Care Home: St Lucia House

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: St Lucia House 54 The Avenue Cliftonville Northampton NN1 5BT two star good service The quality rating for this care home is: 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: Irene Miller Date: 1 3 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. They reflect the things that people have said are important to them: 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 Adults (18-65 years) 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. 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. Internet address www.csci.org.uk Information about the care home Name of care home: Address: St Lucia House 54 The Avenue Cliftonville Northampton NN1 5BT 01604630521 01604626221 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Northamptonshire County Council care home 16 Number of places (if applicable): Under 65 Over 65 12 4 learning disability Additional conditions: The home will limit the service to the following service user categories: Total number of service users: 16 Learning Disability (LD): 16 Learning Disability over 65 years (LD(E)): 4 Date of last inspection A bit about the care home St Lucia is a purpose built Care Home situated in a residential area close to local shops and the bus route to Northampton Town Centre. 16 men and women aged between 46 years to late seventies live at the home, all have a learning disability. No people over the age of 60 would be admitted into the home. All the people living at the home have their own bedroom. There is good communal space in the home. People have access to community health care professionals. There is off road parking for staff and visitors at the side of the house. There is a small garden to the rear of the property, and a decked seating area to the front of the property that is accessible for people using the service. Northampton County Council is the Registered Provider for St Lucia, and fees are in the region of 552.00 per week. Extra charges are made for chiropody, hairdressing and personal care products. 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home How we did our inspection: This is what the inspector did when they were at the care home This inspection was unannounced. The care records of three people using the service were looked at. An ‘Expert by experience’ called Sharon who has experience of using services for people with a learning disability came along to this inspection, she brought a supporter with her called Margaret. They spent time talking with people to hear from them what life was like at the home. They spent time talking with staff to see what it was like working at the home. In addition to the information we gained during the visit the provider completed an Annual Quality Assurance Assessment (AQAA) that gives the provider the opportunity to quality review the service. The AQAA was returned to CSCI within the timescale set. What the care home does well The people using the service are encouraged to make choices as how they wish to live their lives and are treated with respect and dignity. The staff have worked at the home for a long time and they are properly trained and keen to providing the people using the service with a good service. The views of people using the service are sought through group meetings and individual one to one time is made available to discuss things of a more personal nature. Improvements made to the environment ensure that people using the service are provided with a safe, warm, friendly home. What has got better from the last inspection What the care home could do better Internal reporting systems are in place to record accidents and incidents, however the provider must ensure that CSCI are also kept informed of such events. The procedures for monitoring records of money held on behalf of people using the service must be robust this is to ensure that accurate records are kept and people using the service are protected from financial abuse. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Irene Miller Cambridge Local Office PC1 Capital Business Park Fulbourn Cambridge CB21 5XE 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 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The individual aspirations of and needs of people using the service are met. Evidence: Many of the people using the service have lived there for a number of years, in addition to permanent placements the service also offers respite care. The homes Statement of Purpose is kept under review and provides information on the services available and staffing at the home. Within the care plans looked at there was information available on the individual aspirations and needs of the people using the service and there was documentation available to demonstrate that the physical, emotional and spiritual needs of individuals are identified and regularly reviewed. Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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 using the service are supported and enabled to take control over their lives. Evidence: Within the care plans viewed there was written evidence available to demonstrate that that the changing needs and personal goals of people using the service are identified and their care and support plans updated to reflect this. There was records of participation in social, recreational and educational events such as going for trips on a canal boat, trips to the cinema and theatre and walks in a local country park. The written information was supported through discussion with the people using the service who said that they get to spend time with their keyworker and enjoy going on shopping trips, holidays and meeting up with friends outside of the home. There was information available within the care plans on the individual preferences of people using the service in relation to their choice of leisure, educational and recreational activities, and in discussion with people during the visit they confirmed verbally that they felt supported to lead fulfilling lives. A small group of people were busy preparing to go on a holiday to Spain the following day saying they were really looking forward to their holiday, two staff were going with them to provide ongoing care and support. Within the care plans there was records of risk assessments which identified individual vulnerabilities of people using the service, such as household chores and daily living activities. Evidence: Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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 people using the service are supported to lead fulfilling lives. Evidence: In discussion with people using the service and from records within their care plans it was confirmed that the service supports them to attend church services where this is their wish. Individual choices and preferences were identified within the care plans and the staff pay particular attention in recognising the importance of providing individualised care and in supporting each person to pursue their choice of recreational activities. In discussion with the staff it was evident that they ensure that equality and diversity is promoted. Through individual one to one time with their keyworker the views of people using the service are sought rather assuming that the staff know best. People are supported and encouraged to be included in the decisions relating to their care and support needs. Their is a variety of foods available for the people using the service, when asked about the meals available they said they enjoyed their meals and can make their own drinks and snacks. Where people require additional support with eating and drinking this is identified within their care plan. The dining areas within the home were all seen to be homely light and pleasant. Evidence: Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The people using the service receive personal support in a way that they prefer and require. Evidence: In discussion with people using the service they confirmed that personal care is flexible, such as having a choice of when they would like to shower or bathe, they confirmed that where greater support is required with attending to personal care that they have a choice as to whether a male or female member of staff provides assistance. One person said that he only likes people he can trust to help him, and has no preference as to whether a male or female helps, and another person said they only like female staff to help her. People said that they make their own choices as to what clothes they would like to wear, four people spoken with said that they choose their clothes in the mornings. Two people said that they choose their clothes the night before, and lay them out ready for the next day. The care plans viewed had details of when people using the service had seen their GP, attended clinics, such as diabetic nurse and routine medical reviews and to receive their annual flu injections. There was records available within the care plans of visits to attend optical and audiology appointments and to see specialist consultants for individual healthcare needs. Evidence: Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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 people using the service feel assured that their views are listened to and acted upon. Evidence: Six people spoken with said they all felt safe in the home, that the staff treat them very well, and made them happy. Regular meetings are held between staff and people using the service. This enables general discussions to take place, individual one to one time with keyworkers enables things of a more personal nature to be discussed in private. Since the last inspection visit no complaints about the service have been received by the Commission for Social Care Inspection. One safeguarding referral has been addressed by the service. People using the service spoken with during the course of the visit expressed trust in the staff who provide their care and support and stated that they would raise any problems and voice any issues they may have with staff at the home. There is a complaints policy in place which is made available to the people using the service and their representatives. Within the Annual Quality Assurance Assessment the service had identified that a robust monitoring system had been introduced to safeguard people finances, however on sample checking this system there was some minor discrepancies in relation to the records and the actual cash available, this was discussed at the time of the visit as an area that requires further work to ensure that all financial records are accurate. In discussion with the staff they confirmed that they had received training on abuse awareness. Evidence: Within the homes AQAA they state that within the next twelve months they intend to improve by ensuring that all complaints are logged and dealt with pro-actively, that staff are provided with up to date information in relation to safeguarding and to ensure that people using the service have accessible information in relation to how they can be protected from abuse. 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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 . St Lucia House is homely, comfortable and clean and meets the needs of people currently living there. Evidence: On the day of the visit work had just begun on refurbishing the main kitchen of the home, and it was noted that some of the people using the service were a little unsettled due to a new kitchen being fitted. There was a lot of noise at times although unavoidable when a new kitchen is being fitted. The staffs were observed to be very reassuring to people who were finding the noise and the change to their routine difficult. On the first floor of the home there is a second smaller kitchen which enabled staff to prepare the meals and an additional dining room where people could eat their meals away from the noise of the old kitchen fitments being removed. A large activities room is available which contains a pool table, a tread mill, and various DJ equipment enabling people to take part in music, disco and games. All bedrooms viewed were nicely decorated and clean, and had personal items available such as a television, music centre and reading materials. The people spoken with said that they can choose how they want their bedrooms decorated, one member of staff is a talented artist and had created a wall mural depicting a fairy scene on the wall of one persons bedroom. The games room had been brightened up by the use of wall murals showing the of various activities that take place within this room. A stairlift is fitted to both staircases making it easier for people using the service to reach the upper floors of the home. The people who live at St Lucia are now mainly middle aged with several requiring additional help around the home. Evidence: Toilets, bathrooms and some bedrooms were sample checked in addition to communal lounges in the home; all areas were clean, odour-free and homely. The laundry facilities were viewed and in discussion with the area manager he confirmed that plans are in place to replace the washing machine and the tumble dryer with industrial type machines this is to meet the demands of the ageing client group. The boiler room is next to the laundry and on checking this area the door was unlocked and there was some combustible materials and cleaning agents contained within this room. Once this was pointed out to the manager these items were removed before the inspection ended. Bedrooms viewed were personalised, clean and homely. 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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 people using the service are supported by staff that are competent and qualified to meet their needs. Evidence: In discussion with the new manager who has recently took up post it was confirmed that work has begun on updating and improving the staff records held within the home. The recruitment files of three staff were viewed however it was difficult to evidence that the appropriate pre employment checks had been carried out, as it is company policy that all employment records be stored centrally off site from the home. In order for CSCI to be assured that this outcome area was met it was agreed with the manager that details of the dates of when criminal records bureau checks (CRB) and references had been obtained be made available to the inspector following the visit. This information was made available by the provider soon after the visit. Staff retention is good as many of the staff have been employed at the home for a number of years and are committed to providing support for the people using the service. The people using the service were very praising of the staff saying that the staff encourage them to be independent, let them do things for themselves and that they feel that they can trust them. General observations showed that the people using the service and the staff get on well together, this was noticeable in the way they interacted with each other showing mutual respect. Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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 health safety and welfare of the people using the service is promoted and protected. Evidence: Since the last inspection a new manager has taken up post at the home, it was confirmed in discussion that she is to submit her application to register with the Commission for Social Care Inspection. In discussion with the manager she confirmed verbally that she has completed the NVQ 4 in Care Management and the Registered Managers Award. Having worked in the care sector for a number of years she has gained the relevant skills and experience in order for her to effectively manage the home. In discussion with the manager she confirmed that she is keen to move the home forward and that she receives regular supervision and support from her area manager and attends weekly managers team meetings. The area manager was present throughout most of the inspection visit and confirmed that he has regular contact with the home. Monthly unannounced visits take place by the area manager to quality assure the systems and services provided by the home. Records of accidents and incidents were sample checked and it was noted that there were some events that fall under notifiable events which are reportable to CSCI under Regulation 37 of the Care Standards Act 2001. It is important that such events are reported to CSCI without delay. Steps have taken place to consult with staff in introducing a new staff rota with the aim of ensuring that staff are effectively deployed throughout the day day to enable Evidence: more flexibility in providing more individualised support for the people using the service. The views of people using the service are sought through regular meetings and one to one time with keyworkers. Within the AQAA areas identified for improvements are to put in place more robust quality assurance tools to monitor best practise and evidence positive outcomes for people using the service. Are there any outstanding requirements from the last inspection? Yes  No  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 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 Description 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 Description Timescale for action 1 23 16 Robust systems must be in place to ensure that monies held on behalf of people using the service are accurately recorded. 30/01/2009 This is to ensure that the financial affairs of people using the service are managed well and protect from financial abuse. 2 38 37 Notifications of death, illness 30/01/2009 and other events which adversely affects the well being or safety of people using the service must be reported to CSCI without delay. This is to ensure that the process of managing the home is open and transparent. 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 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone : 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web:www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (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. - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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