Inspection on 05/12/07 for Maria Helena Care Home

This is the latest available inspection report for this service, carried out on 5th December 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Maria Helena Care Home Dawsmere Road Dawsmere Spalding Lincolnshire PE12 9NQ Lead Inspector Tobias Payne Unannounced Inspection 5th December 2007 08 40 X10015.doc Version 1.40 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Maria Helena Care Home DS0000070713.V355115.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Maria Helena Care Home DS0000070713.V355115.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Maria Helena Care Home Address Dawsmere Road Dawsmere Spalding Lincolnshire PE12 9NQ 01406 550403 01406 550319 mariacare@tiscali.co.uk www.mariheleanacare.com Terrington Lodge Ltd Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Maxine Lilla Stanojevic Care Home 33 Category(ies) of Dementia (33), Mental disorder, excluding registration, with number learning disability or dementia (33), Old age, of places not falling within any other category (33), Physical disability (33) Maria Helena Care Home DS0000070713.V355115.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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 - aged 60 years and over - Code DE Mental Disorder - excluding learning disability or dementia - aged 60 years and over - Code MD Old Age, not falling into any other category - Code OP Physical Disability - aged 60 years and over - Code PD The maximum number of people to be accommodated is: 33 New service as a result of new ownership on September 2007. 2. Date of last inspection Brief Description of the Service: Maria Helena Care Home is an 18th century country house with a more recent extension. It provides personal care for up to 33 people. The home is situated in a rural location, 2 miles from the village of Dawsmere, which has a local pub, church, post office and shop. The main home is also located in its own extensive grounds, which are laid to lawn with trees and flowerbeds. Accommodation is provided on ground and first floors with a shaft lift serving the first floor. There are 22 single and one double bedroom provided, 19 of which are en-suite. In the grounds of the home but in a separate building is a self-contained small 2 storey building The Lodge. This was registered in January 2006. It provides personal care for 9 people in single bedrooms (en-suite). Accommodation is on both the ground and first floors and includes a domestic style kitchen, utility, dining and lounge facilities. There are garden areas. There are also separate staff working in The Lodge. Maria Helena Care Home DS0000070713.V355115.R01.S.doc Version 5.2 Page 5 The Lodge has its own separate entrance and there are car parking facilities at the front of the building. There is no local transport available. There is however a bus service that can be pre-booked. Maria Helena Care can assist by making contact with this service. The small towns of Holbeach and Long Sutton provide more extensive shopping and facilities and are 5 miles equidistant. The home changed ownership on the 19th September 2007. Terrington Lodge Ltd now owns the home. There is also a new manager who has had experience in the home before becoming the manager. She manages both the main house and The Lodge. The fees at the inspection visit on the 5/12/2007 ranged from £394 to £470 each week. Extras are for hairdressing which range from £3 to £23, chiropody £7, toiletries, personal newspapers and magazines. Information about the home including the statement of purpose and service user’s guide is available from the manager. Maria Helena Care Home DS0000070713.V355115.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced and started at 8.40 am. It took place using a review of all the information available to us about Maria Helena Care Home. We spoke with 10 residents, 2 visitors, 5 staff, the manager and the owner of the home who was visiting the home during our inspection visit. The main method was called “case tracking”. This involved selecting 2 residents and tracking the care they received through the checking of records, discussion with them, the care staff and observation of how staff responded to their needs and that of the other residents. We also looked at an Annual Quality Assurance Assessment completed by the manager. This is a self-assessment report that focuses on how well outcomes are being met for the people using the service. It also gave us some numerical information about the service. What the service does well: What has improved since the last inspection? What they could do better: There were again no requirements or recommendations from this inspection visit. Where improvements are required the manager and new owner are addressing them. All policies and procedures are being reviewed, as is the statement of purpose and service user’s guide and care record system. The Maria Helena Care Home DS0000070713.V355115.R01.S.doc Version 5.2 Page 7 manager is aware of the continual need to increase the number of staff studying for a qualification in care and is actively pursuing funding for this. The manager agreed to carry out a survey of residents to obtain their views about the food and catering service in the home. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Maria Helena Care Home DS0000070713.V355115.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Maria Helena Care Home DS0000070713.V355115.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1, 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There was information available to enable residents to make a choice as to whether or not to enter the home. People received an assessment, which resulted in their needs being met. EVIDENCE: There was a detailed statement of purpose and service user’s guide, a copy of which was given to each new resident. However both documents were not up date and did not yet refer to the new ownership/management changes. The manager and owner acknowledged this and explained this would take place in the near future and provided in larger print. We case tracked 2 recent admissions. Records showed the manager had correctly assessed them both and as much information obtained to ensure the home could meet their needs. From this a letter confirming the home could meet their needs had been sent to each resident. A full care plan had been Maria Helena Care Home DS0000070713.V355115.R01.S.doc Version 5.2 Page 10 produced for each person. Both residents told us they had settled in the home and found the staff welcoming and friendly. The home did not provide intermediate care. Maria Helena Care Home DS0000070713.V355115.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7,8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There was a clear and detailed care planning system in this home. The health and welfare needs of people living in the home were fully met. Medication was safely given by staff who knew what they were doing. There was a medication policy to enable this to take place. EVIDENCE: Following the change in ownership and management, change is taking place in the way care is recorded with the emphasis on making it more person centred. The manager told us that she wished to introduce 3 monthly formal reviews of care plans with the involvement of residents wherever possible and their relatives. All residents had care plans outlining their needs. Records included a photograph, weight chart, blood pressure reading, client information including height, family tree, list of personal belongings and pre-printed care plans allowing individual needs to be highlighted. These included reference to hygiene, mobility with indication the number of staff required, mental illness, Maria Helena Care Home DS0000070713.V355115.R01.S.doc Version 5.2 Page 12 continence, medication, nutrition, risk assessment and daily report and review. Records were seen to be well completed and up to date with review dates. The last pharmacy inspection was in January 2007. There were no concerns. There were 7 named staff responsible for medication administration. Each person had received training and a team leader had supervised their practice before being considered safe to administer medication. There were comprehensive policies. We observed a medication round. There were no issues of concern. The medication was administered to the resident, and then the records signed by the member of staff. The person was conscientious in their practice. Since the last inspection the manager had introduced 3 monthly audits of medication and clear records were available of the last audit, which took place on the 2/10/2007. We saw staff attending to residents in a kind, calm and sensitive manner. Speaking to them kindly and assisting them. Staff did this promptly and with little fuss. Residents commented, “staff are very good” and “I am very happy”. Maria Helena Care Home DS0000070713.V355115.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A variety of social activities were available. This had provided stimulation and interest for people living in this home. Meals provided were nutritious, balanced and offered a healthy and varied diet. EVIDENCE: Care staff provided activities in the home. Social interests were identified in the care plans and an activity programme was available. Activities included dominoes, bingo, card making, flower arranging, reminiscence, music and outside entertainers as well as a religious service every month. The manager was in the process of reviewing the activities and wanted to provide more outside activities. We spoke with 2 relatives who were felt satisfied with the care and support from the home. They told us they could visit whenever they wished to do so and always received a warm welcome and found the staff very friendly”. The home was again awarded 3 tulips (excellent) for its catering service by South Holland District Council in March 2007. The kitchen was clean and tidy as it has been on previous inspections. There were no concerns. Breakfast and lunch was observed in both the main house and The Lodge and there was Maria Helena Care Home DS0000070713.V355115.R01.S.doc Version 5.2 Page 14 a pleasant and relaxed atmosphere. As we walked round the home several residents told us that they were not very happy with the recently introduced menu changes. Comments were, “I like the food” and “the food is variable and I would like more variety”. We discussed these comments with the manager and suggested that they carry out a survey to find out the views of residents about the food. The manager agreed to this. There are extensive garden areas surrounding the home and an initiative of building 2 beach huts in the back of the garden with sand at the front had proved popular with the residents. The idea was of bringing the beach to residents in the home. Photographs of activities were displayed on the wall of the home. A number of residents were seen to be walking around the home with the discreet observation from staff. There was a relaxing and peaceful atmosphere. Staff told us they had time to care and support the residents. Maria Helena Care Home DS0000070713.V355115.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Any complaints received were handled properly and residents knew that any complaints they had would be listened to and taken seriously. Residents are protected from abuse. EVIDENCE: Each person received a copy of the complaints procedure and a copy was displayed in the entrance to the home on the wall. No complaints have been received by the home or CSCI since the last inspection. None of the residents or visitors had any complaints about the home. Staff records examined showed staff had been correctly recruited with a full Criminal Records Bureau check. Each member of staff had received abuse prevention training and had a personal training record. Staff confirmed they had been recruited correctly and knew about abuse and what they should do if abuse was suspected. The home also had an up to date copy of Lincolnshire’s Adult Protection procedure October 2007. Maria Helena Care Home DS0000070713.V355115.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 20, 24 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents lived in clean, well decorated and safe accommodation. Any maintenance was promptly addressed. The gardens were well maintained and provide a relaxing place to enjoy the birds and peace and beauty of the countryside. Considerable effort had been made to orientate residents to where and who they are. EVIDENCE: Since the last inspection 4 bedrooms had been redecorated and 4 new en-suite facilities had been provided in 4 existing bedrooms in the main house. In addition to these changes efforts had been made to improve orientation and personal identity for residents who had dementia. Name plates had been put on bedroom doors and signs showing which rooms were bathrooms, toilets lounges etc had been provided. One of the lounges had been made into a quiet lounge without a television. Maria Helena Care Home DS0000070713.V355115.R01.S.doc Version 5.2 Page 17 Resident’s bedrooms were individual with small items of furniture, television, pictures and personal mementoes. Locks were provided to all these facilities to enable residents to have privacy and allow staff to enter in case of emergency. Residents commented positively about their accommodation and the cleanliness of the home. A Comment was, “I have a very nice room which is very comfortable”. As a result of the management changes a new larger office had been created and the existing smaller office was now a staff room. Garden areas continue to be well maintained. Separate staff were employed for laundry and domestic duties. The home had a separate laundry with commercial washing machines and tumble dryers. There were also sluice facilities. Gloves and aprons were provided for staff and the home had an infection control policy. All areas were clean and odour free. Maria Helena Care Home DS0000070713.V355115.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was adequately staffed with employees who were experienced and competent to care for older people. Residents are protected by robust recruitment practices. EVIDENCE: None of the residents, staff or visitors we spoke with had any concerns about the level of or availability of staff. We examined recruitment records for 2 staff. We could see that staff were recruited correctly with an application form, 2 references and Criminal Records Bureau checks. Each member of staff received a detailed induction programme. Since the last inspection a new training initiative had been introduced known as “training workshop”. This was a formal training programme provided by the training co-ordinator. This programme included prevention of abuse, infection control, supervision, appraisal, moving and handling, first aid, food hygiene and care practices. Care Practices included values of care, general care, communication, food and drink, food hygiene and dying and death. The manager told us she was also looking at a dementia awareness training package. Out of 21 staff, 6 had a qualification in care (National Vocational qualification), 2 had nearly completed NVQ level 2 and 2 staff were studying for NVQ level 3. The home therefore had 37 of its staff with NVQ. Unfortunately due to lack Maria Helena Care Home DS0000070713.V355115.R01.S.doc Version 5.2 Page 19 of funding again as had previously been found no other staff were undertaking NVQ. Four staff were waiting to start NVQ but were waiting funding. The manager was aware of the need for at least 50 to have achieved this or working towards this and was actively trying to obtain funding. There was evidence that staff had the skills to care and support the people living in the home. Maria Helena Care Home DS0000070713.V355115.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 36, 37 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The change in ownership had been handled well and not adversely affected the residents or staff. The home is lead by a competent, experienced and committed manager. There is a confident, supported and trained staff team. Residents and visitors have confidence in the staff and management. EVIDENCE: Since September 2007, the home had changed ownership and management. This transition had gone smoothly and the new owner who was present during the inspection was visiting the home daily and the manager of the other home was working and supporting the manager at this home. A review was taking place of policies, procedures, statement of purpose and service user’s guide to use the same systems. The main house and The Lodge were now being managed and staffed as one service. There were staff in each unit. Maria Helena Care Home DS0000070713.V355115.R01.S.doc Version 5.2 Page 21 This manager had nearly competed a management qualification and had been the previous deputy manager. She was aware that she would need to obtain a qualification in care in the future. Since the last inspection internal quality audits had been introduced to cover health and safety, medication, first aid box, fire safety maintenance, infection control and care plans. These audits were to take place regularly. This had last taken place in October 2007. Clear and detailed records were being kept. Quality assurance surveys were sent out in May 2007 and 8 were returned. These were all complimentary. Comments were, “after Kings Lynn Hospital you have done wonders for him”, “I think you all do a wonderful job. I could not do what you do. Thank you for looking after mum so well”, “of the rest homes I have tried, yours comes out best for care and prices” and “ I am always informed about how my wife has been since my last visit”. The home had maintained the Investor’s in People award for its commitment to the education and development of the staff. Staff received regular formal supervision. The home had detailed policies and procedures, which included employment, induction and training. This enabled staff to care and support residents. Records examined on the day of the inspection were available, well maintained, up to date and kept securely. There were detailed policies and procedures and the equal opportunities policy included a very detailed equality and diversity policy and guidance on cultural differences and anti-discriminatory practice. These were being reviewed. There were no communication or diversity issues. The home had a detailed health and safety policy which include COSHH (Control of Substances Hazardous to Health), Legionella and risk assessments where required. Maria Helena Care Home DS0000070713.V355115.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X x 3 x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X 3 3 3 Maria Helena Care Home DS0000070713.V355115.R01.S.doc Version 5.2 Page 23 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Maria Helena Care Home DS0000070713.V355115.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Maria Helena Care Home DS0000070713.V355115.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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