Archived: St Cecilia Care Home

St Cecilia Care Home specialises in providing accommodation and personal care to older people who are living with dementia. The home also provides a short term respite service. The home can accommodate up to 17 people and all bedrooms are for single occupancy. The home is situated in a quiet residential area close to local shops. The home is staffed 24 hours a day.

The last inspection of the home was carried out in January 2014. No concerns were identified with the care being provided to people at that inspection.

At the time of this inspection there were 13 people living at the home. People were living with dementia which meant some people were unable to tell us about their experiences of life at the home. We therefore used our observations of care and our discussions with staff and professionals to help form our judgements.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The registered manager was passionate about ensuring people received a high standard of care and that they were enabled to live full and meaningful lives. The registered manager used innovative and creative ways to provide staff with the skills, knowledge and insight needed to care for people who were living with dementia. Staff experienced what it was like to ‘live in a residents shoes’ for the day. The registered manager told us “The aim of the themed training was for staff to receive less than good practice as this would reinforce some things which may be done inadvertently but greatly impact on the well-being of the person.” A member of staff said “[Name of registered manager] is just brilliant. The training was excellent and really gave you an insight into what life is like for people.”

The registered manager operated an open door policy and they were very visible in the home. There were various ways for people who lived at the home and their representatives to express their views. Views were sought on a daily basis, through regular meetings and reviews of the care people received. There was an effective complaints procedure, satisfaction surveys and a suggestion box. There were effective quality assurance systems in place to monitor care and plan on-going improvements. There were audits and checks in place to monitor safety and quality of care.

There was a high level of satisfaction from people who had used the service and from people’s relatives. Comments included “I really couldn’t have wished for a better place for my [relative] to be. Every single one of you went above and beyond anything I could have wished for.” And “The carers attitude and the mind-set is dedicated to the patients. They keep the patients occupied and take notice when needed. It is much more relaxed atmosphere than previous care home where my [relative] was.”

In order to break down barriers, promote a homely feel and help people with orientation to time and place, the home had adopted a non-uniform policy for staff. Night staff wore dressing gowns over their uniforms and the registered manager had introduced a ‘night owl’ club for people who may have difficulty sleeping or feel frightened or anxious. The registered manager explained “This enable residents to engage in conversation with staff and other residents during the night and empowers them to be listened to. It gives the resident time to express their feelings of waking up instead of being ushered back to bed.”

A great deal of care and attention had been taken to provide an environment which was based on best practice for people who lived with dementia. For example to assist people with orientation toilet doors had been painted yellow and handrails had been painted red. Raised toilet seats were red and the previous ‘busy’, patterned carpets had been replaced with plain carpets. Plates, cups and condiment pots had been replaced by yellow crockery to enable people to better recognise and distinguish the food on their plates. Bedroom doors had been personalised to help people recognise their rooms.

There was a relaxed and welcoming atmosphere in the home and people were cared for by a happy and well supported staff team who took time to get to know people. A health care professional told us “The staff are very good. They are calm which is just what the residents need. There is always a relaxed atmosphere whenever I visit and that’s at least twice a week.” People looked relaxed and comfortable with the staff who supported them. One person said “The staff are very kind. It’s very warm and comfortable and I am very happy living here.” A member of staff told us “I think our residents get excellent care here. It’s so homely and we able to spend quality time with people. If my [relative] needed care I would be more than happy for them to live here.”

People’s health care needs were monitored and met. The home had established excellent links with health care professionals. A Lead Specialist Dementia Nurse visited the home several times a week to monitor and support people’s mental health needs and helped to ensure people lived well with their dementia. The home was also supported by Complex Care GP Services which helped to ensure people’s mental health needs were constantly monitored and provided staff with access to up to date advice and support daily. A health care professional told us the registered manager was very responsive and implemented any recommendations made.

People were supported to eat well in accordance with their needs and preferences. The cook prided themselves at being able to provide people with a varied and wholesome menu which used fresh local produce. We were present when lunch was served. The atmosphere was relaxed and unhurried and people made choices about what they wanted to eat. Where they didn’t want what was offered, an alternative of their choice was provided. Additional drinks and snacks were available throughout the day.

People were provided with activities and social events in the home and local community. There was an emphasis on providing activities which met people’s individual’s interests and preferences. For example one person enjoyed a trip out to see some buses after it was discovered they used to be a bus driver. The registered manager arranged for a local farmer to bring their tractor to the home after one person expressed their love of tractors. Staff supported people who liked to help with household chores such as dusting, laying tables and helping with the laundry. We observed this during our visit.

People were asked for their consent before staff supported them. Staff had received training and understood the importance of respecting people’s legal and human rights. There were policies and procedures to help keep people safe from the risk of harm or abuse. These were understood and followed by staff. These included recognising and reporting abuse, safe management and administration of medicines and staff recruitment.

The registered manager ensured staff knew how people wanted to be cared for when they became unwell or were nearing the end of their lives. They worked in partnership with health care professionals to ensure people remained comfortable and pain free.

We spoke with two visiting professionals, a Specialist Care Development Nurse and a Community Psychiatric Nurse. Both said that they visited frequently and said the management team at St. Cecilia Care Home were good at requesting and participating in multi-disciplinary discussions about the mental capacity of people who use the service.

We spoke with two people who were receiving care, treatment and support at St. Cecilia Care Home. They told us that 'the staff are very good, if I need anything they get it straightaway for me', 'the staff work hard to get the right things for everybody', and 'I have never regretted coming here, it is like a second home'. At lunchtime we observed the staff talking respectfully with people and attending to them as soon as they requested specific assistance.

We observed the medication system in use at St. Cecilia Care Home and saw that medication was safely stored, administered and recorded.

We saw that there were good staff recruitment practices and sufficient staff who were well trained to meet the needs of people using the service at the home.

People spoken with all told us they were very happy living at St Cecilia's Care home. One person told us, 'Oh, yes I do like living here they are all so nice'. A relative told us, 'they are brilliant really; they are really caring and so polite. They organise activities with plenty to do and they are always talking to people'. The healthcare professional told us, 'They are on the ball here; it is a pleasure working with them. If they spot anything they are unsure of they discuss it with us. They have plenty of pressure relieving equipment and no pressure sores'.

We joined the people who lived in the home for lunch. They were offered a choice and the meal time was relaxed and treated as a social occasion. Staff sat at the table with people and helped them in a dignified and respectful manner.

We found that care planning was person centred and agreed by the individual, a family member or an advocate. Regular reviews were carried out and involved the individual. Staff confirmed they were given the opportunity to build on their skills and received appropriate support from the registered manager. The provider had quality assurance systems in place that ensured people were safe and changes could be made to improve the service provided.