Inspection on 14/12/09 for Mill River Lodge

This is the latest available inspection report for this service, carried out on 14th December 2009.

CQC found this care home to be providing an Good service.

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.

Other inspections for this house

Mill River Lodge 09/09/08

Mill River Lodge 11/03/08

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Key inspection report CARE HOMES FOR OLDER PEOPLE Mill River Lodge Dukes Square Horsham West Sussex RH12 1JF Lead Inspector Ed McLeod Key Unannounced Inspection 14th December 2009 09:00 DS0000070879.V378705.R01.S.do c Version 5.3 Page 1 This report is a review of the 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. 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. Mill River Lodge DS0000070879.V378705.R01.S.doc Version 5.2 Page 2 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 Mill River Lodge DS0000070879.V378705.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Mill River Lodge Address Dukes Square Horsham West Sussex RH12 1JF 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) 01403 227070 Shaw Healthcare Ltd Mr Andrew Hunt Care Home 70 Category(ies) of Dementia (0), Old age, not falling within any registration, with number other category (0) of places Mill River Lodge DS0000070879.V378705.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 (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 (OP) 2. Dementia (DE). The maximum number of service users to be accommodated is 70. Date of last inspection 10th March 2009 Brief Description of the Service: Mill River Lodge is a new-build care home situated in a central location in the town of Horsham in West Sussex. The premises are situated on four floors, with the ground, first and second floors providing accommodation to the people living in the home. There are two lifts, and an electronic system for entering and leaving parts of the building including the central entrance. The home is registered to provide accommodation up to 70 people, and accommodates on the second floor people who come into the category of old age, and accommodates on the ground and first floor people who are diagnosed as having a dementia (such as vascular dementia). The service is operated by Shaw Healthcare, for whom the responsible individual is Mr Peter Nixey. The registered manager for the home is Mr Andrew Hunt. On the day of this visit the manager advised us that the fees are from £388.24 to £750 per week. Mill River Lodge DS0000070879.V378705.R01.S.doc Version 5.2 Page 5 Mill River Lodge DS0000070879.V378705.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. The visit was carried out by one inspector from 9.35 a.m. until 4.15 p.m. on the 14th December 2009. We were on the premises for 6 hours. The visit was arranged to assess the service’s compliance with requirements made at our previous visit and with the key national minimum standards for care homes for older people. In preparation for this visit we looked at all the information that we have received, or asked for, since the last key inspection. This included: - Nine Care Quality Commission (CQC) surveys returned to us by people using the service, five surveys from members of staff, and six surveys received from relatives, carers or advocates of people living in the home. - Information we have about how the service has managed any complaints - what the service has told us about things that have happened in the service. These are called notifications and are a legal requirement - The previous key inspection - relevant information from other organisations, and what other people have told us about the service. Some of the information gained from these sources has been included in the writing of this report. At this visit we spoke with the manager, six members of staff, four people living in the home and a visiting relative. We sampled the care plans for seven people living in the home, and the recruitment records for four members of permanent care staff and three members of temporary care staff. Other records sampled included records relating to pre-admission assessments, activities, meals, complaints, safeguarding issues, medication arrangements, maintenance of the premises, and health and safety. What the service does well: Mill River Lodge DS0000070879.V378705.R01.S.doc Version 5.2 Page 7 People are accessing the health care support which they need. People are being provided with varied and good quality meals. Where issues of risk are being identified, the home is acting to protect people and ensure safety. A member of staff told us “the manager is open and honest, ensures things are followed up. Staff are now more confident about speaking out”. 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 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. Mill River Lodge DS0000070879.V378705.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 Mill River Lodge DS0000070879.V378705.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 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. EVIDENCE: We sampled the pre-admission assessments for three people who have come to live at the care home since our previous visit. We found that an assessment of the person’s needs had been carried out before admission was agreed, and that the person and people close to them had been consulted during the assessment. Mill River Lodge DS0000070879.V378705.R01.S.doc Version 5.3 Page 10 Seven of the nine people living in the home who completed in writing our Care Quality Commission (CQC) survey said that they had received enough information to help them decide if the home was the right place for them. Mill River Lodge DS0000070879.V378705.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans are ensuring that the persons health, personal and social care needs will be 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, people manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. People receive support in a way that maintains their dignity. EVIDENCE: At our visit on 10th March 2009 we found that care plans were not always providing clear advice on how the persons needs were to be met. A requirement was made concerning this. Mill River Lodge DS0000070879.V378705.R01.S.doc Version 5.3 Page 12 During this visit we sampled the care plans for seven people living in the home. We found that care plans were setting out how the person’s needs were to be met, and were being regularly reviewed. A member of staff we spoke to told us that staff training in care planning was leading to more information being provided in care plans. An example of this which the member of staff referred to was how the care plan for one person now advised that they liked to make their own tea and that staff should supervise and support this. This helps the person retain independence and dignity. Another care plan we looked at advised how the risk of falls for one person during the night was to be managed by staff. A care plan sampled for one person who suffers from confusion first thing in the morning set out how the person can be supported to orientate themselves in the morning, and ways in which they like to be useful and to maintain their independence and dignity. The previous requirement concerning care plans was found to have been met. Eight of the nine people living in the home who responded to our CQC survey told us they always or usually receive the support they need, and that staff listened to them and acted on what they said. The six relatives, carers and advocates who responded to our survey told us that the service is meeting the needs of their friend and relative, and that they are being kept up to date with important issues affecting their relative. One person wrote that they were “very happy with the care my mother is receiving”. A relative we spoke to during our visit told us that staff have been able to establish a routine with the person who suffers from confusion, and that staff have been able provide support such as washing and hygiene support that was difficult to do at home. A member of staff told us in their survey form that “families are made welcome and encouraged to be as active as they possibly can with their relative’s care i.e. input of information”. A member of staff wrote in their survey form that “the residents are all treated properly and well cared for”. Mill River Lodge DS0000070879.V378705.R01.S.doc Version 5.3 Page 13 The care plans we sampled included records of medical appointments and these indicated that people were being supported to access medical services such as doctors, community nurses, chiropodists and dentists. Care plans sampled also indicated that nutrition plans, and monitoring of food and fluid intake were in place where there was a need for this. Surveys we received from people living in the home indicated that they believe that the home makes sure they get the medical care they need. Care plans we sampled indicated that people were assessed to see if it was safe for them to store and administer their medication. Interviews with staff and training records sampled indicated that staff who administer medication are continuing to receive training in this. Medication records sampled were found to be in good order, and arrangements were in place for example to ensure that staff have clear guidelines for when an “as required” medication for the person should be administered. Mill River Lodge DS0000070879.V378705.R01.S.doc Version 5.3 Page 14 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 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. EVIDENCE: Surveys received from relatives, staff and people living in the home indicated that while activities are arranged regularly, more could be done. For example, one relative thought that walks into town and exercise would be useful, and a Mill River Lodge DS0000070879.V378705.R01.S.doc Version 5.3 Page 15 member of staff said “the residents should be able to go out more and do more activities”. During our visit we found that there are two staff employed to provide activities, and that recent events in the home have included a Thai meal for staff, residents and relatives, and a firework night. Recent outings have included a visit to a farm, and to an RAF show. There is work going on to give people in the home an opportunity to grow plants and vegetables in the garden. On the day of our visit there was a pantomime taking place, which was well attended and which people told us had been very enjoyable. We spoke with one of the activity co-ordinators who showed us decorations that people in the home had made for Christmas trees. The activity co-ordinator said that people really enjoyed being in the garden during the summer, and that tea, lunch and barbecues had all been arranged in the garden. Photographs on the walls showed some of these events. The staff member said that they had attended a gardening seminar, where ideas such as trays for partially sighted people and painting flower pots were discussed. There has also been training in providing appropriate activities for people with dementia, such as doing watercolours and simple puzzles and games. Activity timetables are posted in the units in the home, and indicate activities are provided seven days a week – activities include outings to church, bingo, cooking, and ball games. We were advised by the activities co-ordinator that they now know what each person is capable of, and can adapt activities accordingly such as by finding puzzles that people can do and the kind of things that interest them. A member of staff told us that one resident in particular likes doing cooking, others enjoy dancing and music, and entertainers who interact well with people are popular. Residents have assisted in decorating the garden for Christmas. A family member we spoke to said that they can visit at any time, and can take their relative to the day centre downstairs for a cup of tea. The menu for lunch was set out on each table in the dining areas. On the day of our visit pork casserole. beef curry and macaroni cheese were the main choices, served with parsley, peas, carrots, and rice or potatoes. Desserts Mill River Lodge DS0000070879.V378705.R01.S.doc Version 5.3 Page 16 offered were trifle, yoghurt, or ice cream. The choice for the evening meal was to be chicken soup, sandwiches or sausage and beans, and cake. The menu also advised that “fresh fruit and cheese and biscuits always available”. We talked to a resident who has diabetes who told us that the home provides diabetic ice cream and diabetic bread for them. One relative told us in their survey form that the home “provides varied and good quality meals”. We found there to be a relaxed and unhurried atmosphere during the serving of lunch. One resident who didn’t wish any of the main choices was able to ask for a cheese omelette instead. If a person needed assistance during lunch this was being provided in a discrete and unobtrusive way that helped them maintain their dignity. Mill River Lodge DS0000070879.V378705.R01.S.doc Version 5.3 Page 17 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. If people have concerns about 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. EVIDENCE: Our survey asked the question “is there someone you can speak to informally if you are not happy?”, and the seven people living in the home who answered this question said there was. Another question asked in our survey form for people living in the home was “do you know how to make a formal complaint?”. Five of the respondents said they did, two said they didn’t. All six relatives, carers or advocates who responded to our survey told us they knew how to make a complaint, and five of them told us the care service Mill River Lodge DS0000070879.V378705.R01.S.doc Version 5.3 Page 18 always responded appropriately if they or the person using the service raised any concerns. One person told us the service usually responded appropriately. In our surveys for staff we asked “do you know what to do if someone has concerns about the home?”, to which all the five staff answered “yes”. The service has advised us of a number of safeguarding alerts that they have raised and forwarded to the local authority. We discussed some of the referrals and the findings from investigations into the referrals with the manager Mr Hunt. We found that the home has acted to ensure the safety of people accommodated – for example by identifying errors such as nearly out of date medication provided by a pharmacy and obtaining a fresh supply. The home has also acted by ensuring that people receive the support with mental health problems which they are in need of, which has helped protect them and those around them. Mill River Lodge DS0000070879.V378705.R01.S.doc Version 5.3 Page 19 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the 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 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. Their room feels like their own, it is comfortable and they feel safe when they use it. EVIDENCE: Mill River Lodge DS0000070879.V378705.R01.S.doc Version 5.3 Page 20 We talked with a member of maintenance staff employed in the home, and sampled records for maintenance and health and safety. We found that the premises were being well maintained, and we found there to be good arrangements in place for problems to be identified, recorded, and acted upon. Improvements to the premises since our previous visit have included developing two areas of the garden, and larger televisions being provided in the main sitting areas. We found that the passenger lift is now key operated, making it more safe and secure. Communal areas in the home continue to be made more homely, for example by people’s paintings, drawings and collages being shown on walls. Some of the Christmas decorations have also been done by residents. Bedrooms visited had been personalised by people or their families with photographs, pictures and other possessions. Some people had also brought items of furniture with them. We asked “is the home fresh and clean?” in our survey forms for people living in the home. Seven of the nine people answered that it was “always” fresh and clean, and two people answered that it was “usually” fresh and clean. All areas of the home visited were found to be clean and odour free. Mill River Lodge DS0000070879.V378705.R01.S.doc Version 5.3 Page 21 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the 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 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. EVIDENCE: We found at our previous visit that staff numbers were not sufficient to meet the care and safety needs of the people accommodated, and a requirement was made concerning this. Previous to this visit, eight of the nine people living in the home told us in their survey forms that staff are “always” or “usually” available when they were needed. One person said staff were “sometimes” available when needed. Mr Hunt advised us that since the previous visit it had been recognised on one unit that because a large number of people wished to be supported to get up Mill River Lodge DS0000070879.V378705.R01.S.doc Version 5.3 Page 22 earlier during the summer months staff shifts were begun an hour earlier to address this. During our visit we found that staff were available when people needed support or help. For example, there were sufficient staff available during lunch on each of the units to ensure that people who needed assistance were receiving this. We observed also that staff were employing good skills with people who were confused. For example, one person was complaining loudly that they needed more tea although their cup was full. Staff were seen to talk quietly and respectfully with the person, and filled the cup when some tea had been drunk from it. One relative wrote in their survey form that “staff are most helpful”. The manager Mr Hunt told us that to respond to residents’ concerns on second floor about lack of staff for helping them get up earlier staff rotas changed for staff to start earlier (7 am). However, with winter and the clocks changing people didn’t want to get up so early, so staff have reverted to starting 8 am. A relative told us in their survey form that “some agency staff are not up to the standard of the permanent staff”. Mr Hunt said that if a member of agency staff is not found to be doing a good job, the agency are advised of this and they are not employed again in the home. Mr Hunt told us that they continue to work towards the position of having a full complement of permanent staff, and that from having 46 permanent support workers at 31/03/09 the home now had 60 permanent support workers employed and a number of staff waiting to start after checks clearance had been obtained. We were advised by Mr Hunt that an additional unit manager who has experience in working with the company and is a trainer and qualified nurse is also due to commence work in the home. There has been an increase in numbers of residents from 35 to 62 during that period, which Mr Hunt said meant that in the short term there was still a need to employ agency staff but that they were continuing to recruit towards being fully staffed. It was the view of staff we talked to that the staff team was now more stable, settled and happy. One member of staff told us “from 15 months ago I feel more confident. The staff team is happier”. Mill River Lodge DS0000070879.V378705.R01.S.doc Version 5.3 Page 23 Comments from relatives in their survey forms also indicated that the overall standard of care provided has improved greatly. The previous requirement concerning staffing levels was found to have been met. The five members of staff who responded to our CQC survey told us that the employer had carried out CRB and reference checks before they started work. They also told us that their induction training covered everything they needed to know to do the job when they started. We sampled the recruitment records for four members of permanent staff and three temporary staff and found that required information and checks had been obtained for them before they started work in the home. In their CQC survey forms the five members of staff who responded told us that they always or usually felt they had enough support, experience and knowledge to meet the different needs of people who live at the home. We asked Mr Hunt what the current staff training priorities were – he advised that a large number of staff will be undertaking first aid courses, and 12 staff are awaiting placement on National Vocational Qualification (NVQ) in care courses. Some distance learning training in dementia, nutrition and medication, and more comprehensive training in working with dementia is being offered. Mr Hunt advised that direct work with staff goes on day to day on the units – for example one person was refusing to be assisted to change their wet clothes, and staff had learned to phrase their request differently so that the person then accepted the assistance. Staff we spoke to told us that recent training in care planning had been helpful in encouraging staff to provide more information and guidance in care plans. Mr Hunt advised that induction training for nursing staff is being put in place, and the new unit manager who is a qualified nurse will be putting together training packages for nurses, team leaders and support staff. Staff we spoke to had attended recent health and safety and medication training. A senior member of care staff advised us that regular arrangements were in place for supervision. Training charts sampled indicated that most staff are up to date with most core trainings. Mill River Lodge DS0000070879.V378705.R01.S.doc Version 5.3 Page 24 Mill River Lodge DS0000070879.V378705.R01.S.doc Version 5.3 Page 25 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the 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 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. EVIDENCE: Mill River Lodge DS0000070879.V378705.R01.S.doc Version 5.3 Page 26 Since our previous visit Mr Andrew Hunt was registered as manager for the service on the 17th April 2009. Mr Hunt has continued to update his skills and training, and to initiate improvement in the service provided. A member of staff we spoke to told us “the manager is open and honest, ensures things are followed up. Staff are now more confident about speaking out”. One relative told us in their CQC survey form that “there have been many changes over the past months, all improvements and all good”. A member of staff told us in their CQC survey form that “communication is good between staff and team leaders/ managers. The home works well”. The home carried out a survey of people’s views on the service in September 2009, and the outcomes of this were discussed at a meeting with residents and relatives. Changes made as a result of listening to people’s views and suggestions have included changes to menus, and providing raised garden beds for growing fruit and vegetables. People were also asked about their preferences for getting up in the morning and staff rotas were adjusted accordingly. Audits carried out in June 2009 and September 2009 by the provider which we sampled during our visit indicates a good level of satisfaction with the service. Senior staff we spoke with advised us that each member of care staff is receiving one to one supervision every 4 weeks, and domiciliary staff also receive supervision from team leaders. We were advised that team leaders receive supervision once per month. We sampled a number of maintenance records, which indicated that for example that in the past year electrical appliance PAT tests, boiler checks, gas safety checks, and checks on hoists had been carried out. Records sampled for hot water temperature checks indicated that where people living in the home have access to hot water the hot water is being distributed at below 43 degrees centigrade to prevent risk of scalding. Fire safety records sampled indicated that weekly call bell tests were carried out during November 2009. Records advise that fire drills are carried out Mill River Lodge DS0000070879.V378705.R01.S.doc Version 5.3 Page 27 every 6 months, and at the fire drill on 18th September 2009 “staff followed procedure, all went very well”. Mill River Lodge DS0000070879.V378705.R01.S.doc Version 5.3 Page 28 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 x 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 3 3 x x 3 x 3 Mill River Lodge DS0000070879.V378705.R01.S.doc Version 5.3 Page 29 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 Mill River Lodge DS0000070879.V378705.R01.S.doc Version 5.3 Page 30 Care Quality Commission South East Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: 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. 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