Care Home: Whitefriars

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What the care home does well Whitefriars provides a caring, homely and inclusive environment to the people who live there. On entry to the home we saw that the atmosphere was vibrant and the residents were happily greeting visitors and chatting to each other and the staff. We received a lot of good feedback about the service. One resident said `we are very well looked after, we are very lucky to have such a nice, kind and caring staff team.` We received feedback from a relative who said `I have visited Whitefriars for 12 years and have found that the staff are caring and helpful. The resident`s always look well cared for, especially on hairdressing day. The home is always clean and with no unpleasant smells. Also work is always going on to improve the decor and facilities.` We saw during our two hour observation that the resident`s are well cared for by a dedicated staff group, who are well trained and who provide appropriate and sensitive care to people who have dementia. People are encouraged to be involved in daily life activities giving them a sense of purpose and familiarisation. There is a wide range of activities going on for all people in the home and as it was Christmas their was a variety of festive events taking place. The home had been decorated by a relative who each year provides hand made decorations to make the home look festive. People said that the food is very nice and that their is plenty of choice. People`s preferences, likes and dislikes are fully recorded on their care plan. The staff team and manager are well trained and recruitment procedures protect the safety of the people living there. What has improved since the last inspection? A new care planning system has been introduced and we saw that each person has a comprehensive plan of the person`s needs, aims, goals and preferences along with action to be taken by staff. Comprehensive records had been maintained of the care that had been provided. Some areas of the home have been refurbished and new double glazing has been fitted which is a continuing rolling programme. A new wet room has been added and their is a choice of baths to meet individual needs. A second sensory garden has also been created. The staff hours have increased and their is a senior member of staff who is a Dementia Care Champion. What the care home could do better: We did not make any requirements or recommendations as the outcome of this inspection was excellent. Key inspection report Care homes for older people Name: Address: Whitefriars St. George`s Avenue, Ryhall Road Stamford Lincs PE9 1UN     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: Alison Jessop     Date: 1 6 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 24 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Whitefriars St. George`s Avenue, Ryhall Road Stamford Lincs PE9 1UN 01780765434 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: manager.whitefriars@osjctlincs.co.uk www.osjct.co.uk The Orders Of St John Care Trust care home 57 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 57 The registered person may provide the following categories of service: 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 Dementia - Code DE Date of last inspection Brief description of the care home Whitefriars is a 60 place, purpose built residential home for older people and older people who have dementia. The home is situated in the market town of Stamford, adjacent to a residential area and within close proximity of a post office, a small group of retail outlets and supermarket. Car parking for at least twenty vehicles is situated to the side of the home. All accommodation is on the ground floor level and the majority of bedrooms are single occupancy. The home has 4 units which all contain lounge/dining areas and a small kitchen where service users can make drinks if they wish. All main meals are prepared in the main kitchen area. The home is one of a Care Homes for Older People Page 4 of 24 57 0 Over 65 0 57 Brief description of the care home group of homes run by the Orders of St Johns Care Trust and its stated aim is to provide a homely, relaxed and caring environment that takes into account the individual needs of the residents. A copy of the service user guide and statement of purpose can be obtained from the manager. The weekly fees for accommodation range from £406 to £628. This does not include charges for newspapers, chiropody, hairdressing. 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: This was an unannounced visit which formed part of a key inspection, focusing on key standards, which have the potential to affect the health, safety and welfare of the people who use the service. Throughout this report the terms we and us refer to The Care Quality Commission. The visit lasted approximately 7 hours and we took into account previous information held by us including the previous inspection report, their service history and records of any incidents that we had been notified of since the last inspection. Before we made our visit the provider had returned the Annual Quality Assurance Assessment (AQAA). This gave us information about their own assessment of how well they are meeting the standards and their plans to improve aspects of the service. We also sent out surveys to a sample of residents and staff, the feedback we gained is included in this report. Care Homes for Older People Page 6 of 24 We spent from between 11am to 1pm in the sitting/dining room with the very vulnerable people who live in the home, to see what life is like in the home. We made notes every five minutes on their state of being (mood), their interaction with their surroundings and other people including staff interaction with the people who live there. We made notes every five minutes of what we observed. The details and outcome of this are included in the main body of the report. The main method used to carry out the inspection is called case tracking, this includes following the care of a sample of 3 people through their care records and assessing their care. We spoke to 6 people who use the service, 2 relatives and 3 members of staff. The Registered Manager was present throughout the visit and the general outcomes of the visit were discussed with her at the end. Care Homes for Older People Page 7 of 24 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Older People Page 8 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 9 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 10 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a robust admission procedure which makes sure that peoples needs can be met. Evidence: We looked at the care plans of three people and saw that a comprehensive needs assessment had been completed before offering accommodation to the person. The manager told us that the assessment process is usually carried out by a senior member of the care team who has received training on how to do this. The manager also told us that if the assessor is not certain that the persons needs can be met, the manager will become involved in the process. The information gathered then forms the basis for the persons care plan. This service does not provide intermediate care. 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 receive sensitive and dignified care which meets their individual needs and preferences. Evidence: We looked at the care plans of three residents. We saw that the care plan had been put together with information from the needs assessment and from information gained from the residents and/or their representatives. Each person had a care plan which described their needs for personal care, mobility, falls, communication, eating drinking and nutrition, weight monitoring, elimination, emotional well being, mental state and cognition, behaviour, tissue viability and wounds, resting and sleeping, pain and breathing. The care plans also contained information on peoples choices and preferences, interests, hobbies and religious, cultural and spiritual needs. On one care plan we saw a photo of a resident that was used by the hairdresser to ensure that the residents hair could be done in the same way as in the past as the resident was unable to explain to the hairdresser how she liked her hair to be styled. Care Homes for Older People Page 12 of 24 Evidence: We saw that the care plans and risk assessments had been reviewed regularly and records had been maintained on the care that had been provided each day. We saw that regular records had been maintained where food and fluid intake needed to be monitored and where people were receiving bed care. We also saw records of visits by health care professionals. During our two hour observation we saw that the staff provided care in a sensitive and caring manner to the people who have dementia. We observed that one lady became upset however the carer came along, put her arm around the resident and gave her reassurance, within a couple of minutes the resident was smiling and looked much more settled. One resident who said that she had previously worked as an office administrator was given a box of papers to sort through, this clearly her gave a sense of purpose and well being and she told us that she enjoyed doing her job. Another resident was observed singing at the dinner table and staff were seen laughing and joking with residents which created a nice friendly atmosphere. We observed staff carrying out safe and dignified moving and handling procedures. We received feedback from residents about the care they receive. Comments on the surveys returned told us they look after me really well, I cant think of anything they could do better. A relative said I find it a very nice home, where my mother is very well looked after. We looked at the medication procedures and saw that staff were well trained to be able to administer medications safely. The records were adequately maintained and regular audits are carried out of the medication systems. The last audit was completed in October 2009 where no issues or concerns were found. A new system has been implemented for the daily auditing of controlled drugs. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a variety of suitable stimulation which encourages people to feel valued and feel part of the wider community. Evidence: The home employs an activity co-ordinator who provides a variety of group and individual activities and stimulation to people. During December the activity coordinator has arranged a carol service, a church service (which we saw on the day of the visit), shopping trips, walks, hairdressing, an outing to Stamford Garden Centre, a slide show and visit from Stamford museum to talk about war history. There was also a Christmas raffle, a performance by the local school of dance, a Christmas party, a performance by the mission band, and other entertainment. A drinks trolley goes around the home with a selection of alcoholic and non alcoholic drinks and their is a mobile shopping trolley which is run by volunteers. The home has recently purchased an Internet console which enables residents to speak to their families over the Internet. The activity co-ordinator is also running a pilot scheme to make more use of the local library services. The home has a mini bus which is used to transport people around and a fund raising group of volunteers help to raise money for the various activities on offer. Care Homes for Older People Page 14 of 24 Evidence: The home also runs a support group for the families and people who have dementia. A monthly magazine is produced where residents and their families can submit entries. We saw that people in the home are encouraged to participate in activities of daily living and we saw that residents were seen helping to set the dinner tables, polish the furniture and keep the home tidy. One residents daughter comes in to assist her mother to have a bath as this has been a routine that the resident and relative have continued from living in the community. We saw that people were given a choice of meals at the time the meals were being served. The meals were served from a hot trolley in each dining room. Comments about the food included Its a very nice meal, we get a good choice of food. Another person said the food is great, its like eating the best home cooked dinner. Care Homes for Older People Page 15 of 24 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected by the homes Safeguarding Adults Procedures. Evidence: A copy of the homes complaints procedure is displayed on the notice boards within the home and the people we spoke with said that they would know how to make a complaint. One person said I would just speak to the manager. The manager told us that one complaint has been received in the last twelve months which was fully resolved within the timescale stated on the complaints procedure. There has been two Adult Safeguarding Investigations carried out in the last twelve months. One which is currently under investigation. The manager showed us evidence that safeguards have been put into place to protect people. We spoke with two staff who told us that they have received training on how to safeguard vulnerable adults. They were aware of how to report suspicions of abuse and neglect, although none said they had needed to do this. 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. Whitefriars provides a homely, clean environment to the people who live there. Evidence: The home looked clean and tidy and has been well maintained throughout. The entrance to the home looks welcoming and the area is set out like a small lounge and we saw that residents sat in this area and were welcoming visitors. We looked in the bedrooms for those people who said that we could and saw that they are nicely decorated and contained personal items. Each bedroom has a call bell system so that the residents can call for assistance. The hair dressing room has been refurbished and new double glazed frontage and doors have been put in. Communal areas are spacious and are set out to promote a homely atmosphere. 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 service is provided by a caring, well trained staffing team. Evidence: The home employs a manager, and a care manager in addition to the team leaders. The staffing hours have been recently increased in order to meet the needs of the residents. We received some feedback about the staff from the residents and relatives. They said all the staff are helpful. Another person said I have visited this home for over 12 years and have found that the staff are always caring and helpful. Another person said the home has a fantastic atmosphere as soon as you walk through the door. All the staff are friendly and have a good rapport with the residents, their families and friends. We gained feedback from some of the staff who said we keep up to date with as much training as needed. Another said we really care for the residents and the training is kept current although communication could be a little better. We looked at the staff recruitment files for two staff and found that they contained a check by the Criminal Records Bureau (CRB) and two satisfactory references. When new staff start working in the home they complete an on-line nationally recognised induction programme. They also shadow staff until they are ready to work with the residents. Care Homes for Older People Page 18 of 24 Evidence: We saw that the staff had completed a wide variety of training and the staff told us that this is regularly reviewed and up dated. Over 50 of staff have achieved a National Vocational Qualification in care. 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 excellent 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 by a competent and experienced manager. Quality assurance systems are robust. Evidence: The registered manager has achieved an NVQ 4 in care and the Registered Managers Award. She has also completed a course in Dementia Care Mapping with Bradford University. The manager is also a trainer for the Alzheimers Yesterday, Today, Tomorrow Dementia Training. Comments about the manager were received from residents, relatives and staff. One relative told us the charisma of the manager her level of knowledge and confidence in her team, how she deals with enquiries instills confidence in relatives. Nothing is too much trouble. The staff we spoke with said the manager is very supportive. We looked at the administration records and procedures for the residents personal finances. Accurate records had been kept, along with receipts. The financial systems are audited regularly by the Order of St Johns Care Trust. People have access to Care Homes for Older People Page 20 of 24 Evidence: lockable facilities if they prefer to manage their own personal finances. The Order of St Johns Care Trust has a comprehensive, established quality assurance system where audits are regularly carried out on medication, finances, environmental health, fire safety, policies and procedures and risk assessments. Quality assurance surveys are carried out regularly and there are regular residents and relatives meetings. The last audit was completed in October 2009. 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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