Care Home: Stella Matutina Convent

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What the care home does well The environmental standards in the home continue to be excellent, with the home being very well decorated, comfortable and well maintained. A good standard of care is provided, with peoples` health care needs satisfactorily monitored and any necessary treatment provided when needed. There is a committed staff team, who deliver a good standard of care in a caring, sensitive and professional manner. There continues to be up to date and adequate training provided to staff. The meals within the home continue to be nutritional, varied, appetizing, with people being offered alternatives and specific dietary needs catered for. What has improved since the last inspection? A previous recommendation was made regarding up to date training for all staff. This recommendation has been satisfactorily met. What the care home could do better: Some of the people using the service and some members of staff felt that more opportunities should be available to undertake activities. Whilst the site visit identified that an activities programme was in place, this did not meet with everyones expectations. There is a vacancy for a housekeeper on the first floor. In discussion with people using the service and with some of the staff, they felt that this was having some impact on the service delivery. One comment was, "the staff are so much more busy now, with there being no housekeeper". Discussions with some of the staff, people using the service and in the feedback in surveys indicated mixed views about the management style within the home. The organisation should monitor this and satisfy itself that links between management, staff and people using the service are positively developed. One medication administration record (MAR) was found to be undated and unsigned. The manager must ensure that medication administration record sheets are constantly reviewed. Terminology within care planning documentation should be positive. This will help demonstrate that people are viewed as being treated with respect and dignity. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Stella Matutina Convent 16 Clifton Drive Ansdell Lytham St Annes Lancashire FY8 5RQ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Phil McConnell     Date: 2 3 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Stella Matutina Convent 16 Clifton Drive Ansdell Lytham St Annes Lancashire FY8 5RQ 01253734834 01253794424 pauline@scjm.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Sisters Of Charity Of Jesus And Mary care home 41 Number of places (if applicable): Under 65 Over 65 41 old age, not falling within any other category Additional conditions: 0 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: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 41 Date of last inspection Brief description of the care home Stella Matutina is owned and run by The Sisters of Charity of Jesus and Mary, which is a religious order with a charitable status. The ethos of the home is to provide a good quality care service within a setting that allows service users the opportunity to live their lives in a secure and safe environment, whilst meeting their assessed needs. The home is situated in its own grounds and there is an enclosed garden area at the rear of the home with pleasant sitting areas overlooking the sea. There are parking areas available at the side of the home. Care Homes for Older People Page 4 of 28 Brief description of the care home Stella Matutina is located in a residential area of Lytham St Annes and is close to local shops and amenities. Service users of all religious denominations are welcome to live at Stella Matutina. The home has a chapel and a priest is in attendance, church services are conducted and spiritual guidance is offered if required. The home is registered to accommodate 41 service users and there are 41 en suite bedrooms At present only female service users are cared for. The present rate of charging is £415 per week. Care Homes for Older People Page 5 of 28 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: Various information was gathered in order to be able to assess the National Minimum Standards for Care Homes for Older People, including: The Annual Quality Assurance Assessment, this is a document which the registered manager completes every year and it contains information about the service being provided. We use this information, in part to focus on our inspection activity. An unannounced Key Inspection, which was carried out on the 19th of March 2009 by the Commission for Social Care Inspection (CSCI), with a follow up visit on the 23rd of March 2009 in order to gather further information. The registered manager ( Pauline Louvain Calvert) was present for the majority of the site visits. There was also the opportunity to speak to some of the people who use the service in private. Discussions also took place with some of the staff members. Care Homes for Older People Page 6 of 28 Peoples files were examined, with all relevant documentation being in place. A number of the staff files were examined and they also contained all of the necessary documentation needed for inspection purposes including, recruitment information and Criminal Record Bureau (CRB) checks. Throughout the visits there was the chance to observe the support and care that was being provided to individuals, which was done in a caring, appropriate and professional manner. The organisations policies, procedures and the health and safety documentation was examined and they were found to be up to date and satisfactory. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 28 Care Homes for Older People Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 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. There was sufficient evidence to show that peoples care needs will be satisfactorily assessed and determined if their needs can be provided, before a accommodation is offered. Evidence: Five service users files were examined, including the last person to go and live at Stella Matutina. Generally the assessment documentation was satisfactory, however one new resident initial assessment form was observed, to be limited in information and detail. There was a completed assessment for a person who had been transferred from another care home. The assessment had been completed by Stella Matutina and it contained appropriate and relevant information, with details of the persons care needs, next of kin, GP details, medication and some historical background for the person. Care Homes for Older People Page 11 of 28 Evidence: Another persons assessment documentation contained significant information regarding, some dietary intolerance and a disclaimer for administering their own medication. The manager was informed about the new resident assessment form and an assurance was given that the assessment process would be improved and in future more information would be obtained and documented, giving the carers more details and guidance, enabling people to fully receive their assessed needs. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are supported to administer their own medication. This demonstrates that Independence and choice is positively promoted. Evidence: The care plans of five people were examined and they contained detailed information and guidance,enabling to provide a persons assessed needs. However, some of the wording of the care plans was inappropriate. It was suggested that some care plans were reworded, using more positive terminology. The manager agreed to address this issue. A cardex system is used, containing individual care plans, risk assessments and monthly dependency profiles and evaluation sheets for care plans. This is mainly used for the monitoring of peoples assessed needs. Specific information and satisfactory records were maintained, regarding peoples health care needs, including hospital appointments, GP visits, District nurse treatment Care Homes for Older People Page 13 of 28 Evidence: and any other health related appointment or consultation. This helps to show that peoples health care needs are regularly monitored and people receive appropriate treatment when necessary. The provision of care was observed to be of a generally good standard. However, a lady was observed being transported in a wheelchair without any footrests attached. The persons feet kept scraping along the floor. The carer was asked to stop pushing the chair and make sure that footrests were put on. This practice could potentially cause serious injury. The manager was informed of this incident and agreed that the issue would be addressed. There was a hospital discharge document available for one person, giving detailed information, which would help with the persons care provision after being in hospital. There is a resident transfer to hospital form with relevant details regarding, NOK, name of GP, medication, medical history. There is a fully equipped treatment room, where medication is also stored. The medicines were correctly and securely stored with peoples photographs on their medication files, helping to avoid any confusion with the administration of medication. The current medication records were up to date and accurately recorded. However, there was a copy of an undated previous medication administration record (MAR) sheet in a persons file. Some comments were received about the administration of medication, which indicated that a specific person tended to rush around. This Information was fed back to the manager. However, during the site visit another person was observed administering medication in an unhurried and controlled manner. As previously mentioned there were contracts in place in peoples files for those who were self medicating. This shows that people are encouraged and enabled to maintain their independence when possible. The general feedback from people using the service is that respect and dignity is positively promoted and some comments were, Always knock at my door before entering the staff always show me respect and the staff have accepted that I need time alone. Care Homes for Older People Page 14 of 28 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. There was a good activities programme in place. Although this did not appear to meet everyones high expectations. Evidence: The activities programme was examined and it was found to contain information with regards to what activities had been provided and who had attended. Some of the ongoing activities provided at the home are dominoes, card games, jigsaws, coffee mornings,puzzles and art and crafts. During the inspection visit some of the ladies were observed crocheting and knitting. However, some comments received from people using the service indicated that they would like the opportunity to undertake more activities. There was some evidence that a hotel in Blackpool has been providing afternoon teas with entertainment and they also provide transport, with fifteen people usually attending. There were photographs on the notice board of the recent St Patricks day party and there was other information regarding forthcoming events, for example a St Georges Day event planned for the 23rd April, a trip arranged to go to Southport in May, this is specifically for people who use wheelchairsand it was observed that a summer fair Care Homes for Older People Page 15 of 28 Evidence: is being planned for June or July. At the last inspection visit an activities organiser was employed who has since left . Some of the staff and people using the service linked this to their view that fewer activities were being provided. An open house policy is evident within the home and family and friends of people using the service are encouraged to visit at times acceptable to the service users. There was the opportunity to have a meal at the home and it was very nice. People having lunch at the same time, all commented on how good the meals are. Some other comments were, the food is excellent they are now familiar with my diet and I have diabetes and the cook knows what I need to avoid.The kitchen staff maintain good records of individuals specific dietary needs and it was evident that the cook endeavors to consistently provide nutritional wholesome meals and is fully aware of peoples dietary requirements. Care Homes for Older People Page 16 of 28 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. Satisfactory policies and procedures are in place, giving the assurance that people are protected from abuse. Evidence: There was a comprehensive complaints policy and procedure in place. There was no evidence of any complaints having been received since the last inspection visit, which had been carried out by the Commission for Social Care Inspection (CSCI). The AQAA stated that there is an, accessible, simple and clear complaints procedure in place, which ensures that any complaints are dealt with promptly and effectively and the residents and staff feel that the open culture within the home allows them to speak up and be listened to and all allegations checked. A copy of the complaints procedure is made available in the Service Users Guide and the Statement of Purpose. There was a policy and procedure in place, giving guidance and advice in how to deal with a suspicion or allegation of abuse being made. In discussion with staff it was apparent that staff members are familiar with the different areas of abuse and would know what to do if a safeguarding issue was raised. It was also evident that all members of staff have received satisfactory safeguarding adults training. This helps give an assurance that the protection of vulnerable people is actively promoted. Care Homes for Older People Page 17 of 28 Care Homes for Older People Page 18 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environmental standards within the home are excellent, which gives the assurance that people live and work in a comfortable, clean and pleasant atmosphere. Evidence: A full tour of the premises was carried out and the home was found to be of an excellent standard. The home was fresh smelling, clean, hygienic, well decorated and well maintained. The main kitchen and the laundry are satisfactorily equipped and both well organised, with equipment to meet the needs of the people using the service. It was observed that some people need to have their washing done independently, due to having sensitive skin and it was apparent that this service is satisfactorily provided. Throughout the building there were hand washing facilities, showing that the management of infection control is positively promoted. Peoples bedrooms are all en-suite and it was evident that people are encouraged to bring into the home their own personal possessions and items of furniture, with all of the rooms being individualised, tastefully furnished and very well decorated. The lounges and dining rooms are decorated and furnished to a high standard,with people having the opportunity to either sit in a room with a television, a quieter room Care Homes for Older People Page 19 of 28 Evidence: or in the sun lounge. The home has a chapel, which is used on a daily basis. During the visit a number of people were observed attending the daily service. All of the communal areas contained comfortable seating and it was apparent that people were able to choose wherever they wanted to go within the home. There were books, up to date magazines,newspapers and fresh flowers in different areas of the home, helping to make the home very pleasant and welcoming. A maintenance man is employed, who maintains the property to a good standard. The grounds are also very well maintained, with quite large gardens and level paths, enabling people to freely take walks in the grounds if they wish too. Some the comments received regarding the environment were, the home is always kept really clean Its like a hotel living here, always smells nice with fresh flowers and some of the staff comments were provides a friendly and homely environment for the service users and the staff to work in I find this a very pleasant place to work in and provides a nurturing and supportive environment, where residents may freely express choices and make decisions about their daily lives. Care Homes for Older People Page 20 of 28 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. A thorough recruitment process is in place, helping to give the assurance that people using the service are protected as much as possible. Evidence: The staff rotas were examined and there appeared to be sufficient carers on duty. At the time of the site visit it was observed that there were adequate numbers of staff on duty. Some of the staff and people using the service indicated that they thought there should be more staff on duty. These views appeared to be linked to specific posts not being filled, for example, the housekeeper vacancy on the first floor. It was apparent that expectations are high in the home and the absence of some key people does appear to have an impact on what people think. Four staff files were examined including the last person to be employed at Stella Matutina, and the files contained the necessary information that is needed, regarding the recruitment process. Files contained two written references, application forms, evidence that Criminal Record Bureau (CRB) checks and the Protection of Vulnerable Adults list (POVA) had been checked, helping to show that vulnerable people are protected as much as possible. The staff training programme was observed and it was clear that the training being Care Homes for Older People Page 21 of 28 Evidence: provided is regular, appropriate, relevant and ongoing. This gives the assurance that people are supported by well trained staff, who have the skills to provide a good service. The staff team are dedicated and committed to providing a good level of care and during the visits the staff were observed caring for people in a caring sensitive and professional manner. Care Homes for Older People Page 22 of 28 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. On the whole the home is managed to provide good outcomes for the people who live at Stella Matutina. Evidence: The registered manager for Stella Matutina has many years of experience in social care,with adequate qualifications. In discussion with some of the people using the service and the staff it was generally felt that the management is approachable, with some of the comments from staff being, the manager is a friendly visible part of the care team and the manager helps out with residents in the afternoon. The AQAA says, The excellent relationship between the manager, owners and staff strongly influences the caliber of care and management of the home. However some people using the service were critical of some of the homes management team. In the feedback received from some of the staff and from some of the people using the service. there does appear to be a need for the management to relfect on its style. This needs to be monitored by the organisation. Care Homes for Older People Page 23 of 28 Evidence: Stella Matutina have continued to maintain the Investors in People award, which is an independent quality assurance monitoring organisation. The provider has also maintained the RDB Quality Benchmark Company Award, which is also a quality assurance monitoring organisation. There was an up to date health and safety policy in place, with individual and corporate risk assessments in peoples files. The corporate risk assessments had been updated in February 2009. This helps to show that the health and safety of the people using the service is promoted. As previously mentioned a wheelchair was being used without a footrest. This could potentially cause a serious accident. This was brought to the attention of the management, with an assurance being given that this practice would stop. All inspection certificates were up to date and available for inspection, including electric inspection certificate, gas, fire alarm and emergency lighting system,on call system,portable appliance testing (PAT) and a lift safety certificate. Health and safety checks are regularly carried out for example, fire alarms, emergency lighting and water temperature checks. As already mentioned the home is well maintained, with a maintenance book being kept with records of reported repairs and dates of when they have been completed. This helps to show that the health and safety, within the home is satisfactorily managed and maintained for the benefit of the people living and working there. There were good systems in place to demonstrate that peoples finances are satisfactorily managed, helping to ensure that people are protected and safeguarded. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 28 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 1 9 17 The registered person should ensure that the medication administration record sheets (MAR) are all dated and signed. Accurate recording will demonstrate that medicines have been correctly administered. 31/05/2009 2 32 12 The registered manager shall, in relation to the conduct of the home maintain good personal and professional relationships with service users and staff. The manager must ensure that the management approach of the home creates an open, honest, positive and inclusive atmosphere. 30/06/2009 3 38 23 The registered person shall ensure that equipment provided by the care home for the use by service users 28/05/2009 Care Homes for Older People Page 26 of 28 is maintained and in good working order. Wheelchairs that are being used by service users must have footrests attached, helping to prevent potential accidents. 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 2 3 7 Ensure that all documentation is appropriately dated and signed were necessary. Appropriate terminology should be used in all documentation. This will help promote equality, respect and dignity. Consideration should be given to recruiting an activities organiser. This will help ensure that people are given the opportunity to take part in appropriate and meaningful activities. 3 12 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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