Care Home: St Mary`s Residential Care Home

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What the care home does well People receive consistently good care and are treated with respect and kindness. Staff are ensuring that people receive the health care support they need. The home listens to people`s suggestions and ideas for improvement, for example changes to meal times and the names and photographs of staff on duty being displayed in the home. Staff receive the support and training they need to continue to provide a good quality of care. People are able to live the lifestyle they choose and to continue to observe their faith each day. What has improved since the last inspection? Improvements to the premises have included the renewal and replacement of the hot water system to ensure that people receive a good supply of safe hot water. The appointment of a deputy manager has assisted in the management of people`s care and health needs. Suggestions for improvements made by people living in the home continue to be implemented, such as changes to the menu and meal times. What the care home could do better: No requirements were made during this visit. Key inspection report Care homes for older people Name: Address: St Mary`s Residential Care Home 14 Westbrooke Worthing West Sussex BN11 1RF     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: Edward McLeod     Date: 0 7 0 9 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 Mary`s Residential Care Home 14 Westbrooke Worthing West Sussex BN11 1RF 01903233523 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: david@stmarysworthing.org Institute of our Lady of Mercy care home 25 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 25. The registered person may provide the following category/ies of service only: Care home only - (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 (OP). Date of last inspection Brief description of the care home St Marys Care Home is a home for older people registered to accommodate up to twenty-five residents over the age of 65 years. It is a large detached property arranged on three floors situated in a quiet residential area of Worthing. Accommodation is provided in twenty-five single rooms all with en-suite and shower facilities. There is a large sized garden at the rear of the property. Facilities include two lounges, a sun lounge, a conservatory and a dining room. The service is owned by The Sisters of Mercy and the manager is Mr David Chadwick. The fees at the home range from 450 to 495 pounds per week. Care Homes for Older People Page 4 of 25 Over 65 25 0 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 inspection visit was arranged to assess the services compliance with the key national minimum standards for care homes for older people. , We prepared for this visit by obtaining the homes annual Care Quality Commission (CQC) quality assessment audit (the AQAA) which told us how they have been running the service and the improvements to the service they have made or are planning to make. The AQAA provided the information we asked for, and was returned by the date by which we had asked for it. We also took into account information received from the service, for example in the form of notifications, and any views on the service received from other sources. Care Homes for Older People Page 5 of 25 Some of the information received in the period previous to the visit to the service has been included in this report. The visit was carried out by one inspector who was on the premises for five and a half hours. During the visit we spoke with five people living in the home, six members of staff, and the manager. We also sampled care assessments, records and plans for three people living in the home. We observed interactions between staff and people living in the home, including during the serving of lunch, and attended a staff handover meeting. We sampled three sets of staff training, supervision and recruitment records to help assess how staffing arrangements were protecting and meeting the needs of people living in the home. Other records we sampled included complaints and health and safety records. Care Homes for Older People Page 6 of 25 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 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 8 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 are confident the care home can support them. This is because there is an accurate assessment of their needs they they or people close to them have been involved in. This tells the home all about them and the support they need. Evidence: The manager Mr Chadwick tells us in the AQAA that the service is developing a website which would provide all the information that a prospective resident might require. At our visit Mr Chadwick told us that the great majority of people living in the home follow the Roman Catholic religion. There is a chapel on the ground floor of the home (also open to the public) and daily opportunities for observance of the Roman Catholic faith. We looked at the assessments carried out for three people living in the home before Care Homes for Older People Page 9 of 25 Evidence: their admission. We found that the assessment was assessing peoples needs, including soical needs. Staff we talked to said that the assessment was carried out in the persons own home if this was possible. We found that Care Management assessments completed by the funding authority (for example the local authority) were being obtained where applicable. We found that the needs assessment carried out by the home was not always including sufficient detail on the needs to be met, and was not recording an outcome saying if the home could meet the persons needs or not. We discussed this with the manager Mr Chadwick and were advised that the need for more thorough pre-admission assessments had been identified, and that an outside consultant was assisting them to develop a new format for pre-admission assessments. Care Homes for Older People Page 10 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. Peoples 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. Peoples 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. Evidence: During our visit we sampled the care plans for three people living in the home. We found that risk assessments and the plan of care were being regularly updated. We attended the afternoon staff handover where eight care staff were present. Various actions had been taken during the morning to help people access the medical Care Homes for Older People Page 11 of 25 Evidence: care they were in need of - for example a G.P. had been contacted about one persons eye irritation, and a prescription for eye ointment had been agreed. Also staff had reported their concerns about the skin condition of one persons leg, and a district nurse was being arranged to carry out an assessment. At the handover meeting staff were also given updates to peoples care plans, for example changes to one persons denture care arrangements. The AQAA tells us that people are encouraged to be responsible for their own medication, providing a risk assessment shows them to be confident and competent. During our visit we sampled the arrangements for people holding their own medication, and advised Mr Chadwick that there was a need to ensure that medication risk assessments were regularly updated. Discussion with staff indicated that risks in relation to self-medication were being assessed though not always recorded, and that where staff or the person had concerns about their medication that this was being discussed with the persons G.P. We found that staff are receiving regular updating training in the administration of medicines, and that appropriate arrangements are in place for the management of controlled medication. Staff we spoke to said that one of the strengths of the home was that people were treated as individuals. It was our observation that staff are sensitive to assiting people to maintain their dignity, and a discussion at handover concerning one persons oral care was evidence of this. Peoples privacy and choices are also observed, for example when and where they eat. Staff we talked to told us that they felt it important to continue to care for people after they had become bed bound or very frail as this was their home and staff were more than willing to do the extra work involved. Mr Chadwick advised us that end of life care in the home is given in the catholic tradition, with visits from sisters and priests and support from local health care services. Care Homes for Older People Page 12 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. 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. Evidence: A part time activities co-ordinator is employed to provide some activities in the home. The bedrooms we visited had a copy of the weekly activities programme. One person we spoke to said they liked to go along to watch the weekly film, and people living in the home make suggestions for the film to be shown. We talked with the activities co-ordinator who told us that the yoga and quiz sessions are particularly popular, and that on the coming weekend entertainers in Edwardian Care Homes for Older People Page 13 of 25 Evidence: costume were coming to do a performance and singalong. The activities co-ordinator said that a visit to a garden centre had been arranged for two weeks time. A hairdresser visits usually once a week. Mr Chadwick told us that a room was being set up for staff to provide manicures, pedicures and aromatherapy. The AQAA tells us that events such as Valentines Day, St Davids Day, St Patricks Day and St Georges Day are celebrated in the home. Staff also told us that people enjoy a barbecue and when their families visit and have dinner with them. People also have the opportunity to make decorations for religious festivals such as Easter, and decorating cakes. Staff told us that because the chapel on the premises was open to the public it encouraged their friends to visit and stay and have a chat with them. The manager told us that the previous week eight people had gone on a coach outing to Brighton, Peacehaven and Devils Dyke where they stopped for lunch. There are morning and evening Catholic services each day. People gather for coffee after morning prayers. Staff providing breakfasts have a breakfast tray list which advises them of each persons breakfast preferences. On the day of our visit the main course lunch choices were sweet and sour pork with rice or pancakes filled with chicken. Staff served individual portions of vegetables at the table. It was our observation that people were receiving any assistance they needed during lunch. One person we spoke to said that the food was good and there was plenty of it. Care Homes for Older People Page 14 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. 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 home safeguards people from abuse and neglect and takes action to follow up any allegations. Evidence: The AQAA tells us that improvements to be made in the coming year include introducing a complaints form to make it easier for residents to complain, and to record the outcome of the complaint. We sampled the records for two complaints recently received by the home, and the records indicated the investigation that had taken place and the findings. It was recorded that the outcomes had been discussed with the complainants. There have been no safeguarding concerns or referrals in the home in the past year. Training records sampled indicated that staff are receiving training in safeguarding the people they care for. Mr Chadwick tells us in the AQAA that it is planned for all staff to have updated their safeguarding training by the end of the year. Care Homes for Older People Page 15 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 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. Their room feels like their own, it is comfortable and they feel safe when they use it. Evidence: St Marys was renovated 8 years ago and all rooms have en-suite facilities. Improvements made since our previous visit have included replacing boilers and hot water tanks to ensure that residents have a constant supply of hot water. A number of measures have also been taken to increase hygiene facilities in the home. Our visit indicated that the home is being maintained to a good standard. The garden and grounds and outdoor shrines are being well maintained. The ground floor has two main sitting areas, and the chapel on the ground floor is an important part of community life. There is a communal dining room. Care Homes for Older People Page 16 of 25 Evidence: All areas in the home visited, including three bedrooms, we found to be decorated and furnished to a good standard. The premises are comfortable and homely, and people living in the home we talked to liked the environment they lived in. The bedrooms visited had been personalised by the resident, and people had brought with them some items of furniture, belongings and effects. Bedrooms visited were free of clutter or hazards to safety. Bedrooms visited were all light and airy, and one person we spoke to said he was very pleased with his room and the view he had from it. All the areas of the home visited were clean and free from odours. 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. People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff in 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. Evidence: Staff we spoke to said the staff team was very stable and that there had not been many changes in the team. The AQAA tells us that temporary (agency) staff are not being employed in the home at present. It was our observation during our visit that sufficient staff were being employed to meet peoples needs, and people were receiving all the support they needed. The AQAA tells us that induction training at the required level is being undertaken by new staff. Mr Chadwick tells us that all but two of the permanent care staff in the home have achieved the National Vocational Qualification (NVQ) in care to level 2 or above. We are told in the AQAA that all people who have started work in the home in the last Care Homes for Older People Page 18 of 25 Evidence: 12 months (including permanent, temporary, agency and volunteer staff) have had satisfactory pre-employment checks. We sampled the recruitment records of three members of care staff and found that the required checks and references had been obtained to ensure they were safe to work with the people living in the home. During our visit we sampled training records which indicated that most staff are up to date with the training they are expected to undertake. Staff we talked to told us that recent training has been provided and other training has been arranged. Dates for upcoming training were displayed on staff notice boards. 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. 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. Evidence: At our visit Mr Chadwick said that the service had achieved the renewal of their Investors in People certificate, which is awarded when a company can show good management planning in areas such as service planning, training, sharing information, and responding to complaints. Mr Chadwick has continued to update his training and skills, to seek the views of Care Homes for Older People Page 20 of 25 Evidence: people living in the home, and to initiate improvements in the service provided. Mr Chadwick said that improvements to the service since our previous visit included the appointment of a deputy manager who is a qualified nurse and who has achieved the registered manager award, and who has been able to make improvements to the care provision in the home. Staff we talked to said they felt it was important for the people in the home that it was a religious community and that the Christian ethos was still being observed day to day. People living in the home and staff believe there is a good atmosphere. One member of staff told us there is a good relationship between people living in the home and staff. Mr Chadwick told us that residents meetings are opportunities for people to tell managers what they would like to see changed or improved. We were told that changes made at the request of residents has included supper being served half an hour later, changes to menus, and the photographs and names of staff on duty being posted on a notice board. The AQAA tells us that the home does not assist in the management of peoples money. Mr Chadwick told us there the home does not usually hold even small amounts of money on behalf of people living in the home. Staff records we sampled indicated that there are arrangements in place for staff to receive one to one supervision which supports them in the job they do. Records of residents meetings which we sampled indicated that safety issues such as fire drills are being discussed with people living in the home. We are told in the AQAA that independent practical support and advice on health and safety issues is provided to the home. Staff we spoke to told us that recent training provided had included COSHH and manual handling, and that the deputy manager was trained in teaching manual handling. We are advised in the AQAA of the most recent services and checks carried out on equipment in the home. Care Homes for Older People Page 21 of 25 Evidence: Care Homes for Older People Page 22 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 23 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 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 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. 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. 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