Care Home: St Mary`s Convent

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What has improved since the last inspection? "Communicating" doors between bedrooms have been removed to ensure privacy and safety of occupants. The stair lift has been replaced with a more effective model that reduces the need for transfers on the intermediate landing. Water temperatures are checked regularly and recorded.St Mary`s ConventDS0000007504.V376315.R01.S.doc Version 5.2 Page 7 What the care home could do better: The home needs to do a risk assessment on the unenclosed flights of stairs that are accessible from the upper floors. The home would benefit from having a "Loop Induction" system installed for hearing aid users. The disposal methods in the sluice rooms are dated and should be upgraded to a closed system. Corridors without natural light should remain well lit and lighting should not be routinely turned off. Key inspection report CARE HOMES FOR OLDER PEOPLE St Mary`s Convent St Mary`s Convent Ebchester Consett Durham DH8 0QD Lead Inspector Tom Moody Key Unannounced Inspection 12th May 2009 10:00 DS0000007504.V376315.R01.S.do c Version 5.2 Page 1 This report is a review of the 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. 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. St Mary`s Convent DS0000007504.V376315.R01.S.doc Version 5.2 Page 2 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 St Mary`s Convent DS0000007504.V376315.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Mary`s Convent Address St Mary`s Convent Ebchester Consett Durham DH8 0QD 01207 560288 F/P stmarysconvent@tiscali.co.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) The Order of the Good and Perpetual Succour Patricia Elizabeth French Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places St Mary`s Convent DS0000007504.V376315.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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 category: Old age, not falling within any other category - Code OP, maximum number of places: 16 The maximum number of service users who can be accommodated is: 16 18th April 2007 2. Date of last inspection Brief Description of the Service: St Mary’s Convent is owned by the nuns of The Order of the Good and Perpetual Succour, who have their own accommodation and chapel within the same building as the care home. The care home is registered to provide care and accommodation for up to 16 older people and the home has decided that it will only provide services to females. In addition to the nuns who live at the convent, St Mary’s Convent employs a staff team and manager to provide care and run the home. The convent is an old building that has been adapted for use as a care home. As a result the building has a number of different levels and accessibility varies throughout the building. All of the bedrooms are singly occupied and some bedrooms have en-suite toilets. There is a lounge, entrance sun lounge, large internal hallway with seating and a dining room on the ground floor. There is also a large office used by the manager and staff. Bathrooms, a shower room and toilets are located through out the building. The first floor is accessed by a passenger lift, while the mezzanine floors and levels are accessed by a stair lift. Some bedrooms and levels require access by two or three stairs, which have been fitted with handrails to make access easier. The convent is surrounded by well-maintained gardens and also has a pleasant internal courtyard area with seating. Car parking is available at the front of the building. At the time of this inspection the fees charged to live at St Mary’s Convert were St Mary`s Convent DS0000007504.V376315.R01.S.doc Version 5.2 Page 5 £392.50 per week. Additional charges include hairdressing, chiropody and personal toiletries. Up to date information about fees should be sought from the manager. St Mary`s Convent DS0000007504.V376315.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. Information sent from the home, including a Self Assessment was used for this report, together with other information on file. Surveys, returned by service users and relatives were also read together with other notifications sent by the home. A site visit was carried out on 12 May 2009 and this lasted 6 hours. During this a tour of the premises was carried out. Documents relating to 4 service users, including care plans, were examined and these service users were spoken to by the inspector. We call this case tracking. The inspector spoke with the manager and other staff in the home. A number of visitors and service users were interviewed. Other records and documents were also examined at this time. We told the manager what we found. As a result of this inspection the quality rating for this service remains at three stars – excellent service. This means that the people who use this service experience excellent quality outcomes. What the service does well: The home provides good information and encourages trial visits for people wishing to stay. The home provides a good level of equipment and furnishings. Service users said, “It’s a lovely place” and “it’s nice, it’s very pleasant” The home has well kept gardens and grounds that are accessible to service users. The home has friendly and knowledgeable staff who show a caring and respectful attitude to service users. Visitors and service user’s comments, such as, “The staff are wonderful,” reflected this. What has improved since the last inspection? “Communicating” doors between bedrooms have been removed to ensure privacy and safety of occupants. The stair lift has been replaced with a more effective model that reduces the need for transfers on the intermediate landing. Water temperatures are checked regularly and recorded. St Mary`s Convent DS0000007504.V376315.R01.S.doc Version 5.2 Page 7 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. St Mary`s Convent DS0000007504.V376315.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection St Mary`s Convent DS0000007504.V376315.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the 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 service users needs are accurately assessed and the home can meet those needs Service users have information they need to make choices and a service users guide is available containing all the necessary information. Service users can make a trial visit and are able to make an informed choice about coming into the home. EVIDENCE: The homes self-assessment says that, “All brochures and documentation given to perspective residents outline all our facilities and services and our aims and objectives, to provide all parties with enough information for them to make an enlightened decision on choice of home” and that “On admission each residents is supplied with a contract, a St Mary`s Convent DS0000007504.V376315.R01.S.doc Version 5.2 Page 10 statement of purpose, and service user guide.” The examples of these documents, seen during the site visit, confirmed this although some details about regulatory bodies and contacts need to be updated. The homes self-assessment says that all prospective new clients and their families and friends are encouraged to come and view the home, if they are able, before admission. Service users and relatives confirm trial visits are available and care plans contain a wide-ranging assessment of their needs. The home says it makes a full assessment is made on all residents for either full time care or respite care, and the home do not admit residents for care, unless they are sure that all needs can be met. If applicable, they also receive social worker reports and care plans prior to admission. Examples of documentation seen during the site visit confirmed this. St Mary`s Convent DS0000007504.V376315.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person has a detailed plan, which explains how their care they will be given and people’s health care needs are met. The homes policies, procedures and practice, for dealing with medication, protect service users. Service users feel that they are treated with respect by the staff. EVIDENCE: The homes self-assessment says that, “All the assessed needs are detailed within their individual plan of care. The staff use these care plans as their action plan, for all aspects of the residents health and personal care.” And that, “The care plans are written, with the assistance of the resident their families or their representatives, and are signed by the parties involved, when approved.” These documents were seen during the site visit and the inspector was able to confirm St Mary`s Convent DS0000007504.V376315.R01.S.doc Version 5.2 Page 12 this. Care plans contained evidence that service users were able to access health care specialists including, Continence Advisors, Occupational Therapists, Community Nurses, Dentists, Opticians and Chiropodists. The local GP was visiting the home at the time of the site visit. It was evident from looking at staff care practice, and their interactions with service users, that they knew about preserving their dignity and privacy. For example, staff used the service users preferred name, they spoke to service users respectfully, staff allowed service users time to make choices, all of which enhanced the dignity of service users. Staff always knocked before entering bedroom doors to preserve the privacy of service users. Clear medication records are kept and staff were observed giving out medicines. This was done correctly and safely. Medicines are stored safely in appropriate cabinets. St Mary`s Convent DS0000007504.V376315.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes provision matches service users recreational, social, spiritual and cultural needs, and helps them maintain contact with the surrounding community. People are able to exercise choice and control over most aspects of their lives and they enjoy nutritious and appetizing food. EVIDENCE: The homes self-assessment says that, they have, “A strong connection With local communities, attending coffee mornings and school plays. Our local Methodist church, have brought the children from their congregation to spend time with our ladies on occasions. We have local groups coming into the home to supply us with in house entertainment.” There is an entertainment programme and details of forthcoming events are displayed on the notice board. Service users confirmed they went out of the home on visits. They also said they enjoyed the garden and grounds when the weather was suitable. They St Mary`s Convent DS0000007504.V376315.R01.S.doc Version 5.2 Page 14 were able to spend time in their own room if they wished or were able to go into communal areas of the home. Visiting is not restricted and visitors were welcomed into the home at all times during the site visit. The home has a varied menu of traditional dishes suitable for the age and experience of the service users. There was only one menu choice but the kitchen staff knew the likes and dislikes of service users and they were able to supply suitable alternative meals. Service users enjoyed their meal. One said “I always enjoy the food, the cooks very good”. Visitors confirmed the food was good. One said, “The food is very good and she enjoys it.” St Mary`s Convent DS0000007504.V376315.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the 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 service users and relatives know how to raise issues and they are confident staff and managers will act on their concerns. Training and procedures ensure service users are protected and that their rights are upheld. EVIDENCE: Relatives and service users said they would be happy to approach the manager or staff if they had any concerns. One relative said, of the Manager, She always keeps her door open, she is very approachable. The homes self-assessment says that, “All our staff have been sent on all the relevant courses, including Protection Of Vulnerable Adults (POVA) and Safe Guarding Vulnerable Adults.” And that they, “Have information about Advocacy Services for any families that require assistance.” Training record conformed this. The home has a suitable complaints policy. The manager holds regular meetings with service users and relatives and she says this tends to defuse problems before they reach the stage of complaints. St Mary`s Convent DS0000007504.V376315.R01.S.doc Version 5.2 Page 16 Recruitment records indicate all pre employment checks are carried out including Criminal Records Bureau, POVA list and previous employers references. St Mary`s Convent DS0000007504.V376315.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a largely safe and comfortable environment although there is limited access to a few rooms. The home is very well equipped in most respects, and well furnished. It is spacious, clean and meets most of the service users needs EVIDENCE: The home has pleasantly landscaped surroundings. There is a secure and sheltered patio areas that service users enjoy in fine weather. There is ample parking space and views of the surrounding countryside. The décor and furnishings of the home have a traditional appearance and homely feel. The home has it’s own chapel that worshipers can access. St Mary`s Convent DS0000007504.V376315.R01.S.doc Version 5.2 Page 18 There is a good standard of equipment such as mobile and fixed hoists, and handrails. A suitable call system has been installed. However, the home does not have a loop induction system installed for hearing aid users. Showers toilets and bathrooms are of appropriate size and fitted with rails and hoists. Thermostatic mixer valves are fitted to bath and shower outlets. Water temperatures are recorded each time a facility is used but it may be better to routinely check all outlets on a regular basis. The home has generous communal and circulatory space. Unfortunately some of the corridors had low natural-light levels and staff had a tendency to put the lights out in these areas. These areas would not meet the national minimum standards in this respect and lights should be left on at all times to ensure the safety of anyone using these areas. Some upper corridors have unguarded access to steep flights of stairs. Service users are able to use a lift to reach the upper floors at any time. The manager is aware of the risk posed by the stairs and she is going to carry out a risk assessment to improve safety without compromising service users access to the upper floors. Bedrooms are a generous size and are furnished with peoples own possessions and in a style which they prefer. A few rooms are accessed via a small flight of steps and may not be suitable for service users with mobility difficulties. The sluice disposal facilities are of an old design which is open and could produce aerosol contamination for the user. A more closed system would be safer for the operator and less likely to produce cross contamination. The home has a well equipped laundry and suitable hand washing facilities for service users and staff. There were no discernable bad odours during the time of the site visit and the home was clean and tidy in all areas. St Mary`s Convent DS0000007504.V376315.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the 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 staffing of the home meets service user’s needs. They are supported in a safe manner, by staff who are properly recruited, and have the appropriate training. EVIDENCE: The homes self-assessment says that, “We have increased our staffing levels, to reconcile with the increased needs of our residents, especially the residents with dementia with high dependency needs Our staff skill mix also reflects the changing assessed needs of our residents. We always ensure there are increased Staffing levels at peak times. At the present time 95 of our care staff have their NVQ II. We have a detailed training matrix, and training needs are highlighted at induction and at staff appraisals.” During the site visit, staffing rota, and training records were examined and they confirmed this. Staff employment records indicate all pre-employment checks are carried out including Criminal Records Bureau, Protection Of Vulnerable Adults list and previous employer references. Records also show that staff are interviewed and they receive terms and conditions. All staff who were spoken to confirmed they held NVQ qualifications. St Mary`s Convent DS0000007504.V376315.R01.S.doc Version 5.2 Page 20 Staff also said they received an induction, and training Service users needs were met, call buzzers were answered within a reasonable time and care was given in an unhurried manner. St Mary`s Convent DS0000007504.V376315.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed by an experienced, and qualified person who has service users interests at heart. The home is run in the best interests of service users. People are kept safe and their welfare and rights are protected by good record keeping and the promotion of good practice EVIDENCE: The manager is experienced and qualified. She is supported by two deputies. She states that although the home is administered by a board of trustees, she is free to make her own management decisions. She has been well supported St Mary`s Convent DS0000007504.V376315.R01.S.doc Version 5.2 Page 22 financially and the home’s equipment, staffing levels and maintenance records support this statement. Staff felt well supported. Staff now receive formal supervison at least 6 times a year and records are kept. Relatives were equally positive and said they would be happy to approach the manager if they had problems. Staff and relatives are also aware that the manager has an open door policy. The standard of record keeping is good. There are good records of service user’s personal allowance, and all receipts are kept, but a second signature at the time of reconciliations would show better accountability. The manager and staff have a good appreciation of health and safety issues, in most areas, and there are records of appropriate risk assessments being carried out. The home caries out quality audits and the results of these show a high level of customer satisfaction. St Mary`s Convent DS0000007504.V376315.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 2 3 3 2 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 2 3 3 3 3 St Mary`s Convent DS0000007504.V376315.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP22 Regulation 23 (2)(n) Requirement The home should have a loop induction system to assist service users who have hearing loss and are using hearing aids Lighting should be maintained at a level specified in The National Minimum Standards in all parts of the home used by service users. Access to the top of open flights of stairs should be reviewed and an accurate risk assessment carried out to ensure safety of service users moving in these areas. Timescale for action 31/07/09 2. OP25 23(2)(p) 30/06/09 3. OP22 13, (4) 30/06/09 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations DS0000007504.V376315.R01.S.doc Version 5.2 Page 25 St Mary`s Convent 1. Standard OP26 A closed system of disposal should be considered for the sluice to avoid contamination of operatives and potential spread of infection. Two signatures should be procured when service user’s personal finances are reconciled, to ensure the accountability of those carrying out the check. Hot water temperatures should be recorded on all outlets on a regular basis, as well as at the time of using the bath. 2. OP34 3. OP25 St Mary`s Convent DS0000007504.V376315.R01.S.doc Version 5.2 Page 26 Care Quality Commission North Eastern Region Citygate Gallowgate Newcastle upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries.northeastern@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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