Care Home: St Matthews

Similar services:

• Claremont House
• Oak Ridge
• Sun Court Nursing Home
• Ashville House
• Bilney Hall
• Hill Barn
• Mabbs Hall Nursing Home
• Henrietta House

What the care home does well The residents and visitors praised the staff and manager of the home. They said that care staff were well trained and able to meet the needs of the residents in the home. We saw evidence that staff training levels are good and that employees have thorough recruitment checks completed to ensure the safety of the people who use the service. Relatives we spoke with said they were fully involved in care planning and that care staff met the residents` needs in an appropriate way and supported individual choices. Residents enjoy the food provided and make choices about meals on the day they are provided so that they can be sure what meal they want on the day. All the people we spoke with confirmed that the home is well run and that their views are always listened to and acted on where appropriate. They also told us the home was well maintained and always kept clean and hygienic. What has improved since the last inspection? Care planning is more detailed and residents and relatives confirmed they are involved in this planning. New facilities have been provided in the grounds for residents. Most areas of the home have been redecorated or refurbished and all areas were being well maintained. Residents and relatives confirmed that all parts of the home are kept warm and made comfortable for residents to enjoy. More permanent staff have been recruited and the care staff we spoke with confirmed that the staff team is self supporting and provides good continuity of care for residents. More equipment has been provided for the dementia unit so that the more confused residents can find comfort and benefit from more varied stimulation on a daily basis. What the care home could do better: No requirements have been made as a result of this inspection. Key inspection report Care homes for older people Name: Address: St Matthews Chequers Lane Redbourne Herts AL3 7QG     The quality rating for this care home is:   three star excellent 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: Patricia House     Date: 1 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 24 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 24 Information about the care home Name of care home: Address: St Matthews Chequers Lane Redbourne Herts AL3 7QG 01582792042 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: stmatthews@bmcarehomes.co.uk www.bmcare.co.uk Colley Care Limited (Trading as B & M Care) care home 53 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The registered person may provide the following categories of service: Care Home - PC to service users of the following gender: Both Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE The total number of service users accommodated must not exceed 53 persons. Date of last inspection Brief description of the care home St Matthews was opened in 2003. It caters for the needs of 52 older people. 27 beds are dedicated to personal care on the ground floor. The remaining 25 places are on the first floor and are offered to residents with dementia. There is ample storage space and a room has been assigned specifically for therapies and another for hairdressing. The laundry, kitchen and staff room are situated on the lower ground floor. Care Homes for Older People Page 4 of 24 Over 65 0 53 53 0 Brief description of the care home Throughout the home there are facilities for visitors to prepare refreshments. The home has a large enclosed garden and this enables residents to utilize the grounds safely. A number of bedrooms have a patio area outside with direct access for the benefit of residents. Closed circuit television cameras are discreetly positioned over the main entrances to the home. The home is adjacent to a childrens nursery and therefore benefits from additional security measures. Copies of the homes Statement of Purpose, Service Users Guide and the most recent CQC report are on display in the reception area. The current fees range from £703 to £759 per week, according to need. Care Homes for Older People Page 5 of 24 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: three star excellent 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 last key inspection of this service was completed on 22nd May 2007. The information in this report is based on an unannounced inspection of the home, which took place over one day with one regulation inspector carrying out the work of the Commission. For the purposes of this report the Commission will be referred to as we. The registered manager was on duty throughout the day and we spoke with staff, residents, visitors and a G.P. We visited all parts of the home and checked a variety of records. Before the inspection the manager had completed and returned to the Commission an annual self-assessment quality review, the Annual Quality Assurance Assessment, (the AQAA).This document included statistical information about the home and confirmation Care Homes for Older People Page 6 of 24 of policy reviews and equipment checks. We have also reviewed any other information we have received about this service. Care Homes for Older People Page 7 of 24 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 8 of 24 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 9 of 24 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 who use the service are provided with appropriate information to enable them to decide whether to move into the home. Detailed assessments are completed so that all parties can be clear about how best to meet individual and specialist needs. Evidence: The homes Statement of Purpose and Service Users Guide are displayed in the home and are available for inspection. The documents have been updated since the last inspection visit and provide good information for people about the home, enabling everyone to be clear about the services provided. We checked a selection of residents records and in all cases full assessments had been completed before the people concerned were admitted to the home. We also saw written care summaries on records where people had been referred from other agencies. This information ensured that the services available at the home were appropriate to meet each persons needs. From these assessments initial care plans Care Homes for Older People Page 10 of 24 Evidence: had been drawn up so that care staff could be clear about individual needs and how best to meet them. We spoke with the manager and with care staff and everyone demonstrated a clear understanding of dementia care and how best to meet such specialist needs. All the care staff we spoke with said they had received dementia care training and the manager has completed an intensive training course about dementia care provision. As a result of staff understanding of such specialist needs, we saw approriate equipment provided to encourage the more confused people to feel stimulated and comforted by their surroundings and were told about the activities provided for people in the dementia unit of the home. The manager confirmed that dementia care provision was an on-going consideration and that new initiatives were being introduced in this unit as current good practice was researched. Care Homes for Older People Page 11 of 24 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Detailed care planning in the home enable care staff to ensure that people who use the service have their health needs met in the way they prefer. The system in operation for the administration of medication is thorough and helps to promote residents good health and to protect themfrom the risk of harm. Evidence: We spoke with residents and some visiting relatives during the inspection. Everyone told us that they were very satisfied with the care provided by staff at the home and everyone said that care staff always treated residents with respect and dignity. One resident said they really enjoyed a bubble bath and their relatives confirmed that care staff enabled the resident to have this bath nearly every day. Visitors told us that their relative entered the home with bad feet but that the resident had seen a chiropodist regularly and there was no longer a problem. They also confirmed that the resident had seen an optician and had received new spectacles since entering the home. The relatives said they had been fully involved in the care planning process and in the subsequent reviews of care. They were aware of their relatives named key Care Homes for Older People Page 12 of 24 Evidence: worker and aware of this persons role. This means that everyone involved with the resident are clear about their agreed needs and how these needs are to be be met. Another resident said that they see their GP immediately if they have a health problem and also said that, if they activate their call alarm, care staff come very quickly. During the inspection we saw care staff responding immediately when call alarms were activiated. We tracked the care records of some of the people we had observed and in all cases the information accurately reflected the needs of the individual concerned. Planning was up to date and we saw evidence of regular reviews of care needs. Appropriate risk assessments had been completed and these were up to date. Where a resident had been asessed as at high risk of falling, monitoring arrangements were in place and we saw that the person had been referred to a local falls clinic. Body charts were in place and were being completed where this was needed and turning charts had details of the care provided for people spending long hours in bed. Care staff complete daily records for every resident as well as their night time observations. Currently no one in the home has a pressure sore. Care plans also contained peples wishes about death and dying arrangements, signed inventories of belongings and records of their prescribed medication. We saw details of peoples life histories recorded and their preferences about interests and hobbies. Staff said thet the activity co-ordinator was provided with these details so that the activities provided could reflect peoples interests. The weight charts we saw showed that the people concerned had mostly gained weight to some degree. We checked the system for the administration of medication during the visit. Medication was being stored and recorded appropriately and the home has regular inspection visits by the local pharmacist, and had been inspected the previous week. Staff confirmed that senior staff book in all medication and that any drug which was not provided in a blister pack was audited and amounts verified each time it was administered. Senior staff also confirmed that any controlled drugs were counted and signed for by two members of staff during every staff shift handover meeting. Senior staff at the home complete a medication profile for each resident which documents any changes to residents prescribed medication. Any outcomes from the changes are then monitored to ensure there are no adverse effects for the resident concerned. Staff have written to local GPs to request general reviews of residents medication, to ensure the drugs prescribed are still beneficial to the individual. Some doctors have started this process. Care Homes for Older People Page 13 of 24 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. People who use the service are provided with daily stimulation and supported to spend their days in the way they choose. Residents enjoy the meals provided and these help to promote everyones good health. Evidence: We spoke with a group of residents and with individual residents and their visitors. Generally people thought the home provided a good level of activities for residents and people told us that care staff reminded them about the events each day and encouraged them to take part. Some people said they preferred to remain in their rooms at least on some days and said staff respected their wishes. We saw people were looking at newspapers which had been delivered and some visitors said they had attended a barbeque in the summer where there was singing and dancing. One resident said they enjoyed playing cards and that staff always came to see them if they remained in their room. The home has its own small vehicle for taking people out on trips and the residents can also use a larger vehicle belonging to a local charity, for trips out. A group of residents said they liked to meet together each evening and that they could then go to bed at any time they chose. Care staff confirmed that residents who wished to go were taken to religious services on Sundays and that people attended different Church denominations on alternate weeks. Two guinea pigs have Care Homes for Older People Page 14 of 24 Evidence: also just been provided for the enjoyment of the residents. The home has an activity co-ordinator who works five days each week, including Sundays. Residents confirmed that care staff also provided some activities and provide events when the co-ordinator was not at work. We saw the menus for the days meals displayed in the home and residents confirmed they chose their food daily usually from two meal choices. The staff said these choices were made on the day concerned so that people could be sure what they felt like eating on that actual day. The people we asked said they enjoyed the meals and visitors said the food always looked appetising and plentiful. We saw fruit juice provided with the mid-day meal and saw drinks and glasses available in the bedrooms we visited. Care staff said that biscuits and fruit, cut into manageable pieces, were available to residents every afternoon and that jugs of juice were also refilled at that time. We saw the drinks trolley taken round between the main meals and saw everyone offered a choice of hot and cold drinks. The tea and coffee was nicely served in tea pots and jugs and milk and sugar were offered separately so that everyone could have their drink in the way they preferred. We visited the kitchen and saw details of the special diets prepared for residents and saw that the systems for ensuring appropriate food was provided for each individual was thorough, for the residents protection. Food and appliance temperature checks were being taken and recorded and food was being appropriately stored and labelled. There had been a recent inspection from an Environmental Health Officer. The report from this visit had not been sent at the time of this inspection, but the chef said that this inspection had been positive and the few minor recommendations had been actioned. There are risk assessments in place for kitchen equipment but we saw that the industrial tin opener was broken and had not been replaced and noted that the home had no potato peeling equipment. These items should be provided to ensure the efficient running of the kitchen especially as there are only two members of staff providing all the meals for the residents. Care Homes for Older People Page 15 of 24 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 who use the service can be sure any concerns they might have will be listened to and acted on and that procedures followed by staff in the home will help to protect them from the risk of harm. Evidence: The home has written policies on Making a Complaint, Adult Safeguarding and Whistle blowing. The staff we spoke with were aware of these policies and their implications. The visitors we spoke with also confirmed they were aware of how to make a complaint and the residents we asked said they would not hesitate to voice any concerns they might have. We spoke with care staff and checked a selection of records and saw that all staff at the home have received training in adult safeguarding. The manager was fully aware of the system for using safeguarding procedures in Hertfordshire and has made one referral to the Local Authority under these procedures. Care Homes for Older People Page 16 of 24 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 who use the service benefit from living in a home which is well maintained and where procedures followed by staff for infection control help to protect residents from the risk of harm. Evidence: We visited all areas of the home and garden briefly and all areas were being well maintained and most had been recently redecorated. The grounds looked very attractive and a new gazebo and summer house had been provided for the benefit of the residents. The bedrooms we visited were all well decorated and fitted and people had personalised these rooms with their own belongings and furniture. In all bedrooms we saw call alarms appropriately placed so that residents could summon assistance wherever they were in the room. The bathrooms and toilets were very clean and some visitors told us that all areas of the home were always kept clean and hygienic. They also said that their relatives clothing was kept clean and was looked after by care staff. Liquid soap and paper towels were provided in all communal bathrooms and toilets as recommended in current guidelines for good infection control. Care staff confirmed they were provided with two uniforms so that they could ensure their protective clothing was always clean. Care Homes for Older People Page 17 of 24 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 who use the service are supported by a well trained work force who are employed in sufficient numbers to enable them to be sure they can meet individual needs in a professional way. Procedures for staff recruitment are thorough and ensure that residents are protected from the risk of harm. Evidence: We spoke with residents and some visitors and everyone we asked praised the staff in the home. We observed good interaction between care staff and residents and felt that the staff were very aware of individual needs and preferences and that staff took pains to meet these needs. One member of staff said there was a really good staff team and that they all covered for one another at times of sickness or when staff were on holiday, so that residents always received continuity of care. At present the manager is interviewing for night care workers and for domestic assistants but residents said they felt that there were usually enough staff on duty to meet their needs. The manager has now appointed two laundry assistants and said that laundry services were now much improved. Care staff confirmed that they were encouraged to undertake NVQ training and said that general training levels were good and enabled them to feel confident in their roles. Care Homes for Older People Page 18 of 24 Evidence: We checked a selection of recruitment files and in all cases evidence of appropriate recruitment checks had been in place before the employee started work. We also saw evidence that basic training had been completed by all the individuals concerned and that regular supervision was taking place. Care Homes for Older People Page 19 of 24 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 who use the service benefit from living in a home which is well managed and where their views are listened to and acted on. Procedures followed by staff ensure that the welfare of both staff and residents is promoted at all times. Evidence: The manager is registered with the Commission and, during the inspection, demonstrated a clear awareness of current guidelines and legislation relating to care services. The residents, staff and visitors we spoke with praised the manager and said that their views were always listened to and acted on where appropriate. The manager informs the Commission in writing about appropriate issues and incidents in the home. We checked the homes accident records and these were being appropriately completed. Staff confirmed that all seniors complete a three day course in first aid and that all other staff complete basic first aid training. This means there is always a senior on duty who has a thorough competence in first aid for the safety of residents. We checked the fire drill records and these showed that staff are aware of appropriate Care Homes for Older People Page 20 of 24 Evidence: procedures and confident in safety measures. The home uses the company quality assurance programme to ensure that everyones views are considered in the running of the home. We saw evidence that regular staff and residents meetings take place and that comments from these meetings are recorded and acted on where appropriate. Formal surveys are distributed every six months to check service provision. The manager confirmed that none of the staff at the home holds or handles residents finances. Peoples financial affairs are dealt with by families or other nominated people. The manager also completes monthly monitoring audits of the homes records to identify any areas that need reviewing. Care Homes for Older People Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 24 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 15 An appropriate tin opener should be provided in the kitchen and the provision of potato peeling equipment should be assessed so that kitchen staff can continue to use their time to ensure appropriate nutrition is provided for all residents. Care Homes for Older People Page 23 of 24 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 24 of 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!