learning disability or dementia Code DE Mental Disorder Code MD Date of last inspection 55 4 0 Over 65 0 0 55 Care Homes for Older People Page 4 of 21 Brief description of the care home St Johns Residential Care Home is a large Victorian building, formerly known as the Old Vicarage, which has been extended to provide additional accommodation. The accommodation is located on two floors. The home is registered to provide care for 55 service users who are in need of care due to dementia, needs associated with old age and up to 4 residents who have needs associated with mental health. The home is situated approximately one mile from the centre of the market town of Spalding, which has a wide range of amenities. The home has large grounds laid to lawns and flower- beds, with a summerhouse. Car parking is situated to the rear of the property. The aim of the home is stated as to provide a customer focused service, meeting individual needs and preferences. Information provided prior to the inspection confirmed that current fees range from £369 - £600 per week. Charges for chiropody, hairdressing, newspapers and personal toiletries are additional to the fees. The certificate giving important information about the terms and conditions of registration is on display in the entrance hall. A copy of the most recent published inspection report can also be found there. Care Homes for Older People Page 5 of 21 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: The quality rating for this service is two star. This means the people who use this service experience good quality outcomes. 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 Care Quality Commission (CQC). The visit lasted approximately five 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 21 out surveys to people before we visited the service. The main method of collecting information during this visit is called case tracking, which includes following the care of a sample of four people through their records and assessing their care. We spoke to two people who use the service and saw rooms of those people who said we could and to one staff member. The manager was present throughout the visit and the general outcomes of the visit were discussed with her and with the provider by telephone. Care Homes for Older People Page 7 of 21 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 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 21 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 21 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 have good information about the home in order to make an informed decision about whether the service is right for them. Evidence: We saw the statement of purpose which was very comprehensive and contained terms and conditions and contracts. The service user guide we saw contained useful information for people. It was in large print but not in an easy style for older people with dementia to understand. The manager said that she or a senior member of staff always visited prospective residents at home or in a care setting such as a hospital to undertake a thorough assessment of all their care needs. Records we saw confirmed this. We saw written admission records that were clear and gave staff all the information they needed to meet the needs of people. There was information in the entrance hall and a copy of the guide to the home in each bedroom. A resident we spoke with described how he had visited for the day before he was sure Care Homes for Older People Page 10 of 21 Evidence: he wanted to move in permanently. A relative told us that this home had been chosen because it was the best of the ones they saw. A staff member described the admission process and the importance of making new residents and their families welcomed. Care Homes for Older People Page 11 of 21 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. Care plans are in enough detail to ensure that the health and personal care needs of people can be met. Evidence: Care plans we saw contained information about the health and personal care needs of people. They were reviewed regularly and signed where possible by people or their relatives or advocates. We saw a medication policy that gave clear instructions on how to deliver medicines safely. All senior carers had qualifications in the administration of medication. The pharmacist visited every six months, the last visit being three weeks ago and no issues were identified. People also received regular visits from district nurses, GPs and other agencies involved with their care. People we spoke with said they liked the staff and a visitor was full of praise for their cheerfulness and politeness. We saw staff 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 21 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 regular and are tailored to suit the individual needs of residents. People have a choice of meals from a balanced and varied menu. Evidence: Care plans we saw showed that people are assessed for their needs and wishes regarding lifestyle and daily activities. There is a programme of regular activities, including entertainers, church services and various board and card games. On the day of the visit people were playing bingo and singing and dancing to music. Craft projects were on display. The activities organiser records all activities and has one to one sessions with people where they have manicures and hand massages, or go out to shops, garden centres or local cafes. There are many activities for people with dementia, including rummage boxes, reminiscence activities and chat sessions. Details of forthcoming events were displayed in the entrance area. People we spoke with all said they had a choice of whether or not to take part and we saw people sitting quietly in the main lounge. People we spoke with all said they enjoyed the meals served. One said the food was very tasty and a visitor said their relative, who was normally a fussy eater, ate everything offered. The menu for the day was displayed in the dining room and offered alternative choices Care Homes for Older People Page 13 of 21 Evidence: of meals. The cook said that if people did not like any of these choices, she would make them an alternative within reason. The cook has the National Vocational Qualification, a recognised award, in care at Level 2. She was knowledgeable about the nutritional needs of service users and described cooking for people with special diets. Care Homes for Older People Page 14 of 21 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 procedures for addressing complaints and for protection from abuse are clear. People and their families are confident that their comments and concerns will be listened to. Evidence: People spoken with said they did not wish to complain but knew how to make a complaint. The home had an up to date copy of the Local Authority adult protection procedures; staff members said they had read it. The training programme showed that there was a rolling training course for staff on safeguarding adults. Staff members we spoke with knew what to do in the event of a serious concern.The manager said that residents and their families were regularly asked for their views regarding the running of the home. A resident said I would go to the manager if I had a problem and visitors spoken with said that they were given information on how to make complaints. Since the last inspection there had been three safeguarding complaints. Two, relating to safety and care were ongoing and a third, relating to personal care was unsubstantiated and closed. There had been no complaints for eight months and any recommendations made from the ongoing complaints had already been acted upon. Staff we spoke with confirmed that they had received training in safeguarding adults. Care Homes for Older People Page 15 of 21 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 comfortable and pleasant environment with both private and communal space that is generally suitable for their needs. Evidence: Overall, the standard of decoration internal was good and people we spoke with said they were comfortable in their surroundings. The gardens were well maintained and offered pleasant places for people to sit out in good weather. Staff described how any maintenance issues were addressed quickly by the maintenance personnel. Recent improvements included the redesign of the gardens and redecoration of some of the bathrooms using different themes. The manager was aware that some of the bathrooms not yet decorated lacked homeliness and said there was an ongoing programme to complete redecoration of all bathrooms and toilets. There were safety notices around the building to prevent the spread of infection and COSHH regulations were observed throughout. The building smelled clean and fresh throughout. Care Homes for Older People Page 16 of 21 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 and staff members are suitably trained, qualified and competent to meet the needs of people. Evidence: The staff rota we saw showed that there were 2 senior carers plus 4 carers in the mornings and one senior plus 5 carers in the afternoons. In addition there was the manager from Monday to Friday, 2 housekeepers, 1 laundry person, a cook, a kitchen assistant, a handyman and gardener. Staff, visitors and residents all said the numbers of staff were enough to care safely for people. Training records we saw showed that the training required by law has been undertaken, with a full training programme for the coming year. A training manager has recently been appointed for the organisation and the manager said this will enable more staff training on issues concerned with dementia. We spoke with staff members who described how they had an interview, gave three references and underwent CRB/POVA safeguarding checks and had induction before starting work. Staff records we saw confirmed this. We saw that staff members all receive regular supervision and they confirmed this. Staff said they felt very supported and that the staff team worked together. There were also minutes of staff meetings, which staff members also confirmed. Care Homes for Older People Page 17 of 21 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 well managed and the health, safety and welfare of people are promoted. Evidence: The manager, who is awaiting an interview to become the registered manager, has been in post since February 2009. The qualifications and experience we saw show that she is qualified to carry out her duties. The manager and deputy manager work very much as a team and staff members spoken with said they were very approachable and accessible. A visitor praised her in particular for support during the admission process and following the admission of their relative. There is a clearly written quality assurance procedure, with separate questionnaires given to people, their relatives/visitors and staff. The results are discussed with the operations manager and acted upon. Health and safety policies are well documented and demonstrate a clear commitment to ensuring the wellbeing of people. Care Homes for Older People Page 18 of 21 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 19 of 21 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 1 The service user guide should be written in a style that is easy for older people, and especially those with a dementia, to read and understand. Care Homes for Older People Page 20 of 21 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. 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