Care Home: St Margaret`s Ltd

Similar services:

• Henry Nihill House
• Birchwood
• The Infirmary
• Orchard House Nursing Home
• St Josephs Rest Home
• Red Court Nursing Home
• Spinney (The)
• Queen Elizabeth House

What the care home does well The home provides a pleasant environment, and is generally providing good outcomes for residents. What has improved since the last inspection? There has been a general improvement, a number of requirements having been met from the previous inspection. What the care home could do better: Supervision needs to be provided on a regular basis. Blister packs for medication need to be introduced. The safeguarding policy needs to be developed further so as to provide clear guidance for staff. Key inspection report Care homes for older people Name: Address: St Margaret`s Ltd 3 - 5 Priestland`s Park Road Sidcup Kent DA15 7HR     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Peter stanley     Date: 0 3 0 3 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 24 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: St Margaret`s Ltd 3 - 5 Priestland`s Park Road Sidcup Kent DA15 7HR 02083002745 02083002745 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Al-Naseer Hudda care home 22 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 22 The Registered Person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old Age, not falling within any other category - Code OP Dementia - Code DE Date of last inspection Brief description of the care home St. Margarets is privately owned by Mr and Mrs Hudda and has been registered since 1971. The home is registered with the Commission for Social Care Inspection CSCI to provide personal care and accommodation for 22 older people, including dementia. St Margaret s is located in a residential area of Sidcup and is within walking distance of a main line railway station, local bus services and shops. The home is located in a large detached two-storey house, with a purpose built extension and a passenger lift. There are two double and eighteen single bedrooms, 1 double and 2 single rooms not having en suite facilities. 4 rooms include a shower. Care Homes for Older People Page 4 of 24 0 0 Over 65 0 0 Brief description of the care home There are two bathrooms with WC s and three single toilets. At the front of the building there is a shared lounge and at the rear of the property there is a large lounge dining room, which looks out onto the garden. The current fees range from GBP484.00 to GBP775 per week. Residents are responsible for purchasing personal items and services such as toiletries, hairdressing and newspapers from their own funds. Care Homes for Older People Page 5 of 24 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: We visited the home and completed a site visit. We looked at staff and service user files and other documentation relating to the day-to-day management of the home. We talked to a number of residents and staff, and met with the manager and registered providers. Care Homes for Older People Page 6 of 24 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 7 of 24 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 8 of 24 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 receive services are being provided with the information they require to make an informed judgement about the home. People who receive services are being properly assessed as to their needs and how these can be met. Prospective residents are being given the opportunity to visit and to assess the quality and suitability of the home. Evidence: The home has a Statement of Purpose and a Service User Guide which provides information about the home as required by the Care Home regulations. Both of these documents were last reviewed and updated in March 2009, and are due for a further annual review. The contact details for the CQC are out-of-date and need to be amended. A copy of the Service User Guide is given to all residents. Some rooms have Care Homes for Older People Page 9 of 24 Evidence: copies in their rooms which are out of date. All residents must be given an up-to-date version of the guide. A requirement applies. The home has an admission and assessment process in place. Prospective residents are invited to visit the home to view the facilities and talk to staff and users of the service. Should the application for admission proceed, there is a 4 week trial period to assess the persons suitability for residential care, and to provide the person with the opportunity to decide if they like the home. The home has an assessment form which prompts staff to consider and record information about specific areas of need such as mobility, health issues, nutrition, continence, safety and behaviour. The assessment template is called a Pre-admission care plan. This needs to be renamed as a Pre-admission assessment so as to reflect its real purpose. There have been six new admissions since the last inspection in May 2009. Inspection of the files found that the documentation provided was generally satisfactory and that individuals had been properly assessed and risk assessed. Files included information about the person and their social network and background, assessments of their needs and wishes, and care plans outlining their care needs and how these were to be addressed. We met with a number of residents including three residents who have been admitted in recent months. The views expressed were generally very positive regarding the home and the care being provided, the impression being that residents liked the home and felt that their needs were being well met. Response from questionnaires was also generally positive, with residents expressing many favourable comments about the home. Each resident is provided with a statement of their terms and conditions upon their admission to the home, this being signed by the resident and the homes representative. The statement outlines the terms and conditions that apply for the individuals placement at the home. Care Homes for Older People Page 10 of 24 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. Generally, residents are having their care needs met, and are happy with the support that they are receiving. There is good health care monitoring, and residents right to privacy is being respected. Evidence: Each residents care needs are being set out in a care plan. A sample of care plans was inspected. Care plans are drawn up using the information that has been gathered during the assessment. Each care plan details the persons care needs and preferences, and how these are to be met. Care plans are providing detailed information, and are being reviewed and updated on a regular basis. A statutory review is held following the first 6 to 8 weeks of placement, and a decision made regarding the suitability of the placement. A 12 monthly care management review is arranged with each resident, at which the suitability of the placement in meeting the individuals needs is reviewed. This is attended by the person concerned, the individuals keyworker, their care manager, and the residents nearest relative. Care Homes for Older People Page 11 of 24 Evidence: Strategies for managing risk have been developed, and actions to manage risk are being recorded in residents care plans. As part of the risk assessment process, the home completes a manual handling risk assessment. The home has a medication policy and procedures in place, a monitored dosage system being in place. Daily audits of medication are being completed by the manager, to ensure that there are no discrepancies, and that all medication is being fully accounted for. Each residents medication is presently being stored in an individually named medication box, these being securely stored within the medication cabinet. However, to help ensure the safe administration of medication, it is required that the home moves towards using individually identified blister packs. A sample of MAR records were examined. These were being satisfactorily maintained. 5 residents are presently being perscribed controlled drugs. These are being securely stored within the medication cabinet, which has been confirmed by the pharmacy as being satisfactory for this purpose. Staff who administer medication are being provided with accredited medication training, with the use of Skills For Care knowledge sets supplementing other training. All staff must maintain an up-to-date knowledge and awareness of medication competencies and procedures. This is an ongoing process. The home has arrangements in place for meeting residents health care needs, which includes weekly monitoring visits from a local GP practice. The timing of GP visits should, however, be reviewed with the GP practice so that the the timing of visits does not coincide with the residents lunch period. Residents health needs are being monitored and recorded in daily logs and care plans. Nutritional and dietary needs are monitored, and any concerns noted and acted upon. A nutritional assessment tool is used to identify any resident who is at risk of becoming malnourished. Residents views canvassed during the inspection indicated that residents are being treated with respect, and that their privacy and dignity are being upheld. Residents are able to see their family and friends in the relative privacy of a quiet lounge, or in their own rooms. Staff were observed to interact with residents in a caring manner and to be sensitive to the needs of individuals. Care Homes for Older People Page 12 of 24 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. Residents are being provided with a varied range of activities, and have opportunities to participate fully in daily routines. Residents are encouraged to maintain contact with their friends and relatives, with privacy being respected. Evidence: There is a varied range of activities being offered, with opportunities for residents to participate in exercise sessions, singalongs, bingo, board games and craft sessions. There is a weekly programme with a designated staff member having responsibility for developing activities. A memory game, involving recognition of objects, was taking place during the inspection, with some good interaction between residents and staff. The home organises occasional outings to places of interest, to which relatives are invited. The home accesses community transport from Bexley Council. A trip to the seaside is presently being planned. The home also arranges occasional barbecues during the summer months, to which friends and relatives of residents are invited. Residents birthdays are celebrated, with family members being invited The evidence indicates that residents are being provided with a wholesome and varied diet within a pleasantly arranged dining area in the main through lounge. Residents Care Homes for Older People Page 13 of 24 Evidence: views indicated that they enjoy the food that is being served, and inspection of the kitchen indicated that attention is given to ensuring good standards of catering and hygiene. Residents are being assisted to exercise choices in their day-to-day routines and activities, and are consulted both individually and at residents meetings. Residents meetings do, however, need to be held on a regular 2 monthly basis, and should occasionally involve the attendance of the homes registered providers. Care Homes for Older People Page 14 of 24 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. Residents have the information they require to know how to complain or express concerns. Residents feel safe in this home. There are procedures in place which though generally satisfactory, need to be revised and updated. Evidence: Staff presented as engaging well with sresidents, and there were examples of some good interaction with individuals during the inspection. The impression gained from talking to residents was that they feel safe and well cared for in this home, and that they will have their views listened to with respect. The home has been developing its safeguarding policy and procedures. This still, however, needs to be developed further so as to be consistent with Bexleys Safeguarding policy and procedures. In particular, more detail needs to be given to the process for referring any allegations, and the up-to-date contact details for the agencies involved, including the CQC. A requirement applies. The home has a complaints policy and procedure, which is generally satisfactory. However, contact details for the Commission needing to be updated to those for the CQC. The home has a good record on complaints, none having been received since the last inspection. Care Homes for Older People Page 15 of 24 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. Residents are living in a pleasant, safe and well-maintained environment, and have good and sufficient personal and communal facilities. Evidence: The home presents as being generally well-maintained, and in a good state of decoration and upkeep. The communal facilities were pleasantly arranged and suitable for their purpose. There are sufficient bathrooms, shower rooms and toilets, for the use of the residents, with 12 of the 15 rooms having their own ensuite facilities. The ground floor bathroom has been converted into a walk-in shower room. A number of residents bedrooms were viewed. These presented as pleasantly arranged and well-decorated, and, with personal possessions, photos and artefacts, to be reflecting individual tastes and identities. The home presents as generally well equipped, with a residents lift, hoists and other aids and adaptations being in place. It would, however, be good practice to refer for an OT assessment of the home to ensure that the home is a totally safe envioronment, and that there are sufficient aids and adaptations in place. The home presents as being clean and hygienic, with good standards being observed in this area. Care Homes for Older People Page 16 of 24 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. Residents are living in a home where there are appropriately qualified and trained staff in sufficient numbers. Residents safety is, however, being potentially put at risk by the failure to ensure the regular supervision of staff. Recruitment checks are not sufficiently rigorous to ensure the protection of residents, and must be made watertight. Evidence: The home has the requisite numbers and skill mix with which to meet the needs of the resident group. The home has 18 care staff, 7 of whom are full-time, and 11 who are part-time, There are also 4 ancillary staff, who cover catering, cleaning, gardening and maintenance. Approximately 50 of the care staff currently possess an NVQ Level 2 or 3. This proportion should increase as 3 staff are currently studying for their NVQ Level 2. 3 other staff, who have their NVQ 2, are studying for their NVQ Level 3. Staff are receiving an induction and ongoing training which covers the required mandatory training. A training matrix has been developed so as tmonitor the training that staff receive. Recent training has included statutory safeguarding training, and training in palliative care, dementia awareness and medication. The home operates a fairly robust recruitment process, which is based on equal opportunities. Inspection of a sample of files, for staff recruited within the last 12 Care Homes for Older People Page 17 of 24 Evidence: months, indicated that criminal records, and identity checks are generally being undertaken. However, a CRB check for one new staff member had not yet been received. The manager confirmed that, pending receipt of the CRB, the staff member concerned was working under supervision and that no one-to-one contact with any resident was taking place. Inpection of staff files indicated that 2 written references had not been received for 3 new staff members, and that verbal references had not been followed up. The manager was reminded that two written references are required for all staff appointments. A requirement applies. Care Homes for Older People Page 18 of 24 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is being managed competently and in the best interests of residents. Health and safety is generally good, promoting and protecting the welfare of residents and staff. The home needs to extend its quality assurance processes and complete an annual quality assurance audit. Evidence: The home is being managed by a person (Linda Chamberlain) who has had extensive previous experience of working with this client group, previously as a deputy home manager, and who, since her appointment in April 2009, has demonstrated her competence in managing this home. She possesses an LMA and an NVQ 4, but needs to complete her registration with the CQC, which has been applied for. From the evidence of this inspection, the home would appear to be run in a generally competent way, and in the best interests of service users. Feedback from residents and staff was generally very positive in this regard. Care Homes for Older People Page 19 of 24 Evidence: The rights and best interests of residents are generally being safeguarded by the homes policies and procedures. These are being reviewed and updated on an annual basis. Record keeping was found to be generally satisfactory. The home completes surveys with residents and their relatives, feedback being generally very good. Monthly regulation 26 monitoring visits by the homes providers, to assess the conduct and quality of the service, are now taking place on a regular monthly basis. The home does, however, need to complete an annual quality assurance audit summarising the survey outcomes, and highlighting both those things that the home is doing well and those things that need to improve. The home is completing the necessary health and safety checks, and has updated its health and safety, and fire risk assessments. Fire drills are being completed on a weekly basis. Hot water temperature checks are being completed, but not on a sufficiently frequent basis. These need to be done weekly rather than monthly. A requirement applies. Care Homes for Older People Page 20 of 24 Are there any outstanding requirements from the last inspection? Yes R 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 1 18 13 The home must develop a 01/10/2009 robust procedure for responding to suspicion or evidence of abuse or neglect. Care Homes for Older People Page 21 of 24 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 1 6 All residents must be given an up-to-date copy of the Service User Guide, and CQC contact details updated. To ensure that service users are given up-to-date information. 30/06/2010 2 9 13 The home must start using individually identified blister packs for residents medication. To help ensure the safe administration of medication, 30/06/2010 3 29 19 Two satisfactory written references are required for all staff applications prior to any decision as to their suitability to be appointed. To ensure the safety of service users 31/03/2010 Care Homes for Older People Page 22 of 24 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 4 30 18 All staff must receive supervision on at least a two-monthly basis. To ensure the safety of service users 31/03/2010 5 38 12 Hot water checks must be completed on a regular weekly basis. To ensure the safety of service users. 31/03/2010 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 3 The Pre-admission care plan should be renamed as a Preadmission assessment so as to accurately describe its real purpose. The timing of GP visits should be reviewed with the GP practice so that the timing of visits does not coincide with the residents lunch period. Contact details for the Commission need to be updated on the complaints procedure to those for the CQC. And amended in any other documentation, including in the Service User Guide. It would be good practice to undertake an OT assessment of the home to ensure that the home is a totally safe environment, and that there are sufficient aids and adaptations in place. The home needs to extend its quality assurance processes and complete an annual quality assurance audit by the end of 2010. 2 8 3 16 4 22 5 33 Care Homes for Older People Page 23 of 24 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 24 of 24 - 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!