Care Home: St Martha's Residential Home

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What the care home does well Peoples needs are assessed before they move into the home. This means that they are only offered a place if their care needs can be properly met. Some of the care plans contain accurate and up to date information which informs the staff about how to provide the people with good care. Information about the home is available to help people decide if it is the right home for them to move in to. Healthcare needs are well met by using a multi agency approach. This helps the people who live at the home to stay healthy. The people have opportunities to take part in a variety of leisure pursuits and interests which provides them with a stimulating environment and helps them keep their social skills and self confidence. The staff team at the home value the differing needs of the people who live there and make sure that they are aware of each person`s preferences. They treat the people who live at the home as individuals and support them to live the life they choose as much as possible so they know they are valued. There are procedures in place at the home that make sure that the people who live there are protected and kept safe from abuse. The staff are supervised and trained so they know how to provide the people with good care. The manager and trainee manager are experienced. They are approachable and clearly present in the home to give direction and support to staff and make sure that the service is centered on the people whom live at the home. What has improved since the last inspection? Care plans are being improved and updated. The Service Users Guide is being up dated at this time. The home now has quality assurance system so they can now evaluate the quality of the service. The financial records kept of residents money are now checked and signed by two staff. The staff now have regular supervision which supports them to carry out their duties and provide the people at the home with good care. The home now keeps a record of any complaints. What the care home could do better: If the downstairs toilet was upgraded this would make it more pleasant for the people in the home and reduce the unpleasant odour. If all of the care plans had sufficient detail and all parts of the plan were completed, staff would know that the information in them was up to date and correct. This would mean that they would be sure they were providing the people at the home with the support and care they need. If staff recruitment records showed that any gaps in an applicants work history had been explored thouroughly this would demonstrate that the organisation properly vet people before they offered employment at the home. It would also show that they have made sure that they only employ suitable people to work at the home and therefore safeguard the people who live there. When staff receive fire instruction, if this was clearly recorded the manager would be able to check that they all have training at the required intervals. This will make sure that staff are clear about what they must do in the case of a fire to keep the people at the home as safe as possible. Key inspection report Care homes for older people Name: Address: St Marthas Residential Home 17 Thornhill Park Sunderland SR2 7LA     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: Hilary Stewart     Date: 1 2 1 1 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 25 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 25 Information about the care home Name of care home: Address: St Marthas Residential Home 17 Thornhill Park Sunderland SR2 7LA 01915656443 01915656411 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Ms Gwendoline Swalwell care home 24 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: Date of last inspection Brief description of the care home St Marthas is a care home that provides personal care for up to 24 older people, some of who may have dementia or mental health needs. Nursing care is not provided. A day care service, meals at home, and a domiciliary care agency are operated from a designated area of the building. The house is a Victorian semi-detached property that has been converted to a care home and extended. It is over three floors and most of the bedrooms are on the upper floors. A passenger lift is provided. There is a large front garden with a paved terrace where residents and visitors can sit. The home is located in a quiet tree lined street in a residential area. It is a short walk into Sunderland City Centre where there are a range of amenities and shops. Care Homes for Older People Page 4 of 25 Over 65 0 0 24 8 4 0 1 2 1 1 2 0 0 8 Brief description of the care home The home charges between £407 to £ 440 per week. Care Homes for Older People Page 5 of 25 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 star. This means the people who use this service experience good quality outcomes. How the inspection was carried out. Before the visit we looked at the information we have received since the last visit on 12th November 2008. How the service dealt with any complaints and concerns since the last visit. Any changes to how the home is run. The providers view of how well they care for people and the views of people who use the service and the staff. An unannounced visit was made on the 4th and a follow up visit on the 12th November 2009. During the visit we talked with people who use the service staff and the trainee Care Homes for Older People Page 6 of 25 manager. We looked at information about the people who use the service and how well their needs are met. We looked at other records which must be kept and checked that staff had the knowledge, skills and training to meet the needs of the people they care for. We also looked around the building to make sure it was clean safe and comfortable. We checked what improvements had been made since the last visit. Then we told the manager what we found. We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future if a requirement is repeated it is likely that enforcement action will be taken. Care Homes for Older People Page 7 of 25 What the care home does well: What has improved since the last inspection? Care plans are being improved and updated. The Service Users Guide is being up dated at this time. The home now has quality assurance system so they can now evaluate the quality of the service. The financial records kept of residents money are now checked and signed by two staff. The staff now have regular supervision which supports them to carry out their duties and provide the people at the home with good care. The home now keeps a record of any complaints. Care Homes for Older People Page 8 of 25 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 25 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 25 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 have an assessment by their care manager before they move into the home. The manager looks at this assessment to see if the home can meet the persons needs. They then carry their own assessment out prior to the person moving in. People can visit the home before they make a decision. Evidence: The trainee manager said that the people who live at the home have had their needs assessed before and after they move in. A person can only move into the home if they are certain that their needs can be met there. The trainee manager said that the assessment of the peoples needs is on going, they evaluate them and up date the care plans if necessary. If a person decides to move into the home they can visit before they move in permanently, so they can decide if they want to live there. Care Homes for Older People Page 11 of 25 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. All of the people who live at the home have individual care plans through which staff monitor and promote their health and maintain their well being. Some did not have enough detail. Furthermore the manager and staff respect the privacy and dignity of the people who live at the home. This is so the people know that they are valued as individuals. Medication procedures are in place but should be more robust. Evidence: The trainee manager said and records showed that each person who lives at the home has an individual care plan. Each plan is being updated. The manager said that some staff are receiving training in care planning and it is their intention to improve and update each persons care plan. Some had been completed but others are still in the process. Records showed that the plans covered health and areas of daily living. The care plans looked at were general and each persons needs were presented in a similar way. Some needed more detail about how to meet the individual needs of each person. For example one persons care plan said needs a little assistance to go to and from the bathroom but it didnt say how many staff, of what gender or if the person needed a hoist. Another said needs the help of carer to get dressed for bed but Care Homes for Older People Page 12 of 25 Evidence: again did not say what type of help was needed. What gender of staff, if the person needed verbal, gestural of physical prompts or do the staff carry out the task for them. Another persons care plan states do not allow her to loose her dignity when eating but again does not given any instruction to staff about how to do this. The new layout of care plans had more detail. There are risk assessments that the manager said were being completed at the time. There are procedures for staff to follow when they deal with medication. The trainee manager said that only staff who have received training in how to safely administer medication administer it. Any changes of medication or medication procedures are recorded and followed in the home. Two staff always sign them as a safety measure. There were some gaps in the recording and there wasnt any evidence to show that the medication had been missed, refused or not recorded. There wasnt any method of auditing the medicines that were loose and not in a measured dosage system. The manager said that excess medication is recorded and returned to the chemist every month. However there wasnt any method of auditing loose tablet or liquids as a means to check if their had been any omissions or mistakes by confirming the amount of administered medication tallied with the amount left. The manager said that people are supported to manage their own medication if, following a risk assessment it was found to be safe enough. The medication records were up to date. Records showed that the peoples health care needs are met at the home. Details of visits by the district nurse visits to their GP and hospital appointments are recorded in the individual files. The manager said that the health and welfare of the people who live at the home is monitored all of the time. One person who lives at the home said the staff look after me. Another said the staff will get the help if I need it. The people who live at the home looked comfortable. One person said they are all very kind the staff that work here another said If staff are not around I know how to use the call system and they come straight away. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live at the home are able to follow their own daily routines which satisfy their social cultural and religious needs. They can see their family and friends at any reasonable time. This helps to prevent them from feeling and becoming isolated. Evidence: The manager and staff said that they arrange a variety of outings for the people who live at the home. An activities coordinator has been appointed and they support people to persue their hobbies or find new ones and they have a theme night every month. There is a service user meeting four times a year and people are supported to suggest activities and trips they would like to take part in. Records showed that people are asked to suggest what they would like to do. The manager said that they also have the opportunity to go to Lourdes every year if they wish to. Records showed that some people had been involved in a variety of activities such as going out to clubs and going to church. Church services are also held at the home. One person said yes I can take part in activities if I want but I prefer to stay in my room. another said there are things to do. Staff and the people who live at the home said that relatives and visitors are welcome Care Homes for Older People Page 14 of 25 Evidence: and encouraged to visit at any reasonable time throughout the day and evening. Visitors were observed during the visit. Relatives of the people who live at the home can have meals with them. The manager said that the people are asked for their opinions about the food provided and the menus are based on the likes and dislikes of the people who live there. A cook is employed and they said that there are choices at meal times and if people want something different they will make it for them. Special diets can be catered for. One person said the manager has provided me with what I have requested another person said the food is nice. Hot drinks and snacks are always available throughout the day and evening. The kitchen was well stocked and there were fresh fruit and vegetables. Staff were observed sitting with people at meals times and talking with and supporting them. Menues are now available in large print. Care Homes for Older People Page 15 of 25 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. Complaints are dealt with so any problems are taken care of quickly which helps good relationships to be maintained. Staff know about and all have had training in how to protect people from harm, so the people who live at the home are kept safe. Evidence: Copies of the homes complaints procedure are on the doors of all of the residents rooms. The manager and staff said that the people who live at the home and their relatives know how to make a complaint. Three complaints have been made to the home and they have all been dealt with. The trainee manager said that there is a complaints record which is kept up to date. One of the people at the home said I would tell the manager or my son if I wasnt happy. Another person said they felt they could speak to some staff about any problems they had. The surveys returned showed that people are aware of the complaints procedure. The manager said that they deal with complaints quickly and efficiently and use them as a tool to improve their standards. The manager and trainee manager said that all staff have had training in how to safeguard the people they care for. There is a copy of the Local Authority procedures and the home has copies of their own adult protection procedures for staff. Staff said that they have had the training and they could describe what they needed to do if someone disclosed abuse to them or they suspected it. All staff have had training on the homes whistle blowing policy and procedure. Care Homes for Older People Page 16 of 25 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 and clean home, although some repairs and improvement are necessary. Evidence: The home is comfortable, warm and clean. There are enough bathrooms and showers for the people who live at the home. The living rooms were warm and looked comfortable. One toilet downstairs had a an unpleasant odour which was probably caused by the floor not being sealed as well as it could be. The cold tap didnt work and there wasnt any hot water coming out of the hot tap. In one bathroom the sealant around the bath needed to be repaired and the grout was discoloured. These issues could lead to difficulty in cleaning them properly and consequently lead to a risk of cross infection. The trainee manager said that they would deal with these issues immediately. Each person has their own bedroom and they looked comfortable and clean. They were all personalised and made very individual. All of the rooms visited were warm. The laundry is organised and clean. Care Homes for Older People Page 17 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Sufficient numbers of staff are in post to meet the diverse needs of the people who live at the home and they have opportunities for training so they know how to give them good care and meet their needs. Furthermore the home has a new recruitment procedure in place, which will help to prevent risk of harm to the people who live there. Some records did not show that all checks had been carried out. Evidence: Staff said that they receive training, which helps them with their work. The manager said that all staff receive the training and support they need. Staff said and records showed that they all have mandatory training such as first aid, food hygiene and safeguarding adults training. The manager said that 75 staff have vocational qualifications. Sufficient staff were on duty at the time of the visit. Staff said and records showed that sufficient staff had been on duty in the home the previous week. The manager said that the staff tend to stay at the home and they never have to employ agency staff. One member of staff said there are enough staff and another said staff tend to stay working here. The trainee manager said that all staff have been CRB Criminal Records Bureau checked at an enhanced level to make sure they are suitable people to work at the home. Recruitment procedure at the home has been revised and updated. All staff go Care Homes for Older People Page 18 of 25 Evidence: through a recruitment process and they cannot not start to work at the home until this is completed. They are interviewed and are only successful when they have two satisfactory references. Copies of staff records showed that checks had been carried out. Some records showed gaps in staff work history. They did not show that they had been explored during the recruitment process. Care Homes for Older People Page 19 of 25 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 registered person is qualified and experienced and runs the home in the best interests of the people who live there and there are procedures in place that make sure they are protected as much as possible. Evidence: The manager said that the people who live at the home and their families are asked their views about the running of the home as much as possible. Staff said and records showed that the people have key workers who monitor their care at the home. One person said the staff are very kind and another said they are very good to me. Safety checks have been carried out on the equipment in the home such as testing electrical equipment and the servicing the central heating boilers. Fire safety risk assessments had been completed. The fire logbook showed that fire drills take place. The trainee manager said that fire instruction has taken place as often as it should but is not always recorded. They agreed to rectify this immediately. Care Homes for Older People Page 20 of 25 Evidence: Staff said that they have fire drills and instruction. One of the people who lives at the home said yes the staff have fire drills. Records showed that regular training is provided for staff in fire safety and first aid. The manager said and records showed that they are experienced to run the home effectively. They plan to have the trainee manager take over when she has completed her management training. It was observed that there was a friendly atmosphere at the home and a pleasant rapport between the people who live at the home the manager, trainee manager and staff. The staff said that they could approach the manager and trainee manager with any concerns. Staff said that they liked working at the home. The trainee manager said that staff receive individual supervision six times a years and they have regular staff meetings. Records showed that individual formal supervision takes place. One member of staff said yes we get supervision sessions every few months or whenever we need one. The home has procedures for staff when they deal with the peoples money so it is kept safe. Records showed that staff sign records when any of the residents money is used and the manager checks them regularly Care Homes for Older People Page 21 of 25 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 22 of 25 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 7 15 All of the care plans must have enough detail about the action staff need to take to meet all of the health, personal and social needs of each person. The care plans must have enough detail and be accurate and up to date so staff have the information they need to to provide each person with good care and keep them safe. 28/02/2010 2 28 18 All staff must have a full work history and any gaps should be explored during the recruitment process. This will make sure that only suitable people work at the home. 31/01/2010 Care Homes for Older People Page 23 of 25 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 9 Medication stocks at the home should be audited regularly so the manager can identify if there have been any mistakes or omissions. The manager should record each members of staffs name when they complete fire instruction so they know every member of staff has received it at the required intervals. 2 38 Care Homes for Older People Page 24 of 25 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. 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