Care Home: St Mary`s Nursing Home Hull

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What the care home does well The home was well managed. Staff were well supported by management and morale was high. Consequently, there was a low staff turnover and consistency of support for the residents. The staff team enjoy their work at the home and residents describe them as friendly. They told us the staff looked after them well and listened to what they had to say, `the majority of staff are fantastic` and `they are marvellous`. The home had a calm and pleasant atmosphere on the day of the visit. People have their health and personal care needs met in ways that promote privacy and dignity, `excellent care standards and facilities` and `they look after patients exceptionally well`. Nursing staff managed medication well and ensured that people received their medication as prescribed. People told us in surveys and discussions that there were enough activities going on and that they enjoyed the meals provided. One person said, `there are lots of activities to get involved with`. The home provides a clean and spacious, purpose-built environment for people. It is well maintained and there are lovely gardens for people to enjoy fresh air in warmer weather. One person said, `it is always warm and comfortable`. The home received few complaints and those that were received were dealt with quickly. There are policies and procedures and staff training in place to help protect residents from abuse and poor practice. The staff told us in discussions and in surveys that they received sufficient training to help them complete their tasks. 70% of care staff have gained a national vocational qualification (NVQ) in care at level 2 or 3, which is an excellent achievement and exceedsthe standard. There is a good quality monitoring system in place that ensures the home is audited and that people are consulted about the way it is managed. Residents` money, held for safekeeping, is managed well. What the care home could do better: Staff must ensure that all assessed needs are included in care plans and they could also include more preferences for care. This will give staff clearer guidance and ensure that important care is not missed. Random inspection report Care homes for older people Name: Address: St Mary`s Nursing Home Hull 344 Chanterlands Avenue Kingston Upon Hull East Yorkshire HU5 4DT three star excellent service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Beverly Hill Date: 0 9 0 4 2 0 1 0 Information about the care home Name of care home: Address: St Mary`s Nursing Home Hull 344 Chanterlands Avenue Kingston Upon Hull East Yorkshire HU5 4DT 01482307590 01482307590 stmarys2@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Lyn Wilson Type of registration: Number of places registered: Conditions of registration: Category(ies) : Private Medicare Limited care home 48 Number of places (if applicable): Under 65 Over 65 48 0 old age, not falling within any other category physical disability Conditions of registration: 0 48 Registration includes eight stroke rehabilitation patients and two intermediate care. The maximum number of service users who can be accommodated is: 48 The registered person may provide the following category of service only: Care home with nursing - Code N, 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 and Physical disability - Code PD Date of last inspection Care Homes for Older People Page 2 of 11 Brief description of the care home St Marys Nursing Home is a single storey, purpose-built home, situated in its own extensive grounds in a residential area of west Hull. There are a variety of local community facilities close to hand. The home offers ample parking and a bus stop is very close to the home. The home offers long-term care with nursing to a maximum of forty-eight older people. Accommodation is provided in thirty single and nine shared bedrooms, all on one level. There are eight stroke rehabilitation beds and two NHS funded beds, which people occupy for relatively short stays. This section of the home has a rehabilitation kitchen, a shower room and a bathroom, a small lounge/dining room and a therapies room to help people regain daily living skills before returning home or move on to other accommodation. The main part of the home has a large lounge, a separate dining room and three bathrooms. The home has pleasant wheelchair-friendly grounds for the enjoyment of the residents. The basic weekly fee the home charges is £505.30p for a single bedroom and £476.80p for a shared bedroom. The weekly top-ups for a local authority funded placement are £11 for a shared room and £39.50p for a single bedroom. Residents will pay further costs for optional extras such as hairdressing, private chiropody treatment, toiletries and newspapers/magazines. Information about the home and its service can be found in the statement of purpose and service user guide, both these documents are available from the manager of the home, and copies are given to every new resident. The latest inspection report for the home is on display and copies are available from the manager on request. Care Homes for Older People Page 3 of 11 What we found: We visited the home from 10.00am to 16:30pm. During the visit we concentrated on three core areas of practice; health and personal care, complaints and protection, and management and administration. We checked specific records and spoke to several residents, the registered manager, the training manager and care staff. Choice of Home Not assessed at this inspection. Health and Personal care We looked at three care files during the visit. The home used the,standex system that provided documentation to enable staff to record information from the initial assessment and risk assessment stage, through to the care planning and ongoing recording of care from a range of people. The manager completed a pre-admission assessment and assessments and care plans were obtained when completed by the local authority, for people funded by care management. The assessments enabled the manager to decide whether the home was able to meet the persons needs. Staff formulated a care plan from the information gathered during assessments and some of these were comprehensive and contained good information for staff, especially around any nursing task. However, there were some areas of assessed need that had been missed when planning the care in the three files we examined. For example, with one resident and their, severe communication needs and another for their health needs associated with pain control and constipation. A third care plan could have had more detailed information around how their indwelling catheter and colostomy were managed. Care plans could also contain more personalised information, especially regarding how residents preferred to be cared for. For example, one residents care plan for personal hygiene stated that one staff member was required for assistance and the tasks were, maximum assistance with all care, weekly bath and daily body audit. It could have been much clearer about the actual care required, what the person could do for themselves however minimal, what clothes they preferred to wear, what toiletries they liked to use and any creams that were needed to be applied, whether they had a wet or dry shave and how oral hygiene was carried out. The other two care plans also could have contained more preferences for care. This was mentioned to the manager and training manager, who were keen to improve the plans and encourage participation from residents when they are able. The care plans were signed by the resident or their representatives to show that they agree with the contents. There was evidence that reviews of the care provided had taken place annually with the resident, their family, staff and the local authority present. There was clear evidence that people had access to health professionals for advice and treatment. All residents were registered with a General Practitioner. Surveys received from six residents all stated they received the personal and medical care they required either, always or usually. People spoken with told us they were happy with their care. Care Homes for Older People Page 4 of 11 Comments from discussions and surveys were, excellent care standards, looks after the patients exceptionally well, very good attention by matron and staff, I see the chiropodist and the optician - they look after us well, I certainly do feel looked after and she has been well and patiently looked after at St Marys for over six years - very few faults. In discussions, staff members spoken with described ways in which they would promote the core values of choice, independence, privacy and dignity, ask people when they want to get up and give them choices about food and where to sit, knock on doors and pull curtains and care with as much dignity as possible. In staff surveys it was clear that people enjoyed their work and took pride in keeping standards high. Some comments were, staff are chosen based on experience, skills and quality to ensure high standards of health and personal care, its a very happy home - relaxed atmosphere and settled, we provide individualised care and we work very well with other agencies and health professionals. The home managed medication well. It was stored, recorded and administered in line with safe practice and policies and procedures. Daily Life and Social Activities This area was not assessed but surveys received and discussions with residents and staff told us that activities and occupational stimulation was provided in the home and meals were enjoyed. One person commented in a survey that the food was, mostly good but they would like to see more variety for the evening meal. This was mentioned to the manager. Other comments from discussions with residents were, I like it very much - its warm and tasty, oh yes, its good, its excellent, the fish could be better but the rest of the food is fine and the food is marvellous. Complaints and Protection The home had a complaints policy and procedure that was on display. The manager confirmed that any complaint was taken seriously and resolved as soon as possible. Records seen evidenced this. In discussions and surveys staff were clear about what they had to do if people raised concerns with them. Residents also confirmed they knew how to make a complaint and who to speak with if they were unhappy about anything, I would see whoever is in charge - yes they would sort it out, I feel able to complain and I know what to do, I would see Lynn the matron - she would sort things out, I have no complaints and no complaints at present. One resident did mention something to us that required checking out and they agreed that the manager could do this. The home follows the multi-agency safeguarding of adults policy and procedure. The registered manager and training manager have both completed the more in-depth safeguarding of adults from abuse training with the local authority. This is specifically for managers, regarding the referral and investigation role. In discussions, care staff were very clear about their role in alerting any incidents of abuse or poor practice. They were able to describe what they would do if they became aware of any concerns, who they would report them to and what documentation they Care Homes for Older People Page 5 of 11 would complete. Staff complete safeguarding training in induction, during their NVQ training, and also as part of a rolling programme of training and development. Environment Not assessed at this inspection but parts of the environment seen were clean and tidy, and there were no malodours. All six surveys received from residents stated the home was clean and fresh either, always or usually. Staffing Not assessed at this inspection but surveys and discussions with residents indicated people were happy with the care provided by the staff team. Some comments were, good information, help and support to families and carers, the staff are alright - they look after you well, smashing and the staff are pleasant. Two residents made a negative comment about staff and this was mentioned to the manager to address. The home is well staffed with two, sometimes three nurses on shift during the day, including the manager, and between seven and nine carers in the morning and seven in the afternoons. At night there are five staff on duty, occasionally four. This is made up of either one to two nurses and two to three carers. Comments from a staff team discussion and from surveys indicated that the team worked well, morale was high and they felt well trained and supported. There was a training plan in place that covered mandatory and service specific training and the home had a designated training manager. Nearly 70 of care staff had gained a national vocational qualification (NVQ) in care at level 2 or 3. This was an excellent achievement and exceeded the standard. Catering, domestic and administration staff had also completed NVQ training. Management and administration The registered manager is a qualified nurse and has worked at the home for several years. She is due to start the Registered Managers Award and has completed training in deprivation of liberty safeguards, a mental capacity briefing, medication and moving and handling updates, and infection control. She also completed training in how to use a syringe driver for pain control, when supporting people at the end of their lives. Staff members describe the manager as having an open door and always being there to support them. They also commenetd that the provider visits the home and is very approachable and friendly, he knows your name and history and he speaks to staff when he visits. There is a financial incentive for staff completing NVQ training and recognition for long service. There was a formal staff supervision system in place, which meant that people had one to one time with their line manager every two months. Discussions included, training and development, workload and support for the residents. The training manager also completed observations of practice, although these had not been documented. Staff said that the support and high morale meant that there was a very low staff turnover and if staff did leave, they often returned to work at the home again. Care Homes for Older People Page 6 of 11 There is a good quality assurance system that consists of questionnaires to residents, relatives, staff and professional visitors and a range of regular audits. Action plans were produced to address any shortfalls. There are various meetings for managers, nurses, general staff and residents to ensure consultation, an exchange of information and to address any issues. We did not check finances thoroughly but discussed with the manager the system for safekeeping peoples monies. Generally residents themselves, or family members, manage finances but a small amount of personal allowance is held for safekeeping for those residents that request it. Individual records are maintained and receipts obtained for purchases. There is restricted access to the finances and residents have lockable facilities in their bedrooms to store their vaulables. The home has a residents fund held in the bank and used to provide equipment and social activities for residents. The home continues to be a safe place to live in and work in. Staff participate in mandatory training, fire drills and fire alarm checks are completed, risk assessments are in place, equipment is serviced and the home remains well maintained. What the care home does well: The home was well managed. Staff were well supported by management and morale was high. Consequently, there was a low staff turnover and consistency of support for the residents. The staff team enjoy their work at the home and residents describe them as friendly. They told us the staff looked after them well and listened to what they had to say, the majority of staff are fantastic and they are marvellous. The home had a calm and pleasant atmosphere on the day of the visit. People have their health and personal care needs met in ways that promote privacy and dignity, excellent care standards and facilities and they look after patients exceptionally well. Nursing staff managed medication well and ensured that people received their medication as prescribed. People told us in surveys and discussions that there were enough activities going on and that they enjoyed the meals provided. One person said, there are lots of activities to get involved with. The home provides a clean and spacious, purpose-built environment for people. It is well maintained and there are lovely gardens for people to enjoy fresh air in warmer weather. One person said, it is always warm and comfortable. The home received few complaints and those that were received were dealt with quickly. There are policies and procedures and staff training in place to help protect residents from abuse and poor practice. The staff told us in discussions and in surveys that they received sufficient training to help them complete their tasks. 70 of care staff have gained a national vocational qualification (NVQ) in care at level 2 or 3, which is an excellent achievement and exceeds Care Homes for Older People Page 7 of 11 the standard. There is a good quality monitoring system in place that ensures the home is audited and that people are consulted about the way it is managed. Residents money, held for safekeeping, is managed well. 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 set out on page 2. Care Homes for Older People Page 8 of 11 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 9 of 11 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, 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 Care plans must reflect all assessed needs. This will ensure that the guidance about care tasks and support for residents is written down fully, and will avoid important care being missed. 31/07/2010 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 7 Care plans should be more personalised to include preferences for care. This will help to provide more detail and give staff a clearer picture of how people wish to be cared for. Care Homes for Older People Page 10 of 11 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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