Latest Inspection
This is the latest available inspection report for this service, carried out on 27th January 2010. CQC found this care home to be providing an Adequate service.
The inspector found no outstanding requirements from the previous inspection report,
but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.
For extracts, read the latest CQC inspection for St Joseph`s Home.
What the care home does well The quality of the premises and hygiene levels are outstanding. All communal rooms are spacious, provide excellent facilities and are well maintained. The grounds and quadrangle garden are interesting and well maintained. The standard of care provided in the home is high so that peope`s well being is maintained. There is a homely and positive atmosphere and people living in the home were spoken to in a friendly and cheerful manner by the staff. The home enjoys a low staff turnover resulting in a loyal and committed workforce who deliver consistent standards of care. There is a dedicated GP consulting room and a physiotherapy room located on the ground floor which is easily accessible to the people living in the home. The recreational programme and facilities available to residents are extensive and voluntary workers who run the craft room provide guidance to the people living in the home. Voluntary staff also run a shop within the home, which people living in the home can access four times a week to make purchases. Staff also go out shopping for them. Comments we received from people living in the home and their relatives include: "Its paradise. Very clean." "I am being looked after." "I am happy here, its always warm and the food is good." "The staff at St Josephs are exceptionally kind, caring special people who provide an excellent standard of care. The home is spotless and odourless (no smells of urine etc) and the environment is bright and cheery and does not have an institutionalised feel. The food is of a high standard and the welfare of the residents appears to be of paramount importance, somehow costs for residents are kept very moderate." "This is a model of care." "St Josephs home is excellent. They do everything possible for my brother. I wouldn`t wish for him to be anywhere else." Two professional visitors to the home told us `People are treated with respect, privacy and dignity observed. Activities and other stimulation for residents are being improved.` What has improved since the last inspection? Some bedrooms have been redecorated to promote a pleasing environment. The menus have been changed following consultation with the people living in the home. A minibus has been made available to take people shopping. What the care home could do better: The home should ensure that the systems for managing medicines in the home are robust ensuring that people receive their medicines as prescribed so that their health and well being is fully promoted. The recruitment processes in the home should be robust ensuring that all the required checks have been received before people start to work in the home. This will ensure that only suitable people can work with the people living in the home. New staff in the home should have induction training that ensures that they have the skills and knowledge to work safely in the home so that people living in the home are protected and cared for properly. Care plans could have more detail to ensure that people receive personalised care. One relative told us that the Home could `Possibly provide more facilities for residents to encourage them to take part in more physical activity or general activities. Sometimes residents need 1:1 attention in order to feel comfortable/motivated to participate. For patients with dementia it would be good to encourage them to do as much as they can for themselves and try to link in with how that person used to be eg hobbies, interests etc and stimulate their particular interests.` Key inspection report
Care homes for older people
Name: Address: St Joseph`s Home 71 Queens Park Road Harborne Birmingham West Midlands B32 2BL The quality rating for this care home is:
one star adequate 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: Kulwant Ghuman
Date: 2 9 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area.
Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection.
This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People
Page 2 of 31 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 31 Information about the care home
Name of care home: Address: St Joseph`s Home 71 Queens Park Road Harborne Birmingham West Midlands B32 2BL 01214272486 01214283209 lspbirm@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Little Sisters of The Poor Name of registered manager (if applicable) Miss Annette Field (Sister Frances) Type of registration: Number of places registered: care home 38 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 38 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: Old age, not falling within any other category (OP) 38 Date of last inspection Brief description of the care home The home is spread over three floors in a large, imposing and impressive building. The home is run by a Roman Catholic order - The Little Sisters of the Poor. The home is part of this working order and Mass is said daily. Registration is for residential and nursing care for up to 38 persons of 65 years of age or above. Persons of any denomination are accepted; there is no spiritual coercion of the people living Care Homes for Older People
Page 4 of 31 Over 65 38 0 Brief description of the care home there. The standard of accommodation is exceptional with a large dining room and numerous other communal rooms situated on the ground floor. The spacious reception is regularly staffed. Smaller lounges and dining rooms are located on each floor. All bedrooms are en-suite, located on the two upper floors and there is a range of aids and adaptations to be able to assist the people living in the home. There are 36 single bedrooms and one shared room. All rooms and communal areas are spacious and of a very high standard. The extensive grounds and garden are well established and maintained. The building complex includes a block of twelve flats for independent living; people living there are free to access the homes dining room and secondary laundry room. The flats are not registered with CSCI and are therefore not subject to the inspection processes. St Josephs is conveniently situated for easy access to Harborne High St and is well served by main bus routes. There are a number of parking areas within the grounds to accommodate numerous vehicles. Chiropody, hairdressing, newspapers and magazines are not included in the fee rate and the reader should refer to the home to get information about the fees charged which are based on the Local Authority rates. Care Homes for Older People Page 5 of 31 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: one star adequate 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 carried out the key inspection over two days during January 2010 where we looked at the majority of the National Minimum Standards. The last key inspection of this home was on 7th February 2007 when it was rated excellent. The home was then reviewed through an Annual Service Review (ASR) in February 2008 and 2009. This meant that we asked for information from the home and people living in the home as well as their representatives to tell us if the home was providing a good service. As a result of the ASRs we did not change our views of this service. Before this inspection the home completed an Annual Quality Assurance Assessment(AQAA). The AQAA shows how the home rates their performance in the areas set out in this report and identifies improvements made during the past year and for the future. We sent out 10 questionnaires to people who live in the home and their Care Homes for Older People
Page 6 of 31 representatives of which 5 were returned from people living in the home and 6 from their relatives. We sent 10 surveys to staff of which 4 were completed and returned. We also sent 5 surveys for professionals who visited the home and two people completed and returned them to us. During the inspection we tracked the care given to three people living in the home. This involves looking at all the records about these people and how the home manages their care, speaking to them if possible, speaking to staff who were involved in their care and observing interactions. We spoke to 5 of the people living in the home whilst we were there. We also spoke to 2 staff and two visitors in the home. We looked around parts of the building and viewed the health and safety checks that were carried out. Care Homes for Older People Page 7 of 31 What the care home does well: What has improved since the last inspection? Some bedrooms have been redecorated to promote a pleasing environment. Care Homes for Older People
Page 8 of 31 The menus have been changed following consultation with the people living in the home. A minibus has been made available to take people shopping. 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 9 of 31 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 31 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 are able to make informed decisions about whether the home is suitable for them and their needs are assessed to ensure that they can be met in the home. Evidence: The Statement of purpose needs to be updated with the name of the current registered care manager and the range of fees charged in the home. This will enable people thinking about moving into the home to know who is responsible for the home on a day to day basis and what the charges for living in the home are. The AQAA told us that before admission people wanting to move into the home are invited to visit the home with their familes or friends and the terms and conditions of the home are explained to them before admission a pre assessment form is filled in to make sure that the home can adequately meet the needs of the prospective individuals. Care Homes for Older People Page 11 of 31 Evidence: A trial period can also be offered to them - they can also come for a meal. We looked at the admission of one person to the home since the last key inspection. This showed us that the individual was assessed on the day that they were admitted to the home. It did not record if there had been a visit to the home by either themself or their representative to see if they home would meet their needs. We were told that there was a waiting list for people wanting to move into the home. Therefore it was even more important that when a place became available for someone to move into the home from the waiting list that the individual was assessed befor admission to ensure that their changing needs can still be met at the home. Care Homes for Older People Page 12 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans could be more detailed to ensure that personalised care could be given by the staff assisting people. Peoples health needs were being met but the management of medicines did not always ensure people got their medicines as prescribed. Evidence: We looked at the care being given to three of the people living in the home by looking at their care documents, talking to them where possible and observing interactions with staff. They all had care plans and risk assessments in place to ensure that the staff knew what assistance people needed and the areas where people were at risk and where special attention needed to be taken. The care files are well organised and indexed to make them easy to access. Following admission the pre admission assessment identifies the areas of need and the information is used to write the care plan. The care plans covered areas such as mobility, bathing, social activities, continence, dressing/undressing and short term
Care Homes for Older People Page 13 of 31 Evidence: memory loss. There were also specific plans in place for health conditions such as glaucoma, depression, pressure sores and frequent chest infections. The care plans covered all the required areas of need however, some of them lacked the detail that would enable staff to provide personalised care. For example, for one person who was sat in a recliner chair the care plan stated minimise time left in chair with feet raise. This does not indicate to staff how long someone should be sat in the recliner chair. Another care plan said for bathing twice a week, hair dresser weekly, mosturise all over, report any changes in skin. From these details it would not be possible for staff to determine what would make bathing a pleasureable experience, for example, use of bath oils, soap, or bubble bath, flannel or sponge and what areas the individual could wash themselves and what areas they would need assistance with. There was ample evidence to show that the care plans were reviewed on a regular basis showing that staff were mindful of changes in needs to ensure all aspects of care are provided to people. There were risk assessments in place for falls, nutrition, pressure ulcers and mobility with appropriate plans to minimise the risks in order to keep people safe. There were daily records of the care provided to individuals however these did not always evidence that the care plans were being followed. For example, one person was to be put on the bed during the afternoon to help with the management of pressure ulcers. The daily records often stated resting in the lounge for this period of the day with no explanation of why they didnt go on their bed so that it could not be determined if it was the individuals wish. There was evidence that the health care needs of the people living in the home were met by nurses in the home, by attending a surgery held by a GP in the home on a weekly basis, by being visited when required by a GP or attending local hospitals where needed. There was evidence that district nurses, chiropodist, physiotherapist, dental and opticians services were also accessible to the people living in the home ensuring that their health needs were being met. During the inspection it was evident that one relative was not happy with the service being provided by a GP and the home was seen to facilitate communication between the two parties. The homes registration includes some beds with nursing care. This means that when an individuals needs increase it is possible for their needs to continue to be met at the Care Homes for Older People Page 14 of 31 Evidence: home. This is good continuity of care for people and means that people can stay in a place that they consider to be their home. The home uses a monitored dosage system for the management of medicines. There was a signature sheet in place showing which staff were able to administer medicines. A medicines fridge was available to store medicines that needed refridgeration. The recorded temperatures of the fridge showed that it was being maintained within a suitable temperature range for the storage of medicines. Controlled medicines were stored appropriately and the records ensured that they were checked by a second person to ensure that they were administered as prescribed. Other medicines were stored in a locked, metal cabinet that was taken around the units when administering medicines. This ensured that medicines were kept safely stored at all times. Auditing of some of the boxed medicines showed that it could not always be shown that people received their medicines as prescribed. The MAR (medicine administration record) did not always record when a medicine had been given. Sometimes the MAR was signed to indicate the tablet had been given but it was evident that they had not been given by the number of tablets left in the box. In addition there were some medicines in the trolleys that had not been recorded as carried forward on the MAR therefore accurate audits could not be carried out. One medication was stored in a bedroom cupboard but the key was left in the cupboard. The key should be kept elsewhere until access is required again to ensure that the medicine is accessible only to those who need access to it. There also needed to be a record of the amounts of medicines used and the balance left to ensure that the correct amounts were used. Where medicines were to be used on a as and when required basis a protocol should be put in place so that the staff were enabled to give it in a consistent manner and that records showed this. We were told that satchets of laxatives, although prescribed for individuals, were used from a communal supply due to the space needed in the medication trolley for storage. Although this manner of administration may be acceptable for liquid preparation this is not appropriate for satchets as there is no possibility of an audit being carried out and it would not be possible to identify an error in administration. Care Homes for Older People Page 15 of 31 Evidence: There were good interactions seen in the home between staff and the people living there indicating that people were treated with respect and their dignity was appropriately managed. One person told us that staff knocked on doors before entering and another told us I am being looked after. Bedrooms were lockable and people had en suite facilities promoting their dignity and privacy. At around the time of the inspection a funeral was being arranged from the home for someone who had recently passed away. There appeared to be a good relationship with the family of the deceased and other people living in the home were aware of the funeral taking place. This shows that people can talk about the process of dying and are enabled to attend the funeral of people that they know. Relative comments included: The staff at St Josephs are exceptionally kind, caring special people who provide an excellent standard of care. The home is spotless and odourless (no smells of urine etc) and the environment is bright and cheery and does not have n institutionalised feel. The food is of a high standard and the welfare of the residents appears to be of paramount importance, somehow costs for residents are kept very moderate. This is a model of care. St Josephs home is excellent. They do everything possible for my brother. I wouldnt wish for him to be anywhere else. Care Homes for Older People Page 16 of 31 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 home provides varied social activities and outings that meet the expectations of the people living there. People are enabled to exercise choices and staff actively encourage and promote individuality and independence. People are provided with a varied and nutritious diet. Evidence: The AQAA told us that there are meetings with the people living in the home every month where people can discuss various topics such as meals, activities, outings and are asked their advice and suggestions. Some people had asked to go shopping as a result a minibus has been made available every two weeks to go shopping if people want. Although care plans for social activities were in place they did not identify specific individual interests and how they were to be met. There is a programme on display of in-house and external recreations. There is an activity co ordinator available three days a week to facilitate activities. People living in the home are encouraged and supported to undertake daily living
Care Homes for Older People Page 17 of 31 Evidence: tasks such as dusting bedrooms and laundering and ironing of their clothes where appropriate. Daily mass can be heard in the integral chapel that people living in the home and others not connected with the home can access. People living in the home can also watch the mass via their bedroom televisions. Activities in the home include tea parties, birthday celebrations, music, quizzes and card games. The home has its own library, which contains many videos as well as large print and talking books. There is a large craft room where voluntary staff carry out activities. Voluntary staff also run a shop that is open four times a week enabling people living in the home to buy small items such as sweets and toiletries. The AQAA told us that several changes had been made to the menu at the request of the people living in the home. We were able to take a meal with some of the people living in the home and the meal was found to be plentiful, nutritious and well presented. One visitor told us he regularly ate at the home and found the food to be good. One of the people living in the home told us that there was rather a lot of chicken on the menu and sometimes it was a bit bland. This was discussed with the cook and the manager who felt that it would be possible to enable individuals have access to more spicy food such as curries. The home has a four week rotating food menu, the range of foods offered is extensive with plenty of options given. Breakfast offers two hot meals as well as cereals, fruit and toast. The main meal is served at lunchtime consisting of three courses and a light meal, salad or sandwiches and sweets are provided for the evening meal. Specialist diets are also catered for. Meals may be taken in the spacious, well appointed dining room, the unit dining room or in peoples own bedrooms. It was obvious that visitors were welcome to visit and they stayed as long or as short a time as they wanted. There was also contact with the local community through activities on the ground floor, mass in the chapel and through a luncheon club. It was also clear that daily routines were flexible. When we arrived at the home some people were still getting up, other people were sitting in the lounge areas and some had decided to stay in their bedrooms. Comments made by people living in the home included: Care Homes for Older People Page 18 of 31 Evidence: Like being in paradise, very clean I am being looked after. Happy here, always warm, enjoy the food. A visitor told us that the food was always good. Care Homes for Older People Page 19 of 31 Complaints and protection
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are confident that their views will be listened to and any complaints made will be dealt with effectively. Evidence: The AQAA told us that the home had complaint and safeguarding policies in place. These were not looked at during this inspection but the manager should check to ensure that they are up to date with the details for contacting us if people wish to do so. We were told that no complaints have been made to the home directly and none have been received by us. People living in the home have told us that knew who to talk to if they were unhappy. Meetings are held with the people living in the home and this gives people the opportunity to raise any issues they may have. There were also seen to be good relationships between the staff and peole living in the home and this will mean that people living in the home will be able to raise any concerns they may have comfortably. Care Homes for Older People Page 20 of 31 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with a warm, comfortable, safe and clean environment in which to live. Evidence: The location and layout of the home is suitable for its intended purpose and offers a very good standard of accommodation in terms of size of bedrooms, bathing facilities and en suite facilities. The many communal rooms are spacious, well appointed and very well maintained. The main dining room situated on the ground floor is especially spacious and furnished to a very high standard. All areas of the building are well presented and the decor and furniture is age appropriate. There are suitable adaptations made in the home to enable people living in the home to access all areas of the home, to be assissted to bath, to be able to move around the home safely and to be able to summon assistance if needed. Equipment is availabe for specific needs such as beds that can be raised up and down to make them easier to get in and out of, recliner chairs so that feet can be raised and pressure relieving equipment necessary for those at risk of developing pressure ulcers. There is a main laundry where bedding and so on can be laundered for the people
Care Homes for Older People Page 21 of 31 Evidence: living in the home but people can also access washing machines and irons to enable them to launder some of the own clothes if they wish. The fully enclosed public phone booth ensures that calls can be made or taken in private. The majority of communal rooms are located on the ground floor and include seating areas where people can hold a confidential meeting. A visitors room with tea making facilities is available, there is a staff meeting room and a dedicated GP consulting room. The chapel can be accessed via the ground floor or via a balcony on the first floor. The central garden forms a secluded quadrangle where people can sit during warm whether. There are 12 flats attached to the home whose occupants can access the dining room and laundry room. The flats are not included in the registration with CSCI and are therefore not inspected. Care Homes for Older People Page 22 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels are maintained in sufficient numbers ensuring that the needs of the people living in the home are being met. Staff have the skills and knowledge needed to care for people safely but documentation does not always support this. Evidence: The staffing levels at the home were sufficient to meet the needs of the people living there. There were a minimum of six care staff during the mornings, 4 care staff during the late shift and 3 during the night. In addition there are senior care staff and a trained nurse is available at all times. There are also ancilliary staff to carry out domestic and catering tasks. A specific activities co-ordinator is also available three days a week to facilitate activities with the people living in the home. We looked at three staff files to see if the appropriate checks were being undertaken to ensure that only suitable people were employed in the home. Two of the files were for people who were not directly involved in hands on care with the people living in the home. However, they would have had access to different areas of the home and would come into contact with people living in the home from time to time. Therefore it was just as important to ensure that all the checks were carried out for them also. The third file was for someone who was involved in the care of the people living in the
Care Homes for Older People Page 23 of 31 Evidence: home. The three files that we looked at showed us that checks such as the Criminal Records Bureau (CRB) check, checks against the list of people prevented from working with vulnerable people and references had not been received before the individuals starting working in the home. This potentially put the people living in the home at risk from people who were not suitable to work with them. We also looked to see that people new to the home had been given sufficient induction training to ensure that they could safely assist the people they were caring for. The documentation we saw during the inspection did not reassure us that the appropriate induction training was in place. The AQAA told us that over 75 of the care staff had achieved NVQ level 2 training or above. The majority of staff have also undertaken infection control, nutrition and fire training. The AQAA told us that there was a rolling programme of staff training to ensure that all staff are catered for in respect of mandatory and refresher courses as well as specialist training such as wound care. There was no training matrix available that could evidence this for the staff and it is recommended that this is put in place. Care Homes for Older People Page 24 of 31 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 experienced and possesses the skills to oversee the day to day running of the home. Arrangements in respect of health and safety are robust and prevents people living in the home suffering from unnecessary injuries. Evidence: The registration of the home was changed during October 2009 to show that Sister Frances was the care manager of the home. The manager has many years of overseeing the management of the home and the needs of the people living in the home. The manager and deptuy manager were available throughout the inspection. The manager and deputy manager were keen to address any issues raised during the inspection and receptive to the shortfalls noted. During this inspection issues that needed to be improved included: recruitment, induction training and medication. The AQAA told us that a satisfaction survey was to given to the people living in the
Care Homes for Older People Page 25 of 31 Evidence: home and all the comments received were positive. Audits were also carried out on medication, care plans, the kitchen and laundry. The findings of these audits should be formulated into a report that can be made available to interested parties to show how the service is to be further improved. We were told that the home was only assisting one person with managing some monies. We looked at the records for this and found that they safeguarded the individual. There was evidence seen in the home that all the required checks on the fire equipment were undertaken at the required intervals ensuring that they would work safely in the event of a fire in the home. Other equipment in the home was also regularly serviced to ensure it was maintained in good working order. Care Homes for Older People Page 26 of 31 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 27 of 31 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 1 9 13 The registered person must 14/03/2010 ensure that the management of medicines is robust. This will ensure that people get their medicines as prescribed. 2 29 19 All required recruitment checks must be in place before people start their employment. This will ensure that only people suitable to work with vulnerable adults are employed in the home. 14/03/2010 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 Information given to people moving into the home should have up to date information including fees, so that people can make informed choices about whether to move into the home.
Page 28 of 31 Care Homes for Older People 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 2 3 The records should show that a pre admission assessment has been carried out just before the individual is admitted to the home. This will ensure that the current needs of people are known and a judgement can be made as to whether their needs can be met. A record of the pre admission visit should be kept. This will evidence that people have been able to visit the home and ensure that it suits their needs. Daily records should show why the care plan has not been followed. This will ensure that the care plans are followed or show the reason why they have not been followed. Care plans should be specific about what actions staff are to take. This will ensure that personalised care is given to the people living in the home. Medicines kept in peoples bedrooms must be kept safely in a locked drawer. This will ensure that only people needing to have access to the medicines can do so. More storage for medication should be made available. This will prevent medicines being dispensed from communal boxes. Protocols should be in place for medicines to be used on a when required basis. This will ensure that staff admister these medicines in a consistent manner. Care plans should indicate how the social needs of individuals are to be met. This will ensure that they receive personalised care. It should be ensured that the complaints procedure is up to date with the current contact details of the commission. This will ensure that people can contact us if they wish. A training matrix should be in place. This will identify when people need refresher training or training in specific areas to meet the needs of the people they care for. Induction training should be in place for all staff to ensure that they have the skills and knowledge to carry out their roles safely. The finding of the quality assurance system should be formulated into a report that can be made available to people using the service to inform them of how the service 3 5 4 7 5 7 6 9 7 9 8 9 9 12 10 16 11 30 12 30 13 34 Care Homes for Older People Page 29 of 31 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 will continue to improve. Care Homes for Older People Page 30 of 31 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 31 of 31 - 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!