Care Home: St Katherines Residential Care Home

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What the care home does well There were many positive aspects found at the home. We found evidence that the home was run in the interests of service users. People living at the home that were interviewed or spoken to more informally were found to be very happy with the quality of care and support they received on a daily basis. People were observed to have good relations with the staff team and the deputy manager, and spoke highly of the staff in general. In the majority of cases people living at the home were seen to get on well together. Residents choose the food they eat and are offered alternatives if the main menu options were not to their liking. On the day of our visit there were options to the main meal on offer. There was evidence of regular activities arranged, with a specific staff member allocated the duty to arrange in-house activities. As far as possible the activities were planned and provided on the basis of each individual`s assessed needs and wishes. People were observed in the afternoon of our visit to be playing and enjoying a game of bingo. It was evident that people were being supported to lead the lifestyles they chose, and that support also took account of the abilities and skills of the person concerned. The home was, clean and pleasantly presented providing a homely environment for residents. The property has 8 of it`s 20 registered beds in shared bedrooms but this was not an issue for existing residents spoken to who were happy sharing their bedroom. There are currently 2 of the 12 single bedrooms that have en suite facilities. The home continues to develop systems of assessment and care planning aimed at promoting and monitoring good quality outcomes for people living at the home, as well ensuring there is good support and continuity of services. Each person benefits from an individualised plan of support and care, and from these documents the home plans service development that is in line with the needs and wishes of the people living at the home. People told us there are resident meetings where they felt consulted about the running of their home. Other forms of consultation are ongoing and also happen on a daily basis informally. Residents said they felt they were listened to and action is taken on the basis of their feedback and/or comments. Staff members were found to engage well with residents, and there was a range of skills and experience in the team. Staff are supported in their training and development, and 6 of the 10 permanent staff are trained and qualified to NVQ level 2, and the home is consequently achieving the current 50% of staff trained to national vocational qualification levels as set out by Government benchmarks. In addition to this the manager is trained and qualified, and the deputy manager has a NVQ level 4 in management of care and the Registered Managers Award. The manager makes sure documentation provides information needed by staff members relevant to any specialist needs of service users and also provides staff with opportunities to attend more specialist courses. We were advised that any visitors are always made to feel welcome, and could visit at any reasonable time. There is a clear statement in respect of visiting arrangements atthe home. Visitors who responded to our survey said they could visit their loved ones when they wished and were always made welcome. A number of residents said they received visitors at any reasonable time and could always see their visitors in private. There was a reasonable response to surveys being returned by the service users, all of which were positive and included feedback such as "I have received a contract and had enough information about the home before moving in." "I always receive the care and support I need." "The staff listen to me and do as I ask." "Staff are always available when I need them." "I always receive the medical support I need." There are always activities at the home I can choose to take part in." "There`s a good choice of food." "There is a lovely garden to use when the weather is good." " I know who to speak to if I am not happy." "The home is always fresh and clean." We interviewed two vising GPs and one local district nurse. All said they felt confident that people who were their patients were being well looked after from their professional perspectives, and that the staff follow any guidance of other instruction given in respect of individual patients. On entering the home staff were recording the guidance of a nurse who had just visited, in the resident`s personal notes. We also received a survey back from a local GP and comments included, "I am always called appropriately when staff are concerned. The staff take part in the management of the patient really well and responsibly." "I find the staff are very sensitive to peoples privacy and dignity." "Every time I visit there is a good environment and people always seem happy." "I feel the home staff and management are caring and have created a really good and relaxed atmosphere." "I am always impressed when I visit St Katherine`s and would recommend it to anyone who may need to go there." Another external professional told us, "The person I support has had some significant care needs recently and he has been well supported to hospital and helped to understand what is happening." "I am free to visit when we agree, or when I`m passing and if I phone the staff go and find my client rather then simply taking a message. He maintains his busy social life with their support." "The staff here are always helpful, respect privacy with whomever I am dealing, and are helpful to myself." We spoke to a number of people who said they had regular visiting relatives to the home. They confirmed they were free to visit as and when they liked/needed. People said they felt confident that the staff or the manager would deal with any issues as they arose. What has improved since the last inspection? The home`s annual quality assurance assessment (AQAA) tells us the following changes have been made following consultation with people using the service recently Resident meetings are maintained and questionnaires are used to audit the quality of the service. St Katherine`s management survey the views of people using the service, their families, friends and advocates as well as external professionals. We have increased outings, made changes to menus, introduced new activities and the layout of the garden as a result of listening to our residents. What the care home could do better: From our case tracking exercise it was evident that some areas of recording could be further developed and improved in line with current best practice. While each person had an assessment and an individual plan of care and support, the manner that these plans were being monitored and reviewed was not clear. Daily notes appeared to fail to fully capture the quality of outcomes for people living at the home or the interventions of staff with people. Other systems aimed at maintaining an overview via monthly reviews were also unclear and did not appear to be capturing important information that would need to feed into such forums as the annual reviews. The deputy manager listened to our comments and said they would be passing our observation onto the owners as to any changes needed to ensure these areas improved. We have been advised that it is planned to develop more person centred planning approaches. We also had to leave an immediate requirement notice at the time of this visit. This was due to references not being available on staff members files that were inspected during our visit to St Katherine`s. This notice was followed up by a letter, and we have also spoken to Mrs Afghan the registered manager who has advised us she is dealing with the matter and will be responding in writing to us. Inspecting for better lives Key inspection report Care homes for older people Name: Address: St Katherines Residential Care Home 9 Cobbett Road Bitterne Park Southampton Hampshire SO18 1HJ     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: Richard Slimm     Date: 2 9 1 0 2 0 0 8 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 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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 31 Information about the care home Name of care home: Address: St Katherines Residential Care Home 9 Cobbett Road Bitterne Park Southampton Hampshire SO18 1HJ 02380556633 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Parigul Afghan Type of registration: Number of places registered: Mr Zamir Afghan,Mrs Parigul Afghan care home 20 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: Service users in MD and DE categories must be at least 55 years of age. Date of last inspection Brief description of the care home St Katherines is a care home situated in Southampton. The Registered providers also own another care home in Southampton and a Nursing Home in Fareham. The home provides accommodation to twenty service users within the categories of older persons, dementia and older persons with mental health issues. The home also offers accommodation to four service users within the categories of dementia or mental health who are aged over fifty five. The home offers accommodation in a range of Care Homes for Older People Page 4 of 31 Over 65 20 20 20 4 4 0 Brief description of the care home single and double rooms over three floors. The home has a stair lift to all three levels of the home enabling service users access to the entire home. The home has a large central lounge and dining room and service users who wish to smoke must do so outside the home. To the front of the home is a car parking area and to the rear of the property is a large well maintained and pleasant garden, which is accessible to service users. The home is situated close to local facilities and is a short journey away from Southampton. Please contact the home for up to date information about fees. Service users are responsible for paying for their own toiletries, hairdressing, chiropody and items of a personal or luxury nature. 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: 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 2 stars. This means the people who use this service experience good quality outcomes. This inspection was an unannounced Key Inspection of the home, a Key Inspection being part of the CSCI inspection Programme, which measures the service against the key National Minimum Standards, and outcomes for people using the service as part of a process known as Inspecting for Better Lives (IBL). This report incorporates information gained from people using the service and/or their advocates / relatives, staff, including managers and comments from external stakeholders who completed professional comment cards. Care Homes for Older People Page 6 of 31 We were also provided with the services annual quality assurance assessment (AQAA) completed by the manager and other relevant information gained by the inspector via such processes as observations, interviews, inspection of documents and records and case tracking, during a site visit to the home. The visit to the home was undertaken by one inspector and lasted 5 hours. What the care home does well: There were many positive aspects found at the home. We found evidence that the home was run in the interests of service users. People living at the home that were interviewed or spoken to more informally were found to be very happy with the quality of care and support they received on a daily basis. People were observed to have good relations with the staff team and the deputy manager, and spoke highly of the staff in general. In the majority of cases people living at the home were seen to get on well together. Residents choose the food they eat and are offered alternatives if the main menu options were not to their liking. On the day of our visit there were options to the main meal on offer. There was evidence of regular activities arranged, with a specific staff member allocated the duty to arrange in-house activities. As far as possible the activities were planned and provided on the basis of each individuals assessed needs and wishes. People were observed in the afternoon of our visit to be playing and enjoying a game of bingo. It was evident that people were being supported to lead the lifestyles they chose, and that support also took account of the abilities and skills of the person concerned. The home was, clean and pleasantly presented providing a homely environment for residents. The property has 8 of its 20 registered beds in shared bedrooms but this was not an issue for existing residents spoken to who were happy sharing their bedroom. There are currently 2 of the 12 single bedrooms that have en suite facilities. The home continues to develop systems of assessment and care planning aimed at promoting and monitoring good quality outcomes for people living at the home, as well ensuring there is good support and continuity of services. Each person benefits from an individualised plan of support and care, and from these documents the home plans service development that is in line with the needs and wishes of the people living at the home. People told us there are resident meetings where they felt consulted about the running of their home. Other forms of consultation are ongoing and also happen on a daily basis informally. Residents said they felt they were listened to and action is taken on the basis of their feedback and/or comments. Staff members were found to engage well with residents, and there was a range of skills and experience in the team. Staff are supported in their training and development, and 6 of the 10 permanent staff are trained and qualified to NVQ level 2, and the home is consequently achieving the current 50 of staff trained to national vocational qualification levels as set out by Government benchmarks. In addition to this the manager is trained and qualified, and the deputy manager has a NVQ level 4 in management of care and the Registered Managers Award. The manager makes sure documentation provides information needed by staff members relevant to any specialist needs of service users and also provides staff with opportunities to attend more specialist courses. We were advised that any visitors are always made to feel welcome, and could visit at any reasonable time. There is a clear statement in respect of visiting arrangements at Care Homes for Older People Page 8 of 31 the home. Visitors who responded to our survey said they could visit their loved ones when they wished and were always made welcome. A number of residents said they received visitors at any reasonable time and could always see their visitors in private. There was a reasonable response to surveys being returned by the service users, all of which were positive and included feedback such as I have received a contract and had enough information about the home before moving in. I always receive the care and support I need. The staff listen to me and do as I ask. Staff are always available when I need them. I always receive the medical support I need. There are always activities at the home I can choose to take part in. Theres a good choice of food. There is a lovely garden to use when the weather is good. I know who to speak to if I am not happy. The home is always fresh and clean. We interviewed two vising GPs and one local district nurse. All said they felt confident that people who were their patients were being well looked after from their professional perspectives, and that the staff follow any guidance of other instruction given in respect of individual patients. On entering the home staff were recording the guidance of a nurse who had just visited, in the residents personal notes. We also received a survey back from a local GP and comments included, I am always called appropriately when staff are concerned. The staff take part in the management of the patient really well and responsibly. I find the staff are very sensitive to peoples privacy and dignity. Every time I visit there is a good environment and people always seem happy. I feel the home staff and management are caring and have created a really good and relaxed atmosphere. I am always impressed when I visit St Katherines and would recommend it to anyone who may need to go there. Another external professional told us, The person I support has had some significant care needs recently and he has been well supported to hospital and helped to understand what is happening. I am free to visit when we agree, or when Im passing and if I phone the staff go and find my client rather then simply taking a message. He maintains his busy social life with their support. The staff here are always helpful, respect privacy with whomever I am dealing, and are helpful to myself. We spoke to a number of people who said they had regular visiting relatives to the home. They confirmed they were free to visit as and when they liked/needed. People said they felt confident that the staff or the manager would deal with any issues as they arose. What has improved since the last inspection? What they could do better: Care Homes for Older People Page 9 of 31 From our case tracking exercise it was evident that some areas of recording could be further developed and improved in line with current best practice. While each person had an assessment and an individual plan of care and support, the manner that these plans were being monitored and reviewed was not clear. Daily notes appeared to fail to fully capture the quality of outcomes for people living at the home or the interventions of staff with people. Other systems aimed at maintaining an overview via monthly reviews were also unclear and did not appear to be capturing important information that would need to feed into such forums as the annual reviews. The deputy manager listened to our comments and said they would be passing our observation onto the owners as to any changes needed to ensure these areas improved. We have been advised that it is planned to develop more person centred planning approaches. We also had to leave an immediate requirement notice at the time of this visit. This was due to references not being available on staff members files that were inspected during our visit to St Katherines. This notice was followed up by a letter, and we have also spoken to Mrs Afghan the registered manager who has advised us she is dealing with the matter and will be responding in writing to us. 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 10 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 11 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 who may use the service and their representatives have the information needed to choose a home that will meet their needs. People are assessed by suitably trained staff before admission to the home. Evidence: There had been a number of emergency admissions recently due to the closure of another care service in the locality. St Katherines had taken four people and had already put in place appropriate assessment and care planing. We spoke to three or the four admissions who while still settling in were positive about the kindliness they had been shown to date at St Katherines. It was evident that people were still getting used to their new home, but were being supported through a difficult experience by the staff of St Katherines. Care Homes for Older People Page 12 of 31 Evidence: We found evidence that any new or prospective resident is fully assessed by a competent and suitably trained staff member. Assessment materials were seen and covered all relevant areas of daily living, key information; key contacts / networks; likes/dislikes; activity based risk assessments and this information was then used to inform a plan of care and support. People said their needs were known and met on a daily basis. Staff confirmed that they used the assessment and care planning information. We were advised of plans to introduce more person centred approaches. The deputy is usually the person who carries out the initial assessment. The AQAA tells us - The manager/senior carer completes fully a pre-assessment before any person is admitted to the home, they are invited to come and spend the day at the home and have lunch and meet other service users so they will be able to exercise some degree of informed choice. We gather as much information as possible via assessment so that we can develop an accurate care plan, and we also obtain any other assessments such as those carried out by local authorities where possible. We found Assessments provide information about needs and wishes, and take account of any risk issues. Assessments ensure that peoples needs can be met at the home. Assessments ensure that people are only admitted to the home within the legal categories of registration. Care Homes for Older People Page 13 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health, personal and social care needs are set out in an individual plan of care and support. The way the needs and outcomes of service users are monitored, reviewed and recorded did not clearly identify outcomes for people in a person centred way. People make decisions about their lives with support when needed. People where appropriate and able are responsible for their own medication, are supported where ever needed, and are protected by the home practices and procedures for dealing with medications. People feel they are treated with dignity and respect and their rights to privacy upheld and promoted. Evidence: Care plans and daily notes were inspected for three people. Plans of care and support Care Homes for Older People Page 14 of 31 Evidence: were individualised, of a good quality and in place. We found that daily notes, as well as monitoring and review records needed to be improved in detail, quality and content. In two instances daily detailed notes about what had happened and what outcomes were had not been fully recorded. Also monthly review records in some instances lacked detail and some were seen with no monitoring of outcomes for the persons concerned. Annual reviews were not detailed as there was no apparent system of feeding good quality information into this process. There was consequently evidence that staff members may benefit from increased training input in recording, monitoring and review of care planning in order to improve the quality and increase a more person centred approach across care and support planning at the home. We have been advised that there are plans to develop care planning in order to further promote a more person centred approach across the care services owned and run by Mr and Mrs Afghan. Care plans addressed such essential areas as health care needs, and there was evidence that action is taken to meet the health care needs of people accommodated within these records. We interviewed two visiting doctors and one district nurse who also confirmed that the needs and wishes of their patients are identified and met at St Katherines. People told us they had access to their doctors on request. Care plans had clearly been informed by assessments. Staff are using care planning systems to promote peoples wishes as well as to meet individual needs, but recording and review / monitoring notes need to improve. Each resident has a plan and there was evidence care and support plans had been developed with each individual and the information contained in each plan reflected that persons particular individuality. Most people living at the home need some degree of support in respect of taking and/or managing their medications. The home uses a monitored dosage system that ensures medications are stored safely, are recorded and administered in line with doctors instructions. Staff confirmed they were trained in the use of the medication systems. Where possible people are encouraged and supported to remain as independent as possible, and residents spoken to said they were happy with the arrangements made in respect of their personal medications at the home. The home has developed specific medication plans for each person that outlines in detail the needs and the medications taken with important information such as possible side effects. We observed practices of the staff in this area and found then to be safe, and staff were seen to follow the procedures in place at St Katherines. The AQAA tells us - Our delivery of care is individually based on a detailed care plan Care Homes for Older People Page 15 of 31 Evidence: with ongoing assessments, we monitor and review the individuals needs allowing the individuals as much autonomy as possible. We also observed staff interactions during our site visit and staff were seen to promote peoples dignity and privacy. People told us they were treated with respect by the staff team, and these issues were addressed within staff induction and other relevant training. 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. People lead the lifestyle they wish, that matched their skills and their expectations. Social, cultural, religious and recreational needs and interests are met. People are encouraged and supported to maintain contact with family and friends, at their home or in the wider community as they wish. People are encouraged and supported to exercise choice and control over their lives. People receive a wholesome, appealing, balanced diet in pleasing surroundings at times convenient to them. Evidence: The AQAA for St Katherines tells us - We meet our service users needs, they and their families/other involved professionals are satisfied we are a good home. There have been no complaints to either CSCI or to the home. Our survey and questionnaire feedback is very positive. We have made the gardens more accessible with more seating. We plan to continue to maintain our high standards, seek ways of encouraging our service users to have more input with regards to satisfying their Care Homes for Older People Page 17 of 31 Evidence: social, cultural, religious and recreational interests and needs. We will work closely with family friends and other associated professional people, the community and voluntary services, we will continue to use local facilities, local shops, garden centres, the river. This works well for small groups or on a one to one basis and is very practical and cost effective. The home provides some outings. People said they enjoyed the outings and looked forward to these events. People confirmed that there were other activities organised at the home that they enjoyed. Some people are more able and journey out alone to local shops and other facilities in the local community. Others find their own amusement and entertainment and were found to be happy with this approach. There are resident meetings held where such topics are discussed and people are consulted. The home employs a staff member specifically to co-ordinate, consult and plan activities and entertainments at St Katherines. Ten or more residents were playing bingo in the afternoon of our visit, and appeared to be enjoying the game. St Katherines has a visiting policy. There is a visitors book at the entrance to the home, and the policy places services users central to the arrangements. People interviewed confirmed the they can see their visitors at any reasonable time, and felt this would be possible at any time if requested. Several residents who received regular visitors were spoken to at the time of this site visit, and all confirmed their visitors were made to feel welcome at the home. People said they kept in touch with whom they chose. Each persons case record contained information about key people in the residents life and wherever possible how to contact them. Case records outlined peoples wishes clearly, and there was evidence that peoples individual choices are respected wherever possible. People said they are supported to stay as independent as possible, and are encouraged and supported to make decisions about their lives and the running of their home. This also linked to St Katherines quality assurance systems that are designed to, and consult people living at the home. We had the opportunity to join people at lunch time. The meal offer two options, and people confirmed this was normal. People said that the food was good, and that their individual preferences were known and checked. Several people said the home does its best to make food as varied and interesting as possible. A number of people who responded to our survey said they thought the quality of food was very good, and that their own relatives enjoyed the food. People said the meals are at set times and are suitably spaced so you do not ever feel hungry. People confirmed that if you were ever hungry they would make you a sandwich or something. Staff members handling food had received basic food hygiene training. Care Homes for Older People Page 18 of 31 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 who live at the home, and their relatives / advocates are confident that any concerns of complaints will be listened to, taken seriously and acted upon. People are protected from abuse. Evidence: There had been no complaints about the service since the last inspection report. The homes AQAA tells us - Service users legal rights are protected at all times and we adhere to our simple and comprehensive complaints procedure and these are easily accessed. Any problem is resolved immediately before it becomes an issue. The complaints procedure is made available to all service users as we attach a copy to our contract given to all people using the service. Our staff are trained in safeguarding adults, and we have a whistle blowing policy. There had been no complaints at the home since the last inspection. People said they knew who to speak to if they had any concerns or wished to make a complaint. A complaints procedure is available in the home. Residents and other people spoken to said they felt the manager was very approachable and would deal with any matters brought to her attention. The home ensures the complaints procedure is part of the homes contract and is given to all residents and/or their Care Homes for Older People Page 20 of 31 Evidence: Representatives. All surveys returned said they were aware of how to make a complaint. Residents indicated that staff listened to them and acted on what they said. Other survey respondents said they or their relatives/advocates know how to make a complaint. The home has clear safeguarding adult policies and procedures and these link to the local authority protocols. The home are aware of what to do in the event of identifying any safeguarding issues and refer accordingly to the relevant agencies. Staff had received safeguarding training and are able to demonstrate an awareness of what constituted abuse or vulnerable persons. People told us they felt safe living at the home. Records found that staff recruitment and selection did not currently take full account of safeguarding, as records or all relevant references being undertaken at the home on any new staff were not available for inspection as required. As a result an immediate requirement was made under the staff records standard below. Care Homes for Older People Page 21 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 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 well maintained environment. The home is clean, pleasant and hygienic. Evidence: From a tour of the building it was evident that St Katherines is a homely and well maintained home. The environment was clean and tidy providing a valuing home for the resident group. People said they liked their home, and had been consulted about the decoration. People told us they were provided with a good laundry service and always had clean clothes. St Katherines AQAA told us, It is the homes policy and objective to continue to aspire to the improvement of the environment in size and design, which is service user focused. To provide a homely, safe and well maintained environment which is kept clean, odour and infection free. Staff are trained in infection control. We observed staff practices that promoted good infection control. Staff interviewed said they had been trained and were also able to explain how to reduce the risk of cross infection at the home. Staff members confirmed that they always had access to gloves and aprons at St Katherines. Care Homes for Older People Page 22 of 31 Evidence: There are 4 shared bedrooms and 12 single bedrooms. Two single bedrooms had an en suite. We spoke to two people sharing rooms and they were happy with these arrangements. St Katherines provide good access to people with disabilities. There are manual handling aids and adaptations that promote independence, and support staff with safe moving and handling. Staff told us they receive regular manual handling and moving training. The AQAA told us all necessary checks are carried out at the home to promote the health and safety of all concerned. In addition equipment and other systems such as the central heating boiler are all serviced in line with the manufacturers recommendations. The home was cleaned to a good standard. Care Homes for Older People Page 23 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. People know their needs will be met by the number and skill mix of the staff team. People feel they are in safe hands at all times. The safety of people using the service is not fully promoted by the maintenance of records of references taken up as required or in line with the homes recruitment policies, procedures, or the statement in the homes quality assurance assessment. The staff team are trained and are competent to do their jobs. Evidence: Staff members we interviewed told us they had received good training and had been provided with manual handling and moving, basic food hygiene, cross infection and first aid training. There were also records of good quality staff training maintained. Staff spoken to confirmed that the manager was very supportive and that they received supervision and annual appraisals. Staff also said they had regular staff team meetings and that the manager operated an open door approach so she was very accessible should they need guidance or support. Staff surveys indicated that induction and support from the management was good. Care Homes for Older People Page 24 of 31 Evidence: The homes AQAA tells us that diversity in the home is promoted and- We maintain a good skill mix of staff. We meet or exceed the minimum staffing levels. The service users needs are met by the numbers and skill mix of the staff team. Staff are trained and competent to do their jobs. New staff posts are only confirmed after receipt of all relevant checks and references. Service users are in safe hands at all times. All staff follow the homes induction. All new staff receive job descriptions, inductions and GSCC handbooks a long with Contracts. Four staff files were inspected and we found that all relevant police checks had been carried out as part of the selection and recruitment process. However, two staff files did not contain written evidence that references had been carried out in line with legal requirements and best practice that promotes the protection of vulnerable adults. We made an immediate requirement in this area of the service as a result. St Katherines has over 50 of staff trained to NVQ level 2 and also provide staff with core training skills that are regularly updated. In addition the home provides more specialist training when needed. The staff team includes 9 permanent and 2 part time care staff. The home also employs a deputy manager and senior carers. Staffing levels were found to meet the needs of the current resident group. Residents said there are always staff available if needed. People spoke highly of the staff team, the manager and owners making such comments as we are all well looked after. and they are very good. Other external professionals said that staff were always available to help them, and made sure they were able to see their patients in private and where needed supported the resident during any consultation. Care Homes for Older People Page 25 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. People live in a home that is run and managed by a person who is fit to be in charge, of good character and able to discharge his/her responsibilities fully. The home is run in the best interests of the people who live there. Peoples financial interests are safeguarded. The health, safety and welfare of people and staff are promoted and protected. Evidence: The homes AQAA tells us - The manager, deputy and senior carers are well experienced and competent to meet the home statement of purpose / aims and objectives. All staff are fully aware of the standards and ensure they are met, and that the home is run in the best interests of the service users. The registered provider has gained her Registered managers Award (RMA) and the NVQ level 3 in leadership skills, Care Homes for Older People Page 26 of 31 Evidence: and is also working toward her A1 assessors course in adult care. Service users benefit from an open, positive and inclusive atmosphere. Good financial records are kept of any monies of service users in the home. The manager ensure the health, safety and welfare of service users and staff are met at all times. The registered manager/provider work well with the deputy and senior staff in an excellent relationship to the benefit of service users and the staff team. We receive positive feedback from service users, families, friends and external professionals. We have achieved a good reputation and often get recommendations of new service users. The manager is registered with us, has both expereince and qualifications relevant to her role, and runs St Katherines in the best interests of the people living there, by regularly consulting them. There is a quality assurance system at St Katherines that includes regular consultation with the resident group. There are also regular resident meetings that discuss the daily running of the home and other topics such as activities / entertainments. People told us they felt they were listened to at St Katherines, and had a say. We checked and balanced a sample of peoples personal allowances that were being held on behalf of some residents, and the arrangements were found to be safe and well managed. People told us they were happy with the arrangements made in this area of their lives at St Katherines, and that they could access spending money when needed. Systems are in place to ensure that the homes electrical circuits, portable electrical equipment; the lifts/stairlifts; fire equipment alarms and personal alarms; the heating systems and gas appliances are all serviced. Arrangements are in place for the control of substances hazardous to health (COSHH). In addition there are policies and procedures in place in respect to the safe running of the home to guide staff and inform quality induction systems. People said they felt safe living at the home. Staff confirmed that action is taken to promote safe practices in such areas as manual handling and moving, first aid, food hygiene and health and safety, including infection control. We observed good practices of staff during our site visit. Staff told us they felt well supported, and it was confirmed they were receiving regular one to one supervisions and regular support from their managers. There were some omissions in respect of staffing records as identified above. Care Homes for Older People Page 27 of 31 Care Homes for Older People Page 28 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 29 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 1 29 19 In line with Schedule 2 to 05/11/2008 Regulation 19, the registered person must keep a record of two written references for all staff employed at the home. This is to promote the protection of vulnerable people, by taking up references and other checks as to the suitability of people to work with vulnerable adults. 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 7 Methods for monitoring care and support plans, and recording outcomes on a daily basis need to be developed further. Staff may benefit from some training input in person centred planning, with a specific focus on recording quality outcomes with people. These systems need to inform monthly reviews that will in turn feed quality and detailed information about monitoring outcomes, changes in independence etc. into the annual review processes. This in turn will enable plans of care and support to be updated in line with the changing needs and aspirations of people living at the home. Care Homes for Older People Page 30 of 31 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. 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