Inspection on 30/06/09 for Mulberry Court Care Home

This is the latest available inspection report for this service, carried out on 30th June 2009.

CQC found this care home to be providing an Excellent 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

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Larchfield Manor

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Extracts from inspection reports are licensed from CQC, this page was updated on 15/11/2009.

Key inspection report Care homes for older people Name: Address: Mulberry Court Care Home Clifton Park Shipton Road York North Yorkshire YO30 5PD     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: Tony Brindle-Wills     Date: 3 0 0 6 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 26 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 26 Information about the care home Name of care home: Address: Mulberry Court Care Home Clifton Park Shipton Road York North Yorkshire YO30 5PD 01904671122 01904671144 donna.batty@barchester.com www.barchester.com Barchester Healthcare Homes Ltd care home 64 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 64 The registered person may provide the following category of service only: Care Home with Nursing, Code N. To service users of the following gender: Either. Whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category, Code OP, maximum number of places 64 Date of last inspection Brief description of the care home Mulberry Court provides nursing care for up to sixty-four residents. The home is purpose built and has accommodation and communal areas on all three floors, which can be accessed by a lift. All the private rooms have en-suite facilities and whilst most are for single use there are four rooms suitable for double occupancy. The home is located on the northern outskirts of York, with good transport links, to local facilities and the city. It is situated in its own grounds with parking facilities. Information completed by the registered manager indicated that the fees ranged from #478.58 to #1000 per week. Extra include items like hairdressing, newspapers, chiropody Care Homes for Older People Page 4 of 26 Over 65 64 0 Brief description of the care home services, aromatherapy and dental services. Information about the home including previous Commission reports, and service user guide are available from the home. Care Homes for Older People Page 5 of 26 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: The registered manager for the service was not available on the day of the visit as she was on annual leave. The deputy manager was available, and she helped us during the visit. Prior to the visit, the registered manager provided us with an Annual Quality Assurance Assessment, a lengthy document containing information about the service; what it currently does; how it hopes to improve; statistical data about staffing; and information about numbers of complaints, referrals and the people using the service. The information provided within this document was found to be very useful, and of a high caliber, and we were able to cross reference the information with evidence we obtained during our visit. Unfortunately, due to an administrative error on behalf of the Commission, user satisfaction surveys were not sent out prior to our site visit to the service. However, information obtained by us at the site visit by way of talking to people, the homes user satisfaction surveys, compliments book and social work reviews all indicated that people using the service are very happy with it, and that the outcomes for people are very very positive. It is the opinion of the inspector that Care Homes for Older People Page 6 of 26 evidence contained within this report which is supported by information held by the Commission demonstrates that this service is well managed, user focused with a number of strengths. In fact, in many of the outcome areas, the evidence indicates that the service has exceeded the National Minimum Standard. The rules based approach operated by the Commission thus allows this service to be awarded an excellent quality rating, as it has a sustained track record of high performance. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 26 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 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The information given to us by the deputy manager, both verbally and in record form, demonstrates that there are very good systems and procedures in place to ensure that peoples needs are properly assessed prior to moving into the home, and that they are given to the opportunity to visit it before moving in. The home does not provide intermediate care. Evidence: A discussion took place with the deputy manager about what would happen if people wanted to move into the home. She explained that if someone wanted to move into the home, then she or a member of staff with experience of assessments, would visit the person, and their family or representative, and undertake an assessment of their needs. The deputy manager showed us the pre-admission records of 1 person who had recently moved into the home. These records were found to contain assessments about persons needs and desires, their health and personal care needs, and information about their life history. There were written details of how these needs Care Homes for Older People Page 10 of 26 Evidence: should be met, and the deputy manager explained that this information had been gathered through meeting the person, talking to them, and talking to their family and any health and social care professionals involved in their life. Information contained within the care records confirmed that people with experience of undertaking assessments go to visit people to gather information about their on going health and personal care needs. The deputy manager made it clear that if people wanted to visit the home, and meet the people and staff, then they would be able to do this. The records show that once an assessment is made, then a decision based on that information is made as to whether the service can meet that persons needs. The deputy manager gave details of how a letter is given to the person explaining the decision, and if the service can meet their needs, then arrangements are made for the person to move in. Information contained within the care records confirmed this. Care Homes for Older People Page 11 of 26 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. Good information about how peoples needs should be met and how to minimize risks to people is available. Good support is given to help individuals make choices and decisions. Medicine management is very good. People receive personal support in the way they prefer and require and the systems operated by the service realting to meeting peoples healthcare needs are very proactive and, peoples health care needs are met appropriately. Evidence: The deputy manager showed us the care plan files of 4 people living at the home. She explained the care planning process in detail,which includes making sure that the staff learn what is important to a person in their daily life so that they can be supported to live a fulfilling life. She added that the staff involved in the care planning process find out what the health and safety risks are to each person by talking to them and their families, and by undertaking a risk assessment, which was found to be documented. A discussion took place with the deputy manager regarding the need to ensure that all the information about potential risks relating to a person must be considered, and appropriate actions details within peoples files. This was because the missing persons Care Homes for Older People Page 12 of 26 Evidence: procedure for one person had not been made reference to within a risk assessment. The deputy manager added that wherever possible, the person themselves, and or their family members (if appropriate) are involved in the care planning process. Again this was supported by way of information contained within the care plans with peoples signatures being seen on various documents. People living at the home did not speak about the care planning process as such, but did say that the staff ask them about what they like to do, about what their interests are and about how they like to be supported to undertake certain activities such as washing, dressing, shopping and socializing. Staff at the home confirmed that they are involved in care planning, and were able to speak about the process in a manner that indicated that they saw it as an important part of what they do, and not just a task to be completed. We looked at the daily records which were found to contain information about what people had been doing during the day and night. The information was seen to be factual and nonjudge-mental, and when decisions had been made to participate in different activities, the reasons for this had been recorded. It was noted that in some cases, greater detail about what a person has done during their day would be of bebenfit, as opposed to what they havent done. A discussion took place with the deputy manager regarding this, who said she would raise it with the staff and look at it through training and supervision. The deputy manager explained that for some people, decision making can be difficult due to their level of cognitive ability, adding that when decision are made on a persons behalf, to engage in a social activity for example, then the staff always ensure that good records are kept so that the reasons why and when decisions are made by others can be clearly demonstrated. Information contained within the daily records confirmed this. The deputy manager explained that personal supported is always provided to people in private, and that routines such as the times for going to bed, having baths, meals and other activities are flexible. She added that people are encouraged to choose their own clothes and hairstyle, and where possible peoples appearance reflects their personality. Discussions with people living at the home confirmed this. Observations made on the day of the visit confirmed that staff work with people in a sensitive manner, providing flexible personal support in ways that promote peoples privacy and dignity and where possible their independence. Information contained within peoples care files indicated that peoples health is monitored and any potential complications and problems are identified and dealt with at an early stage, including referral to the appropriate health-care professional. The deputy manager explained that people with specific health-care needs are supported to visit a specialist, and if they are unable to make their own appointments, the staff do this on their behalf. This was supported by way of information contained peoples care plans showing when appointment had been made, the outcome, and any action that needs to be taken by the person, or the staff at the home to promote peoples health and wellbeing. Feedback from relatives indicated that they were satisfied with Care Homes for Older People Page 13 of 26 Evidence: the way in which staff at the home support people with their health-care needs. A sample of the medications held at the home were looked at and everything was found to be in good order. The deputy manager explained that records are kept of all medications that are received, administered and disposed of within the home, and these systems were found to be very good and ensure there is no mishandling of peoples personal medication. The records were checled and found to be in good order. The staff training records show that staff have had training in the use and medication. The requirements made at the last inspection relating to undetaking baseline assessments upon admission and the creation of care plans once someone has been admitted have been dealt with and was evidenced, and found to be satisfactory. Care Homes for Older People Page 14 of 26 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. People living at the home lead an active lifestyle, and are very well supported in this area. People are very well supported to keep in touch with their family and friends, have their rights respected, and have a healthy and varied diet. Evidence: The deputy manager explained that the people who live at the home have differing interests and preferences as to how they spend their day. One member of staff said that there are activities put on in the home, and that people do get the opportunity to go out and take part in recreational activities such as shopping, meals out, visits to the pub and visits to see family. The notice board was seen to give information about entertainers that visit the home from time to time. One person living at the home said that they really enjoyed singing and dancing with the staff. Information contained peoples care plans indicated that people do get the opportunity to engage in a range of activities both inside and outside of the home, and the feedback we received from people living at the home, concerning the types of activities people are engaged in and lifestyle they lead was very positive. An observation of activities provided by the staff on the day of our visit indicated that people enjoy and engage in the activities, and that the staff work sensitively and individually with people so that they get the most out of the activity they are taking part in. The menus were looked at, and were Care Homes for Older People Page 15 of 26 Evidence: found to offer people a varied and nutritious diet. One person said that there was always plenty to choose from, and that if they didnt like what was on the menu, then the staff would make them something different. An observation of the mealtime showed that there was plenty of choice on offer, and a discussion with the catering manager demonstrated that peoples individual dietary requirements are recorded, and met effectively. People who were spoken with confirmed that they are supported to keep in touch with their families and friends, and the daily records show when family and friends visit. Care Homes for Older People Page 16 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are very good systems in place for dealing with complaints appropriately. The systems and procedures in place to protect people from abuse and neglect are robust, and in line with those produced by the Local Authority. Evidence: The deputy manager explained that the home has a complaints procedure, which is available for all to see as it is posted in the entrance hall of the home. The procedure was seen to be satisfactory. The detailed, clear and up to date records held at the service show that the service has has complaints within the last year which have been dealt with appropriately and to the satisfaction of the complainants. The records held by the Commission show that we have not received any complaints about this service. People who were spoken with indicated that they knew who to speak to if they had a concern or complaint, and that they felt confident that their concern of complaint would be dealt with quickly and appropriately. One person living at the home who was spoken with said that they would speak to a staff member if they were worried about anything, and that they felt sure the staff would support them and deal with their worries properly. The deputy manager explained that staff have had adult safeguarding training, and added that the service has a adult safeguarding policy and procedure, which is displayed within the home, given to staff, and used as a basis for staff training. She added that the organization also has a whistle blowing procedure. These policies and procedures were looked at the found to be in good order and in line with the local authority safeguarding procedures. One member of staff who was Care Homes for Older People Page 17 of 26 Evidence: spoken with was able to talk about what they would do if they suspected or witness abuse, and their explanation was found to be in line with the policies and procedures operated by the service. The detailed, clear and up to date personnel records held at the home show that the Protection of Vulnerable Adults register is checked before staff are appointed to work in the home. Care Homes for Older People Page 18 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a very comfortable home with plenty of space, and activity areas that cater for peoples needs, and encourage independence and participation in social activities. All parts of the home are kept clean and tidy. Evidence: The deputy manager explained that the comments she and the staff regularly get back from people living at the home, their relatives and visitors state that people see the home as being comfortable, roomy, bright, cheerful and clean. Surveys held by the deputy manager confirmed this. On the day of the visit, the home was found to clean and tidy, with the furnishings and fittings being seen to be of a good quality and in good working order. People living at the home said that it is always kept clean and tidy, and that they are allowed free access in and outside the home, and that there are plenty of communal areas to access and spend time in. This was confirmed on having a look around the building. Hand washing facilities were found to be located appropriately throughout the building, and the deputy manager explained that laundry facilities are sited so that soiled articles and clothing are not carried through areas where food is stored and prepared and access to the laundry is restricted when staff are not around so as to promote peoples health and wellbeing. This was confirmed on having a look around the building. The deputy manager explained that she has a programme from renewal and refurbishment, and that will be worked through over the course of the next 12 months as and when required. Care Homes for Older People Page 19 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A well trained staff team supports the people living at the home to live positive lives. Thee recruitment practices are operated by the service are very good, with excellent procedures in place that offer people protection. Evidence: The deputy manager explained that the comments she regularly gets back from people living at the home, their relatives and visitors that state that people believe the staff team to be approachable, reliable, honest and motivated to make sure people are cared for properly. Survey information held by the registered manager confimred this. Observations made on the day supported this, with staff being seen to work sensitively with people, communicating with people effectively and showing an interest in individuals. Feedback from people living at the home showed that they too believed the staff to be good at what they do, friendly and enthusiastic about the work they undertake. The detailed, up to date and clear personnel and employment records that were looked at contained good levels of information; new starters are only confirmed into post once a satisfactory Criminal records Bureau and/or Nursing Registered check has been undertaken, and a check against the Protection of Vulnerable Adults register is made. The detailed, up to date and clear staff training records show that staff received excellent levels of training in all aspects of work within a care setting. Feedback from people who live at the home indicated that they believed the staff to be well trained. Staff working at the home spoke about the training they had received, Care Homes for Older People Page 20 of 26 Evidence: giving details of scenarios that come up from time to time; details of what they would do; how they would deal with issues; and how they could do things differently if needs be. The deailed and knowledgeable comments made by staff was demonstrated that the staff understood their role, which is seen to be one of enabling people to live active and positive lives. Care Homes for Older People Page 21 of 26 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. Excellent quality assurance systems are in place which allow the management team to monitor all aspects of care and clinical practice within the home, and there are excellent systems in place to protect the promote the health and safety of people living and working at the home providing positive outcomes for people. Evidence: The records held by the Commission show that the manager is registered with us. The deputy manager explained that the service has obtained feedback from people using the service, their relatives, and other relevant parties about the services provided by way of user satisfaction questionnaires. The clear and detailed records of these were seen, and the feedback supplied by people was seen to be very positive. The deputy manager explained that she and the management team has in place audit and monitoring systems for various practices within the home such as medication, money, accidents and incidents. Again, the clear and detailed records of these were seen, and there were found to be very good, with action points for when errors or Care Homes for Older People Page 22 of 26 Evidence: issues arise, and detailed information about how issues have been dealt with, by whom and to what extent rectified. The up to date and clear records relating to the health and welfare of people living and working in the home were seen, and were found to be very good. These included records relating to weekly alarm system tests, food hygiene control measures, infection control systems, the regulation of water temperatures and the maintenance of equipment. People living at, and visiting the home said that the registered manager and mangement team were approachable, open to discussion about issues, always ready to listen, and willing to put things right if problems came up or things needed to be changed. Care Homes for Older People Page 23 of 26 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 24 of 26 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 25 of 26 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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