Inspection on 10/11/08 for The Maples

This is the latest available inspection report for this service, carried out on 10th November 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Maples 11/12/06

The Maples 02/11/05

The Maples 28/06/05

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Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Maples 66 Bence Lane Darton Barnsley South Yorkshire S75 5PE     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Mike ONeil     Date: 1 0 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. the things that people have said are important to them: They reflect 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: The Maples 66 Bence Lane Darton Barnsley South Yorkshire S75 5PE 01226382688 none none Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Vicky Brook Type of registration: Number of places registered: Mr Rizwan Iqbal,Mr Asif Riaz Khan,Mrs Parvin Riaz Khan care home 15 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home The Maples is an extended detached bungalow and is registered to provide personal care for 15 older persons. The home is set back from the road amid mature gardens. There is off road car parking at the front of the home. The Maples is in the village of Darton and is approximately three miles from Barnsley town centre and a few minutes drive from the M1 Motorway. 0 Over 65 15 Care Homes for Older People Page 4 of 25 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: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This is what was used to write this report. Information about the home kept by the Commission for Social Care Inspection. Information asked for before the inspection, this is called an Annual Quality Assurance Assessment. Information from surveys that were returned to us by people, 3 health professionals, 4 relatives and 2 staff. An unannounced visit to the home. This was carried out by Mike ONeil, regulation Care Homes for Older People Page 5 of 25 inspector on 10th November 2008 and included talking to 2 staff and Vicky Brook, registered home manager about their work and the training they have completed. And checking some of the records, policies and procedures the home has to keep. Some time was spent observing staff supporting people and talking with 9 people and 1 visiting relative. We wish to thank the people living in the home, staff, and relatives for their time, friendliness and co-operation throughout the inspection process. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. 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 set out on page 4. Care Homes for Older People Page 7 of 25 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 25 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 25 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. People were individually assessed prior to admission to ensure their needs could and would be met. Evidence: Three care plans checked showed that people within the service had been assessed before moving into the home. Risk assessments and a plan of care reflected any specialist interventions. The assessment forms checked were detailed and fully completed. The manager and staff liaised with professionals, the person and their families to find out about peoples needs. The manager visited people and undertook assessments, prior to admission. Care Homes for Older People Page 10 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health is monitored and arrangements for dealing with health issues were met with support from health professionals. People were treated with respect and said they were very happy with the care they received. Medication policies and procedures were well managed ensuring the safe administration of medication. Evidence: Three peoples care plans were checked. The peoples care plans contained details about the persons biography, personality and their preferences and choices. The manager and staff had continued to improve the plans since our last key inspection. Overall the standard had improved significantly. The plans were being regularly reviewed and the changes in peoples health were being observed and recorded. Risk assessments were included within the documentation and included moving and handling, skin integrity, and other risk Care Homes for Older People Page 11 of 25 Evidence: factors. The care plans identified that a range of health professionals visited the home to assist in maintaining peoples health care needs. People said they had regular contact with their GP and other health professionals such as district nurses and opticians. An optician was visiting people on the day of our visit. The care plans however still needed more attention because staff were failing to record times they made entries in the plans and in some cases staff had failed to sign the plans or risk assessments in the plans. Staff must be reminded that peoples care plans are a legal document and must always be signed, dated and timed. We discussed with the manager further improvements that may need to be made with regard to documentation but also wished to acknowledge the improvements made over the last year. Records had also been introduced to show that people who had had accidents or falls were monitored. A 72-hour monitoring sheet to ensure that any injuries not apparent at the time of the accident were picked up quickly had been introduced and was being used. The manager was also analysing any accidents on a monthly basis to determine if there were any patterns to accidents or falls. People looked clean, well dressed and had received a good level of personal care. People said The staff are excellent Staff are really kind and caring Its a lovely home. Relatives said The care and support is excellent Staff are amazing they treat my relative with real devotion Im kept informed about what is going on and whenever I visit the staff are always helpful. Health professionals said The Maples is a friendly warm and welcoming place Staff treat all residents as individuals The staff team and management work well with us for the benefit of residents at the home. Medication was securely stored. Medication records were up to date with no gaps. Peoples allergies were also recorded which is good practice. The Controlled Drugs Register was checked and this had been completed correctly with two signatures and a diminishing total. Medication that required refrigeration was kept in a metal lockable box on its own shelf in the domestic refrigerator. Staff said they had received medication training and records were seen of this training having taken place. Some staff however had not received any formal medication training for nearly 3 years although the manager said she regularly observed staff undertaking medication administration rounds. We would recommend that all staff undertake medication Care Homes for Older People Page 12 of 25 Evidence: training on a more frequent basis. Staff were aware of the need to treat people with dignity and respect. During our visit we saw good interactions between people and staff. People and relatives said staff are friendly, kind and helpful. Care Homes for Older People Page 13 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People had a choice of lifestyle within the home and were able to maintain contact with family and friends ensuring that they continued to be involved in community life. People were able to make choices about daily living and be involved in some social activities. Meals served at the home were of a good quality and offered choice to ensure people receive a balanced diet. Evidence: People said they were able to get up and go to bed when they chose and generally how they spent their day and evenings. They said they often went out with their families. Relatives said they were able to visit at any time and were made to feel very welcome. We saw that everyone coming to the home was offered hospitality and staff took time to make sure friends and family were made to feel comfortable whilst visiting. People and relatives said that there were some activities planned. A Halloween and bonfire party had also just been held at the home. We saw that some people welcomed Care Homes for Older People Page 14 of 25 Evidence: the opportunity to undertake simple activities and talk to staff or other people in the home. There was a friendly atmosphere in the home and staff spent time talking to people and their families. The mealtime experience for people in the home was very positive. Tables were set nicely. Staff were supporting people with their meal in a polite and discreet way. Some people had their meals in their own room because they said preferred to eat there. People said The food is very good The quality of the food and how it is presented is excellent. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints procedures were in place and people and their relatives felt confident that any concerns they voiced would be listened to. Staff had an understanding of the procedures to be followed should they suspect any abuse at the home, so helping to ensure that people were protected from abuse. Evidence: People and their representatives had been provided with a copy of the homes complaints procedure, which was also on display in the entrance hall. This contained details of who to speak to at the home and who to contact outside of the home to make a complaint should they wish to do so. People said that they felt very comfortable in going to the manager knowing that any concerns they may have would be addressed without delay. Regarding safeguarding adults, the safeguarding policies and procedures were available to the staff. Staff had undertaken Safeguarding Adults training, and the manager was able to evidence this by producing the training records. Care Homes for Older People Page 16 of 25 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was clean, pleasant and hygienic although some areas of the home are in need of redecorating and refurbishing. Evidence: The home was clean and tidy and no unpleasant odours were noticeable. People, and relatives said the home was always kept very clean. Lounge and dining areas were domestically furnished to a good standard. People said they were very comfortable at the home. They had a variety of furniture and touches such as ornaments and pictures that gave their rooms a homely feel. Some areas of the home are in need of refurbishment and redecoration. In particular the paintwork in some bedrooms is damaged and the rooms need redecorating. Also the carpets in some bedrooms are marked and need replacing. Externally the fascias boards and guttering around the home are in need of attention. The fascias boards are in a poor condition and the guttering needs clearing of weeds and other debris. We saw some environmental issues that may affect peoples dignity. No privacy Care Homes for Older People Page 17 of 25 Evidence: screens were available in the two-shared rooms and the locks on a toilet door and bathroom door were not working. The door locks were repaired during the inspection by a handyman called in by the manager. However the privacy screens still need fitting or portable ones purchased. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff were employed in sufficient numbers and recruitment procedures promoted the protection of people. People receive care from a well-trained staff team. Evidence: People spoke highly of the staff team and said staff always listened and acted on what they said. People said that staff were always available when needed. Staff and the manager confirmed that staffing levels were adequate. Three staff files were checked at this visit. The files contained a range of information including two references and a declaration of health and identification. The staff had undertaken a criminal record bureau check (CRB), at the enhanced level. This confirmed thorough recruitment practices were in place, which was sufficient to safeguard people. Staff said that they really enjoyed working at the home and got a lot of job satisfaction. We found that the staff were very enthusiastic and keen to improve the service further. Staff were able to talk about the various training courses that they had Care Homes for Older People Page 19 of 25 Evidence: attended. Development and training records were checked these records showed when staff had completed mandatory training and refresher training. Care Homes for Older People Page 20 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The procedures and ethos of the home ensure that the home is run in the best interests of people who use the service. The homes procedures promote the health, safety and welfare of people who use the service and the staff. Evidence: The manager, Vicky, has several years experience within the caring profession and is currently undertaking the Registered Managers Award. She is committed to ensuring that people staying in the home were consistently well cared for, safe and happy. Health professionals, people, staff and relatives spoke highly of the managers professionalism and said she was very approachable. Since the last CSCI visit the manager had developed and improved the quality assurance system for the home. There was evidence of internal auditing of the homes Care Homes for Older People Page 21 of 25 Evidence: environment, services and records. People and relatives said they did meet regularly with the manager and said that any concerns they voiced would be acted upon. These quality assurance systems will help to ensure that the service is operating in the best interest of the people who live there. People, relatives and some staff said the registered providers did visit the home regularly. People said they saw the providers and spoke to them on a regular basis. However monthly reports are still not being produced following these visits. A sample of monies that was looked after on behalf of people living at the home was checked. Records were kept and money tallied with the records. The temperature of the hot water in one bathroom was found to be excessively high, over 50 degrees centigrade, which may have posed a risk of scalding to some people. Staff had been monitoring this hot water temperature in the bathroom regularly. Records showed that the temperature had been previously recorded as being within safe limits. The manager said that a new pipe had been fitted to the boiler in the last few days, which may have caused the temperature to rise. The manager immediately called for a plumber to visit the home and a thermostat was fitted to the pipe to bring the temperature within safe limits before the end of our visit to the home. A fire risk assessment was in place at the home. No issues requiring attention were highlighted in the assessment. Staff said they had received recent fire safety and other health and safety training .A sample of records showed that staff were receiving this statutory training. At the time of the visit fire exits were clear and hazardous products were safely stored in the home. This will promote the safety and welfare of the people. Despite the failure of the registered provider to produce the reports following their visits to the home, this is a requirement under the Care Home Regulations; evidence shows that people at The Maples experience good outcomes relating to the management of the home. This judgement is based on the evidence that the service has far more strengths than areas for improvement. The manager was also able to act promptly to address the issues in need of immediate improvement. Care Homes for Older People Page 22 of 25 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 23 of 25 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 1 19 12 Peoples privacy and dignity 06/01/2009 must be maintained.(Privacy screens in shared rooms) To maintain peoples privacy and dignity. 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 1 2 3 7 9 19 Staff should ensure that all written entries they make in peoples care plans are dated, timed and signed. Staff should receive practical and theoretical medication training at frequent intervals. A programme of redecoration and refurbishment internally and externally should continue to improve the living environment for people. The registered provider should produce a monthly written report on the conduct of the care home as required by regulation 26 of the Care Homes Regulations. 4 33 Care Homes for Older People Page 24 of 25 Helpline: 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 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. 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