Care Home: St Mary`s Residential & Nursing Home Scunthorpe

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What the care home does well To ensure that individual needs can be met, by the service an indepth assessment is completed before people are offered a place in the home. A copy of the service user guide, statemnt of purpose and complaints policy is available in each room of the home and in the main foyer of the building. People living in the home are given current information about the facilities and services available. The staff and manager also talk through this information for anyone with communication difficulties. People are provided with a warm, comfortable environment that is both homely and welcoming. The staff team work hard to ensure that the building is and odour free. People living in the home said that they were happy with the environment and the fact that they were able to bring their own belongings into the home. People have good access to professionals and medical staff and are able to access external services such as dentisits and opticians. Observations throughout the visit , showed that there appeared to be adequate staff available to meet individuals needs in a relaxed and unhurried manner. People are protected by the way that staff are recruited and selected as they include taking up refereneces and police checks before they are employed. The returned satisafction surveys show that people and their relatives have a say in running the home and the quality of services provided. The action plan provided by the service shows that changes are made to the way the home runs as a result of what people say. What has improved since the last inspection? There have been a number of complaints and safeguarding issues raised since the last inspection, the organisation has taken appropraite action to investigate these and produce an action plan to improve a number of things within the home. This has included, the updating of care plans, additional support from external agencies, staff training, staff recruitment, in order to improve the quality of care provided within the home. Staff practices regarding medication record keeping and administration were not considered safe at the previous inspection and a requirement was made. These have now been improved and the requirement met. What the care home could do better: Although there is an activities coordinator in the home and people enjoy arange of activities, there are no arrangements in place to provide the continuity of the provision of activities in the absence of the activities coordinator. Some of the bedrooms seen appeard to need a thorough hoovering around the edges of the carpet, but all areas were overall clean and well maintained. Inspecting for better lives Key inspection report Care homes for older people Name: Address: St Mary`s Residential & Nursing Home Scunthorpe St Mary`s Court, Speedwell Crescent Scunthorpe North Lincolnshire DN15 8UP     The quality rating for this care home is:   two star good service 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Wilma Crawford     Date: 1 0 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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 27 Information about the care home Name of care home: Address: St Mary`s Residential & Nursing Home Scunthorpe St Mary`s Court, Speedwell Crescent Scunthorpe North Lincolnshire DN15 8UP 01724865461 01724277750 stmarys@schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Ashbourne (Eton) Limited Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 47 Number of places (if applicable): Under 65 Over 65 47 37 old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home 0 37 St Marys is located in a quiet residential area on the outskirts of Scunthorpe town; there is a regular bus service to the town centre however the home is close to a number of local amenities. The home provides care for up to 47 service users who require nursing and residential care support. There are 41 single rooms and 3 double rooms. The accommodation is based on one floor; there are three lounge areas, an activity room and a dining room. Furnishings and fittings are of a high standard. There is a very secluded and pleasant courtyard in the central area of the home, which contains raised flowerbeds, mature shrubs, seating and a large pond. There are lawns to the side and rear of the home. Care Homes for Older People Page 4 of 27 Brief description of the care home Ample car parking is provided to the front of the home. 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. A copy of the latest inspection report for the home is on display in the reception area of St. Marys Nursing Home. Information given by the project manager on 12/11/09 at the site visit indicates the home charges a range of fees from 335.20 pounds to566 pounds. These fees include the nursing band payment (where applicable) for nursing care. There is a top-up fee of between 18.00 and 30.00 pounds per week depending on the room type and facilities within it.however, these are not currently being charged. Residents will pay additional costs for optional extras such as hairdressing, private chiropody treatment, toiletries and newspapers/magazines. Information on the specific charges for these can be obtained from the manager. Care Homes for Older People Page 5 of 27 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: This unannounced visit was carried out over one and a half days with the project manager, staff and residents of St Marys. The visit took place over one day and included a tour of the premises, examination of staff and resident files and records relating to the service. Four of the staff on duty and seven of the people living in the home were spoken to; their comments have been included in this report. the main method of inspection used was called case tracking and involves selecting five people living in the home and tracking the care they receive through the checking of their records, discussion with them, the care staff and observation of care practices. An expert by experience Jean Underwood, also assisted in the inspection for three hours. An expert by experience is a person who, because of their shared experience of using Care Homes for Older People Page 6 of 27 services, and /or communicating, visits a service with the inspector to help them obtain a picture of what it is like to live in the service. She spoke to the majority of the people living in the home and some of the staff on duty. she also took lunck and observed the activites and care provided within the home. Information was gathered from a number of different sources before the inspector visited the home. Questionnaires were sent out to relatives, residents and staff and their written response to these was good. The provider completed an Annual Quality Assessment Audit questionnaire and returned this to the Commission within the given timescale. Since the last inspection there has been a change of manager at the home, In the interim a project manager is managing the home . However a new manager has been appointed. Feedback from the people living in the home, relatives and staff is positive about the new person in-charge 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 set out 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 8 of 27 Care Homes for Older People Page 9 of 27 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 27 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. Quality outcomes in this area are good. All people living in the home undergo a full assessment of needs and are given sufficient information about the home prior to admission, enabling them to be confident that their needs can be met by the service. Evidence: The statement of purpose and service user guide are available in each bedroom as well as being ion display in the reception of the building. These were found to be current and give clear advice about the home and what servces it provides. Information from completed surveys shows that people demonstrated that people had been provided with written information about the service before making a decision about moving into the home. This was further supported during discussion with staff and people living in the home. People spoken with also said that they are also given the oppportunity to visit the home for a meal or overnight stay to see what the home is like. Care Homes for Older People Page 11 of 27 Evidence: Each of the care plans seen contained a needs assessment, completed by the home and a copy of the individuals community care assessment. A copy of terms and conditions/contract was also available. Individual care plans are developed from this initial information, identifying the persons care needs andhow they wish them to be met. Those individuals with nursing needs had undergone an assessment by the local Primary Care Trust, to determine their nursing needs. Staff spoken with had a good knowledge and understanding of peoples individual needs and how these were supported. Staff files examined showed that staff received an induction, and were up to date with mandatory training. Additional support and guidance is also offered through the supervision process, which is recorded and offered on a regular basis. The home does not provide intermediate care so standard six is not applicable to this service. Care Homes for Older People Page 12 of 27 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. People using this service receive good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. Peoples personal and healthcare needs are met and they are protected by the way medicines are dealt with. Evidence: Individual care plans are in place for all people living in the home. A sample of five peoples records were examined and fthese set out the health, personal and social care neeeds identified for each person. the plans looked at had been evaluated monthly and any changes to the care being given was documented and implemented by staff. Risk assessments were seen to cover pressure sores, nutrition, moving and handling and activities of daily living. All care plans had been signed by either the individual or their representative. Information about peoples social interests, likes and dislikes, spiritual needs andtheir wishes regarding death and dying were also included. Medication within the home was found to be appropraitely stored and managed. Care Homes for Older People Page 13 of 27 Care Homes for Older People Page 14 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using this service receive good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. Not all people living in the home benefit from a good range of activities which they enjoy or the food choices they prefer. Evidence: The home has an activities coordinator who organises and provides a programme of social events. Information relating to this is displayed in the reception area. Ten people living in the home were spoken to during the visit and the majority said that they enjoyed the range of activities provided by the home. However some commented on the lack of activities when the coordinator was absent and the provision of activities for people with more physical disabilities. People and their relatives also gave examples of other activites that they would like to be introduced into the programme including playing cards and knitting. There were no structured activities observed on either days of the visit to the home. People living in the home said that they were able to follow their religious preferences and they had regular church services held within the home and the catholic priest Care Homes for Older People Page 15 of 27 Evidence: visits weekly to offer communion to those who wish to partake. Visitors were seen coming ang going throughout the day, staff were observed making them welcome and there appeared to be a good relationship between all parties. Visitors spoken with said that they could visit their friends or relative in private if they preferred. They also said that their visitors were always made welcome and they were offered refreshments. People whose relatives lived away were given the opportunity to stay in touch either through phone calls or assited to write letters. Information about local advocacy services is on display in the home and people spoken with were aware of their rights and said that they had family memebers who acted oon their behalf and managed their finances. People also said that they are encouraged to bring in small items of furniture and personal possessions from home to decorate and personalise their rooms. Discussion with people living in the home showed that they were aware of their care plans and were involved in contributing to the development and ongoing updates of this through their keyworker. The activities room was well equipped and both staff and people living in the home said that the activities coordinator was very good. Two people were looking forward to going out to do some Christmas shopping. There were no activities observed to be taking place on either of the days of the visits. The daily records confirmed that activities take place, but did not contain information about peoples experience and enjoyment of the activity. The menus show that peopel areoffered a balanced and varied diet. The cook said that people living in the home are involved in the planniing of menus incorporating their personal preferences. People spoken with said that they enjoyed the food and that it was of a good quality.They also said that there were always alternatives available should they not want any of the choices on the menu. Lunchtime was observed and was overall a very calm experience in pleasant surroundings, however there were only two staff available to serve and support with meals. When this was discussed with the project manager they explained that audits of mealtimes were being undertaken to look at how mealtimes could be iproved. Records were available to support this audit having taken place. There are snacks and drinks available in the dining room at all times for people to help themselves in betweeen meals. Two ladies were observed enjoying a pre lunch sherry. Care Homes for Older People Page 16 of 27 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. People using this service receive good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. peoples complaints are taken seriously and acted upon and they are prtected from abuse. Evidence: All of the people spoken with said they were aware of how to make a complaint if they felt the need to. People living in the home said that in addition to the complaints policy, residents and relatives meetings, quality assurance surveys, the project manager and area manager also do toursof the building and speak to them to see if everything is to their satisfaction , or if they have any concerns which may need to be dealt with. The completed returned surveys show people are generally happy with the services provided and and the homes ability to deal with commplaints effectively. There have been four safeguarding incidents in the home which were investigated and some of which were found to be upheld. The home has taken appropriate action as a result of these and developed action plans, which have been implemented to identify and improve the areas that required further development. Examination of the complaints book showed that all of thse issues had been recorded and acted upon. Similarly areas of criticism raised in surveys had been recorded and appropriate action taken a a result of this, to the complainants satisfaction. The home has a comprehensive complaints policy, which is available in each bedroom Care Homes for Older People Page 17 of 27 Evidence: as well as in the reception. Training records examined show that staff have safeguarding training as part of their induction and additional annual updates. Everyone spoken with said that they felt safe and secure and they were always spoken to with dignity and respect. Care Homes for Older People Page 18 of 27 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 using this service receive good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. People live in a well decorated, well maintained home that is comfortable clean and safe. Evidence: People were observed throughout the visit relaxing in the lounges, dining room and their own bedrooms. everyone appeared happy and comfortable. One person spoken with said that they had everything that they needed and were happy with their room. Another said that they particularly liked having their own things around them, which made them feel more at home. All of the bedrooms are ground level and were found to be well presented , clean tidy and odour free. Discussion with the domestic staff found that they have everything they need to keep everything clean for people in the home. the returned surveys show that people are happy with the environment provided and the cleanliness of the home. The expert by experience found that a couple of rooms neeeded hooovering around the skirting boards. when this was raised by y the inspector immediate action was taken to rectify this. The maintenance records showed that in oredr to keep people safe, regular checks of Care Homes for Older People Page 19 of 27 Evidence: the fire alarm and emergency lighting equipment are carried out. Staff training records show that staff have Health and Safety and Control of substances Hazardous to Health training. Care Homes for Older People Page 20 of 27 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 using this service receive good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. The number and skill mix of staff meets peoples needs and they are protected by the way staff are recruited. Evidence: Feedback from the staff showed that they were happy with the current staffing levels and they felt that communication had improved and the new systems in place for passing on information was working more effectively. There are currently twenty nine people living in the home (16 nursing and 13 residential)and the current staffing levels are five carers and two nurses during the day and one nurse and three careres during the night. The project manager, administrators,domestic, laundry, catering staff and handyman are provided in addition to this. although occupancy is currently low, there has been no reduction in the staffing hours provided. Training records show that staff are provided with an induction and a mandatory staff training programme as well as more specialised training to help maintain and further develop their skills: Infection Control, Safe use of bedrails, Challenging Behaviour, Safe administartion of medicines Customer care, Pova , Safe administration of Care Homes for Older People Page 21 of 27 Evidence: medicines, Customer care, Pova,Dementia Awareness, Nutrition, Pressure Care, Fire safety, Manual Handling and COSSH. Staff felt that training opportunities particularly for the nurses had improved in recent months, particularly in respect to their own personal development goals. The home has an equal opportunities policy and procedure. Information from staff personnel files and discussion with the project manager shows that this is promotedwhen recruiting new staf and is promoted within the home. The home has a recruitment policy and procedure that is implemented when recruiting new staff. Checks of two staff files demonstrated that police (CRB) checks, written references, health checks and past work history are all obtained and checked prior to the individual starting work.Nurses in the home undergo regular registration audits with the Nursing and Midwifery Council to ensure thay are able to practice. Staff spoken with said that they have regular staff metings at all levels and receive supervision every 4-6 weeks. Records were available to support this. Care Homes for Older People Page 22 of 27 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 using this service receive good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. People live in a home that is run in their best interests and their health and welfare is protected. Evidence: There is curently no registered manager infor this service. A project manager is managing the home and a new manager has been recruited and is awaiting the clearance of a police(CRB) check before commencing her employment in the home. The post is curently being covered by the Project Manager who has extensive experience of working with older people and managing care homes. The satisfaction surveys show that people living in the home and their relatives have the opportunity to comment on the quality of care provided. the quality assurance action plan shows that the home is prepared to listen to what people say and change Care Homes for Older People Page 23 of 27 Evidence: the way things are done as a result of their comments. Information provided in the AQAA document by the home stated that fire safety checks, electrical and gas engineer checksweer up to date. This was found to correspond to the records examined in the home. Records show that fire drills are checjked monthly and extinguishers on an annual basis. Peoples health safety and welfare is promoted and protected as the maintenance records show that proper checks are carried out on emergency equipment, hoists, and safe water temperatures are maintained. Staff training records show that they have health and safety, Moving and handling, Food Hygeine, Infection Control and First Aid training. Risk assessment documents are in place to cover all areas of the home such as the kitchen, fire safety, bedrails, laundry use, and the use of cleaning products. Care Homes for Older People Page 24 of 27 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 25 of 27 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 1 12 The registered provider should consider how absences of the activity coordinator could be covered to ensure that regular structured activities can continue to be offered to people living in the home. Further consideration needs to be given as to how individuals preferences and special needs can be provided for and accommodated within the activity programme. The registered provider should consider how staff should be deployed over the lunchtime period to ensure that people receive the correct level of support during meal times. The registered provider should consider how the cleaning of the home can be planned to enable a thorough deeep cleaning of all bedrooms on a regular basis. 2 12 3 26 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. 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