Care Home: St Pauls Care Centre

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What the care home does well People living at and visiting St Paul`s told us that the "care is exceptional" and the "environment is warm, caring and cheerful". They have carefully designed this new building to cater for residents in a safe and spacious environment. There are risk assessments in place to allow residents to take reasonable risks and visit the local community with an escort. There are two activity co-ordinators which provides a number of various activities for people to choose from and they are able to offer some one to one activities for those who are unable to attend due to their high care needs. There is an informative website for member of the public to have the information they need to make an informed choice prior to visiting the home. Equality and Diversity issues are understood by the organisation and staff and these are addressed for individuals through their care plans, which describe how individual needs and preferences are met. The management team have limited the number of admissions to the home to allow them to provide adequate staffing and ensure they have received their induction and training necessary to meet residents needs. What has improved since the last inspection? This is the first inspection since the home registered in June 2009 What the care home could do better: The care plans must reflect the needs of each resident and care must be taken to ensure that the information is up to date to provide the information for staff to meet the care needs. To enable all residents to have the information about the activities on offer this should be displayed in various formats throughout the home. At meal times additional seating should be available for staff to support residents whilst eating so that is not felt that they are being hurried if a member of staff if not seated. The manager must apply for registration with the Care Quality Commission. Key inspection report Care homes for older people Name: Address: St Pauls Care Centre St Pauls Care Centre Long Mimms Hemel Hempstead Herts HP2 5XW     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: Alison Butler     Date: 2 3 1 1 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 23 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 23 Information about the care home Name of care home: Address: St Pauls Care Centre St Pauls Care Centre Long Mimms Hemel Hempstead Herts HP2 5XW 01442229170 01442229179 stpauls@westgatehc.co.uk www.westgatehealthcare.co.uk Westgate Healthcare Limited Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Anjani Pushyant Patel Type of registration: Number of places registered: care home 88 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 88 The registered person may provide the following category of service only: Care Home with Nursing-code N To service users of the following gender: either Whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category-code OP Dementia-code DE Physical disability-code PD Date of last inspection Brief description of the care home St Pauls Care Centre is a residential and nursing home and provides accommodation for up to 88 residents. It is owned by Mr & Mrs Patel which is part of Westgate Health Care. The home has a car park to the front of the building for visitors to the home and a separate car park for staff to the side of the home. The home is split over four floors Care Homes for Older People Page 4 of 23 88 0 88 Over 65 0 88 0 Brief description of the care home with each floor having kitchen and dining area, lounge, assisted shower and bathing facilities. All rooms have TV, internet and telephone points. The ground floor has 16 bedrooms which are used for people with dementia, there is also a sensory room and a multi purpose/activity room. 29 bedrooms are on the first floor which will support residents with dementia, there is an independent kitchen for residents and visitor to use. The second floor consists of 27 bedrooms, there is also a cinema and a small gym for the rehabilitation of residents. There is a treatment room which is used by the GP. There are four bedrooms on 2nd floor which have wider doors and ceiling hoists. The 3rd floor consists of 16 bedrooms, the hairdressers salon and a small quiet lounge. The gardens are wheelchair accessible and have a number of raised beds and seating areas. For information on the up to date fees contact should be made with the manager. Information about the home and the service it offers is contained in the Statement of Purpose and the Service User Guide a copy of these and the most recent inspection report are available in the home. Care Homes for Older People Page 5 of 23 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 first key inspection was conducted with 3 inspectors, the manager and a director of the company. We spoke with residents, staff and visitors during our time at the home. We conducted a tour of the home. As part of this inspection we conducted a short observation framework for inspection (SOFI) on the dementia unit. As people who have dementia are not always able to tell us about their experiences, we have used a formal way to observe people during this inspection to help us understand. his involved us observing up to 3 people who use the service for up to 2 hours and recording their experiences at regular intervals. This included their state of well being, and how they interacted with staff, other people who use the service and the environment. We also examined care and administration records Surveys were sent to residents, professionals who visit the home and staff and these responses were reviewed and reported on throughout this report. Comments from relatives which were given to us during this inspection are also taken into consideration Care Homes for Older People Page 6 of 23 and again reported on throughout this report. Information received by us was reviewed and this included the Annual Quality Assurance Assessment (AQAA) this information focuses on how the home meets outcomes for the residents and also provides some statistical data. Care Homes for Older People Page 7 of 23 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 23 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 23 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 live at St Pauls can be assured that they have there needs fully assessed prior to admission and are given the information to make an informed choice. Evidence: The home provide prospective residents with a copy of the statement of purpose and service user guide to provide them with the information to make an informed choice. There is a website for the home which provides information, photos and contact details. This site is still working progress. Prospective residents and their families are encouraged to visit the home prior to making a decision to ensure they feel it is the right place for them. The manager carries out a comprehensive pre-admission assessment prior to offering the person a place, this is done to assure the residents that the home is able to meet the persons needs and provide the required staffing levels. There is a three month settling in period where both parties are able to reassess the placement and make sure that the residents needs can continue to be met at the home. Care Homes for Older People Page 10 of 23 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 who live at St Pauls can be assured that their health and personal care needs are met and they can expect to be treated with dignity and respect. Evidence: The care plans examined showed that some additional work needed to be done as whilst various recording forms were available on the plans they had not always been completed for example social life plan and nutritional assessment were seen but were blank. Pressure care/ wound care plans were well kept and regular updates recorded. The plans showed that residents were enabled to take risks and as such risk assessments had been completed and one plan include a road safety risk assessment which showed this person is able to go out in the community without an escort. Risk assessments were in place for bed sides and profiling beds, but they should consider including in the risk assessment the use of the handsets (Control units) as to whether residents are able to operate them themselves or need support etc. The manager has set up a contract with a local GP practice who visits the home twice a week, which is in addition to any emergency visits that are required. Other health professionals are brought in as required to support the well being of the residents and Care Homes for Older People Page 11 of 23 Evidence: ensure that their health care and support needs are being met. Observation of the staff showed us that they were kind, caring, patient and encouraged residents to be independent where possible. Comments received include care is exceptional they are all so patient. The staff are always smiling from the nurses to the carers and the man with the Hoover. A check was carried out on the medication administration storage and records and they were found to be all well managed and all records well kept. A risk assessment is in place for someone who is responsible for taking their own medication, as part of the risk assessment staff carry out checks at set times to maintain the safety of the person and other residents. Care Homes for Older People Page 12 of 23 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 live at St Pauls can be assured that they are offered various activities and recreational interests of their choice, and are encouraged to maintain links with families and the local community. Residents are provided with a balanced and wholesome diet. They are encouraged to maintain links with families and the local community. Evidence: The home has employed two activity co-ordinators and they provide a wide range of activities from quizzes, bingo, singing, flower arrangements. They are in the process of providing a programme to be displayed throughout the home to inform the residents of what is happening and where in the home the activity is being held. During the visit the activities co-ordinator were seen playing their guitar and the residents were enjoying singing along to music hall songs. One resident was seen to be enjoying a walk around the unit. A comment received from the surveys stated activities are excellent During the SOFI observation staff were observed offering drinks and good eye contact was made with the residents. Staff were seen talking to residents in a warm and respectful manner. Lunchtime was observed and we noted that it was a relaxed and unhurried experience Care Homes for Older People Page 13 of 23 Evidence: for most people but a member of staff was seen standing whilst assisting a resident to eat. It was suggested that consideration should be given to purchasing stools for staff to use when assisting residents so that it doesnt look or feel hurried for the resident. Snacks and drinks are available throughout the day for both residents and their families and can be prepared in the kitchens on each of the floors. Residents spoken to were complimentary about the food. There is a cinema room available to residents which has a large TV screen, DVD and seating. During the visit we saw visitors from the local church who had come to carry out a small service for those residents who wished to take part. There is a weekly visit by a hairdresser who is flexible at meeting the residents needs. Care Homes for Older People Page 14 of 23 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 live at St Pauls can be assured that their views and any concerns will be listened to and acted upon and robust policies and procedures are in place to protect them from abuse Evidence: There is a clear procedure in place for the reporting of complaints and anyone is able to send any concerns via a link on the homes website. A folder is in place for the recording of any concerns, on examination it showed that any action taken and the outcome was clearly recorded. The manager feels that any complaints received can help in the reviewing of the service they provide at the home. Staff have all received training in safeguarding policies and procedures. The senior team have received training in the Mental Capacity Act and Deprivation of Liberty. Care Homes for Older People Page 15 of 23 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 live at St Pauls can be assured they live in a welcoming, warm, clean and well maintained environment. Evidence: A tour of the building was conducted. Only the ground and 1st floors were open at the time of this inspection. There is a maintenance man employed at the home who ensures that any maintenance issues are dealt with promptly. as with any new building there are number of issues that are to be dealt with by the builders but these were not having any impact on the residents living at the home. There are a variety of communal areas around the home to allow residents choices of where to sit. There are also various places for residents to sit and enjoy the outdoors when the weather is good. All areas throughout the home are accessible to wheelchair users. Each residents bedroom is fitted out with furniture but residents are encouraged to personalise them with furniture, ornaments and pictures from their previous home. Residents are given the option of having their room decorated in colours of their choice. All rooms have en suite shower rooms. There is assisted shower and bathrooms on all floors. There is a large laundry on the top floor which has different in and out doors to ensure clinical standards and promote good infection control. Since opening St Pauls have experienced some problems with youth vandals and have now fitted CCTV to the outside of the building to protect the residents and staff, contact is maintained with the local police to keep them updated with any problems Care Homes for Older People Page 16 of 23 Evidence: etc. The home has an entry door system which staff can talk to and see the person prior to gaining entry to the home. Care Homes for Older People Page 17 of 23 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 live at St Pauls can be assured that a robust recruitment procedure is in place to keep them safe and there are sufficient trained staff in place to meet their needs Evidence: Examination of four staff files showed that all the required information and checks had been carried out prior to employment. The manager is in the process of carrying out an audit of all staff files to check on expiry dates of nursing personal identification numbers and passports etc She is also ensuring all staff have the required skills and are competent to carrying out their roles. On the day of the inspection there were sufficient staff on duty to meet the residents care and personal needs. Comments we received include always feel welcome when I visit care given to families is wonderful the staff are all so kind and patient. All staff are encouraged to complete an NVQ award in care. Regular supervision of staff is carried out and the feedback from staff felt they were well supported in their roles to make sure the residents receive the best care possible. Care Homes for Older People Page 18 of 23 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. The people who live at the home can be assured that the home is run in their best interest and that their health, safety and welfare is protected through a series of checks and regular maintenance. Evidence: The manager has yet to register with the Care Quality Commission as she has been completing her probationary period and states she will apply for registration as soon as her probation comes to an end. There is an open door policy at the home and everyone is free to speak to the manager at any time if they have any concerns or ideas for making lives better for the people who live at the home. There is a Quality Assurance system in place which includes questionnaires and home forums so the manager can continue to evaluate the service and improve the outcomes for those who live at St Pauls. There are comprehensive policies and procedures in place to ensure that staff are working and supporting residents safely. The manager has made the decision not to take any further admission until they have the correct staffing levels to meet their needs on arrival. The manager informed us that they will be apply Care Homes for Older People Page 19 of 23 Evidence: for the Investors In People Award in the coming year. This is a recognised national award that reflects an organisations commitment to staff and staff training. Equality and Diversity issues are understood by the staff and the organisation and addressed through the care plans, which describe how residents needs and preferences are to be met. Fire safety records were checked and were well kept and appropriate checks had been carried out to protect the residents, staff and visitors to the home. The manager completed the AQAA within the given timescales and it gave us the information required. Care Homes for Older People Page 20 of 23 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 21 of 23 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 22 of 23 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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