Care Home: St Stephens Nursing And Residential Home

What the care home does well By looking at the systems in place we saw the home provides care in a flexible way so that people have choice in their day to day lives. Comments included, " I get more or less do what I want to", " The staff are always around when you want them, they are very good", " There is always something going on its a busy place". We found the way the home plans care for people living there is excellent. The records show they are meeting the needs of a diverse range of people. There is excellent communication between professionals involved with people living there. People we spoke to said they felt the needs of people are clearly met by using a group of staff who have a range of skills, a manager who is available to all users of the service and takes time to plan individual care packages for people, so their specific needs can be met by the home. We observed staff speaking to and treating people sensitively and with respect, which people we spoke to said they appreciated. We saw the staff members talked freely with people and the communication between staff and people living there was positive. Staff we spoke to demonstrated they had a good sound knowledge of the needs of people living there, including the social and cultural needs of residents so that they are not disadvantaged. Comments included, " I like spending time with the residents they are very interesting", "some residents have been here a while and you really get to know them and their families". What has improved since the last inspection? We saw the home has reviewed what activities are available to people living there, so that there is more variation. People we spoke to told us they like the range of activities now available and staff said they have the time to spend with people and carry out the activities. We saw the home has reviewed its systems in place for safeguarding people and staff have received training in this area. We found the way the home manages safeguarding referrals has improved so people are protected. We saw staff have access to training in dementia and managing challenging behavior so they are equipped with the knowledge and skills to meet the needs of people living there. We saw staff are receiving training in mandatory areas of first aid and moving and handling so it is up to date and they have knowledge of current good practice in these areas. What the care home could do better: The home should continue to develop its systems further to ensure the needs of people living there are being met. Key inspection report Care homes for older people Name: Address: St Stephens Nursing And Residential Home St Stephens Nursing And Residential Home 4 St Stephens Avenue Bispham Blackpool Lancashire FY2 9RG     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: Jacqueline Riley     Date: 0 6 0 5 2 0 1 0 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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 Stephens Nursing And Residential Home St Stephens Nursing And Residential Home 4 St Stephens Avenue Bispham Blackpool Lancashire FY2 9RG 01253352625 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): st_stephens@btconnect.com Mrs Brenda Christine Bell,Mr Keith Bell Name of registered manager (if applicable) Mrs Annette Parkinson Type of registration: Number of places registered: care home 31 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The registered person may provide the following category of service only: Care Home only - Code PC To Service Users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia - Code DE The maximum number of Service Users who can be accommodated is: 31 Date of last inspection Brief description of the care home St Stephens Nursing Home is registered to care for up to 31 people with dementia. The home is a detached 3-storey house with a purpose built 2-storey extension to the rear. The home is situated in the residential North shore area of Blackpool, close to the seafront, and approximately 10 minutes by car to the town centre. There is good access to local transport networks. Care Homes for Older People Page 4 of 24 2 1 0 4 2 0 0 9 31 Over 65 0 Brief description of the care home There are a full range of appropriate aids and adaptations in place to meet the needs of residents who are frail and immobile. The home has 27 single rooms, 14 with en suite facilities, and 2 double rooms. The home has a Statement Of Purpose and Service User Guide providing information about the care being provided, the qualifications and experience of the owners and staff and the services people can expect if they choose to live at the home. Information provided by the home on 6th May 2010 showed that fees for the home are £364.70 to £478.73 per week with some additional costs for one to one funding. There are added expenses for transport, magazines and other small items. 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: A key inspection of the home was undertaken which included an unannounced visit to the service on 6th May 2010 and lasted approximately 5 hours. We spoke to five people living there as well as the manager and four staff members. The care records and other records relating to the care people receive were looked at. We also looked around the home with the manager and spent time talking to people living there. In addition we received a number of surveys from people living at the home and took their comments into account when preparing the report. Every year the person in charge or manager is asked to provide us with written information about the quality of the service they provide, and to make an annual assessment of the quality of their service. This document is called Annual Quality Assurance Assessment (AQAA). We use this information, in part, to focus on our inspection activity. Care Homes for Older People Page 6 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 Care Homes for Older People Page 7 of 24 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. Peoples needs are assessed before admission into the home to ensure identified needs can be met. Evidence: We looked at the records of three people living in the home. We saw they had assessment details from social workers and other health care professionals. The information we looked at showed the home is provided with a full history of the care needs of the person to be admitted so that they know what the needs are and whether they will be able to manage those needs. In addition the home has its own assessment format which they use to determine how the needs of the person will be met when admitted to the home. Staff we spoke to said they felt they find the information useful and it helps them recognise individual needs at the point of admission to the home. Information we received during the inspection process confirmed people had been Care Homes for Older People Page 10 of 24 Evidence: asked about their needs before they came into the home, and that staff had been extremely helpful and made them feel comfortable when they went into the home. 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. People are treated with dignity and respect in this home. Their health, personal and social care needs are taken seriously. Evidence: We saw the way the home records information about people care needs is excellent. The information clearly shows individual health and social care needs and how they are being met. People we spoke to told us they are supported by staff to attend hospital, GP and other health care appointments. Comments included, I cant thank the staff enough for what they do, when my support worker comes they stay with me if I ask them to and they always do. The records show there are comprehensive risk assessments in place for people, which highlight what the risk is, what level of risk there is to the person and how that risk will be managed. Staff spoken to said they think people are protected by the risk assessment systems they are using. We saw the risk assessment records are continually reviewed and changes made where necessary so the persons level of risk is managed by the home. Care Homes for Older People Page 12 of 24 Evidence: We saw all of the care planning records are being reviewed monthly and where possible the person is involved in this review so that they know their needs are being monitored and changed where necessary. People we spoke to said they had been involved in their care planning process. Comments included, the staff talk things over with me, and they take time with me to talk about things I want to do and what I need. By looking closely at the records there is evidence the home has excellent links with other health care professionals including, GPs, districts nurses, Psychiatric services and social workers. People who require additional health care have records in place to monitor their care, including appointments, reasons for them and what treatment if any has been prescribed. At the time of the inspection there were professional visiting the home to make deprivation of Liberty Safeguarding Assessment (DOLS). This makes sure a person whose liberty is deprived in some way for their own safety, has the deprivation assessed, monitored and reviewed so they are not disadvantaged in any way. The way the home manages its medication is safe. The procedures they use are based upon good practice guidelines. We saw evidence the home works closely with the supplying pharmacist, who is familiar with the home and its medication practices. The manager told us only trained staff are responsible for medication administration and recording so it is safe. We found the way medication is recorded is clear and up to date and that returns are carried out monthly so that there is no excessive stock of medication in the home. We looked at three records and found them to be complete and accurate. The way the home stores medication is in locked purposeful facilities to ensure security. We saw peoples privacy and dignity is respected by looking at how staff talk to and respond to people. We saw staff are respectful and sensitive to people needs by the way we observed them talking to residents and assisting them. Staff we spoke to said they feel they treat people in a way they would expect their own family to be treated if in care. Comments included, they are such characters and some have been here for some time so you get to know them well. 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. Social activities and meals are both well managed and provide daily variation and interest for people living in the home. Evidence: Since the previous inspection the home has worked hard to review activities and put in place a routine which is flexible but gives people choice about what activities they may want to take part in. In addition there is a coordinator who is responsible for monitoring and organising activities for people. We spoke to some of the people living at the home and staff about what the routines are. They told us they are flexible so people can choose how they want to spend their time. This includes no restrictions on what time people get up and go to bed, whether they choose to stay in their rooms or use the communal facilities. We saw people using various parts of the home throughout the inspection. Some people choose to stay in their rooms where they have included TV and audio equipment of their choice as well as furnishings which make it homely. Staff told us they are given the time and the resources to provide activities which they said was usually enjoyed by everyone although they respect peoples rights if they Care Homes for Older People Page 14 of 24 Evidence: choose not to join in. We spoke to people about meals in the home. They told us they enjoyed all the meals and the staff know if they dont like something. We spoke to the cook who was preparing lunch. They told us they use fresh ingredients wherever possible and they are provided with information about peoples individual nutritional needs when they are admitted, so they can identify any specific nutritional need if necessary. 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. Complaints are handled well and taken seriously ensuring people feel listened to. Staff have access to safeguarding protocols to protect people. Evidence: We looked at the homes complaints procedure. It is made available to people using the service so they know how to raise any concerns or complaints. Surveys we received told us people know how to make a complaint. People we spoke to said, I always tell the staff if Im not happy about something. We spoke to the manager about how people are protected and they showed us records of staff training in this area. Staff we spoke to said they have received training in protecting people and they said they would know what to do if they had any suspicion of abuse taking place. There has been one safeguarding investigation since the previous inspection and the manager and staff worked closely with the investigation team for a satisfactory outcome. 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 live in a suitably adapted, clean, comfortable and very pleasant surroundings. Evidence: We looked around the home and found it to be clean,comfortable and homely. There is a dedicated maintenance team who constantly review the internal areas of the home as well as the external areas so it is maintained to a high standard. People we spoke to and surveys we received told us they are happy with the homes environment and comments included, they are always doing something to keep it up to scratch, I like my room because I can have it the way I choose, Its always warm and inviting when you come in. There is a good range of aids and adaptations in place to help people who have poor mobility or need help to get around. There is a large communal dining and lounge area which most people use during the day. Some people said it can get a bit noisy at times. Staff were seen to try and manage this by spending time with people who may get agitated. Other people said they like using their own rooms, which they can do as they choose to. 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. The procedures for recruiting staff are good, ensuring the safety and protection of people. People are supported by well trained and effective staff so their needs can be met. Evidence: We spoke to the manager about how staff are deployed for the benefit of people using the service. We looked at the staffing rota which showed there are sufficient numbers of staff on duty at any one time so the needs of people living there can be met. In addition the manager takes care to ensure the skills of the staff team are mixed in order to provide consistent levels of support and for the staff team to develop further. Staff we spoke said they thought the manager supported them well, and listened to them. Comments included, We work well together as a team, you can always talk to the manager about things if you are not sure about something. We looked at the homes training records and found there is a full range of training for staff, including mandatory training in moving and handling, first aid, health and safety and safeguarding people. In addition all staff either have a national care qualification or are currently undertaking training to gain a recognised qualification in healthcare. Staff spoken to said they are encouraged to attend training for their personal development. They also said they now have access to training in managing challenging behavior and dementia care, so the staff team can identify and respond to Care Homes for Older People Page 18 of 24 Evidence: the specific needs of people living at the home. Staff training records we looked at showed some staff have received this training. A staff member spoken to said they feel they have the necessary skills through training to meet the needs of people living in the home. We looked at three staff files. They showed us staff are recruited safely using procedures which take into account, qualifications and experience, their suitability for the role, references, Protection of Vulnerable Adults (POVA), Criminal Record Bureau (CRB), in order to make sure people are protected. 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. The home is managed well with systems and policies in place for the safety and protection of people living there. Evidence: We found the home is being run in the best interests of people using the service, comments included, I like living here everybody is so kind, the manager has always got time for you. We saw the manager has developed a thorough supervision programme for the staff team. The records we looked at showed the staff are supervised regularly and their personal and professional development is identified and this is monitored and followed through so that there is evidence of the support they are receiving. Comments included, the manager supervises me and we talk about how I can develop in my job, we are really encouraged to take courses whenever they come up. The manager has put in systems which help staff to contribute to the recording of care Care Homes for Older People Page 20 of 24 Evidence: needs in records which are easy to follow. In addition the manager has implemented risk assessments to meet the requirements of the Mental Capacity Act 2005, whereby a Deprivation of Liberty Safeguarding (DOLS), is carried out for people living there. If it is identified a person is being deprived of their liberty in order to meet their care needs and in their best interests a referral is made to Social Services for this to be recorded, monitored and reviewed. By talking to people and looking at records we found the home manages this system well and the manager has undertaken training in this area so that they are suitably qualified to carry out this assessment. We looked at how the home gains the views of people using the service and found there are records of staff meetings so that people have the opportunity to contribute to the development of the service. We saw records showing the owners make regular visits to the home to ensure it is being managed and run in peoples best interests. We saw there is a clear line of management responsibility and staff communicated well with the manager throughout the inspection at the home. Comments we received by talking to people and through surveys told us people are very happy with how the home is run and they said they feel supported. By looking at records we saw regular tests and servicing of essential equipment including lifting equipment, gas and fire and electric were up to date. 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 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. 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